用于术后监测的新型数字健康干预措施的开发阶段：一项系统评价的方案
Development stage of novel digital health interventions for postoperative monitoring: protocol of a systematic review.
作者信息
McLean Kenneth A, Knight Stephen R, Diehl Thomas M, Zafar Syed Nabeel, Bouamrane Matt, Harrison Ewen M
机构信息
Centre for Medical Informatics, The University of Edinburgh Usher Institute of Population Health Sciences and Informatics, Edinburgh, UK.
Department of Surgery, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA.
出版信息
BMJ Surg Interv Health Technol. 2022 Mar 4;4(1):e000104. doi: 10.1136/bmjsit-2021-000104. eCollection 2022.
INTRODUCTION
The postoperative period represents a time where patients are at a high-risk of morbidity, which warrants effective surveillance. While digital health interventions (DHIs) for postoperative monitoring are promising, a coordinated, standardized and evidence-based approach regarding their implementation and evaluation is currently lacking. This study aimed to identify DHIs implemented and evaluated in postoperative care to highlight research gaps and assess the readiness for routine implementation.
METHODS
A systematic review will be conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify studies describing the implementation and evaluation of DHIs for postoperative monitoring published since 2000 (PROSPERO ID: CRD42021264289). This will encompass the Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Web of Science and ClinicalTrials.gov databases, and manual search of bibliographies for relevant studies and gray literature. Methodological reporting quality will be evaluated using the Idea, Development, Exploration, Assessment and Long-term Follow-up (IDEAL) reporting guideline relevant to the IDEAL stage of the study, and risk of bias will be assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework. Data will be extracted according to the WHO framework for monitoring and evaluating DHIs, and a narrative synthesis will be performed.
DISCUSSION
This review will assess the readiness for implementation of DHIs for routine postoperative monitoring and will include studies describing best practice from service changes already being piloted out of necessity during the COVID-19 pandemic. This will identify interventions with sufficient evidence to progress to the next IDEAL stage, and promote standardized and comprehensive evaluation of future implementational studies.
引言
术后阶段是患者发病风险较高的时期，需要进行有效的监测。虽然用于术后监测的数字健康干预措施（DHIs）前景广阔，但目前在其实施和评估方面缺乏协调、标准化且基于证据的方法。本研究旨在确定在术后护理中实施和评估的数字健康干预措施，以突出研究差距并评估常规实施的准备情况。
方法
将根据系统评价和荟萃分析的首选报告项目指南进行系统评价，以识别自2000年以来发表的描述数字健康干预措施用于术后监测的实施和评估的研究（PROSPERO编号：CRD42021264289）。这将涵盖Embase、护理及相关健康文献累积索引、Cochrane图书馆、科学引文索引和临床试验.gov数据库，并手动搜索相关研究的参考文献和灰色文献。将使用与研究的IDEAL阶段相关的构思、开发、探索、评估和长期随访（IDEAL）报告指南评估方法学报告质量，并使用推荐分级、评估、制定和评价（GRADE）框架评估偏倚风险。将根据世界卫生组织监测和评估数字健康干预措施的框架提取数据，并进行叙述性综合分析。
讨论
本综述将评估数字健康干预措施用于常规术后监测的实施准备情况，并将纳入描述在2019冠状病毒病大流行期间因必要而已经在试点的服务变更中的最佳实践的研究。这将确定有充分证据推进到下一个IDEAL阶段的干预措施，并促进对未来实施研究进行标准化和全面评估。
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