Department of Health Management and Informatics, School of Medicine, University of Missouri-Columbia, CE707 CS&E Bldg., One Hospital Drive, Columbia, MO, USA.
Missouri Cancer Registry and Research Center, University of Missouri-Columbia, Columbia, MO, USA.
Curr Diab Rep. 2018 Oct 18;18(12):130. doi: 10.1007/s11892-018-1105-2.
This study was to present meta-analysis findings across selected clinical trials for the effect of health information technologies (HITs) on glycemic control among patients with type 2 diabetes.
HITs may be promising in diabetes management. However, findings on effect size of glycated hemoglobin level (HbA1c) yielded from HITs varied across previous studies. This is likely due to heterogeneity in sample size, adherence to standard quantitative method, and/or searching criteria (e.g., type of HITs, type of diabetes, specification of patient population, randomized vs. nonrandomized trials). We systematically searched Medline, Cumulative Index of Nursing and Allied Health Literature (CINAHL), and the Cochrane Library for peer-reviewed randomized control trials that studied the effect of HITs on HbA1c reduction. We also used Google Scholar and a hand search to identify additional studies. Thirty-four studies (40 estimates) met the criteria and were included in the analysis. Overall, introduction of HITs to standard diabetes treatment resulted in a statistically and clinically reduced HbA1c. The bias adjusted HbA1c reduction due to the combined HIT interventions was - 0.56 [Hedges' g = - 0.56 (- 0.70, - 0.43)]. The reduction was significant across each of the four types of HIT intervention under review, with mobile phone-based approaches generating the largest effects [Hedges' g was - 0.67 (- 0.90, - 0.45)]. HITs can be an effective tool for glycemic control among patients with type 2 diabetes. Future studies should examine long-term effects of HITs and explore factors that influence their effectiveness.
本研究旨在通过对 2 型糖尿病患者使用健康信息技术（HIT）对血糖控制影响的多项临床试验进行荟萃分析。
HIT 在糖尿病管理中可能具有广阔的应用前景。然而，以往研究中 HIT 对糖化血红蛋白（HbA1c）水平影响的效应大小存在差异，这可能是由于样本量、对标准定量方法的依从性以及/或搜索标准（例如，HIT 的类型、糖尿病的类型、患者人群的具体情况、随机与非随机试验）的差异所致。我们系统地检索了 Medline、Cumulative Index of Nursing and Allied Health Literature（CINAHL）和 Cochrane Library，以查找评估 HIT 对 HbA1c 降低影响的同行评议随机对照试验。我们还使用 Google Scholar 和手工检索来确定其他研究。符合标准并纳入分析的研究有 34 项（40 个评估）。总体而言，将 HIT 引入标准糖尿病治疗可使 HbA1c 显著降低。由于联合 HIT 干预，HbA1c 的平均降低幅度为 -0.56 [Hedges' g=-0.56（-0.70，-0.43）]。在本综述中评估的 4 种 HIT 干预类型中，HbA1c 的降低均具有统计学意义和临床意义，基于手机的方法产生的效果最大[Hedges' g=-0.67（-0.90，-0.45）]。HIT 是 2 型糖尿病患者血糖控制的有效工具。未来的研究应关注 HIT 的长期效果，并探讨影响其有效性的因素。
