Amsterdam UMC Location University of Amsterdam, Surgery, Meibergdreef 9, Amsterdam, The Netherlands.
Amsterdam Gastroenterology and Metabolism, Amsterdam, The Netherlands.
Surg Endosc. 2023 Jun;37(6):4224-4248. doi: 10.1007/s00464-023-10007-y. Epub 2023 Apr 4.
Mobile applications can facilitate or improve gastrointestinal surgical care by benefiting patients, healthcare providers, or both. The extent to which applications are currently in use in gastrointestinal surgical care is largely unknown, as reported in literature. This systematic review was conducted to provide an overview of the available gastrointestinal surgical applications and evaluate their prospects for surgical care provision.
The PubMed, EMBASE and Cochrane databases were searched for articles up to October 6th 2022. Articles were considered eligible if they assessed or described mobile applications used in a gastrointestinal surgery setting for healthcare purposes. Two authors independently evaluated selected studies and extracted data for analysis. Descriptive data analysis was conducted. The revised Cochrane risk of bias (RoB-2) tool and ROBINS-I assessment tool were used to determine the methodological quality of studies.
Thirty-eight articles describing twenty-nine applications were included. The applications were classified into seven categories: monitoring, weight loss, postoperative recovery, education, communication, prognosis, and clinical decision-making. Most applications were reported for colorectal surgery, half of which focused on monitoring. Overall, a low-quality evidence was found. Most applications have only been evaluated on their usability or feasibility but not on the proposed clinical benefits. Studies with high quality evidence were identified in the areas of colorectal (2), hepatopancreatobiliary (1) and bariatric surgery (1), reporting significantly positive outcomes in terms of postoperative recovery, complications and weight loss.
The interest for applications and their use in gastrointestinal surgery is increasing. From our study, it appears that most studies using applications fail to report adequate clinical evaluation, and do not provide evidence on the effectiveness or safety of applications. Clinical evaluation of objective outcomes is much needed to evaluate the efficacy, quality and safety of applications being used as a medical device across user groups and settings.
移动应用程序可以通过使患者和医疗保健提供者受益,来促进或改善胃肠道外科护理。目前,在胃肠道外科护理中应用程序的使用程度在很大程度上是未知的,这在文献中有报道。本系统评价旨在概述现有的胃肠道外科应用程序,并评估它们在提供外科护理方面的前景。
检索了截至 2022 年 10 月 6 日的 PubMed、EMBASE 和 Cochrane 数据库中的文章。如果文章评估或描述了用于医疗目的的胃肠道手术环境中的移动应用程序,则认为其符合入选标准。两位作者独立评估了选定的研究,并提取了用于分析的数据。进行了描述性数据分析。使用修订后的 Cochrane 偏倚风险(RoB-2)工具和 ROBINS-I 评估工具来确定研究的方法学质量。
有 38 篇文章描述了 29 个应用程序,这些应用程序分为七个类别:监测、减肥、术后恢复、教育、沟通、预后和临床决策。大多数应用程序用于结直肠手术,其中一半用于监测。总体而言,证据质量较低。大多数应用程序仅在可用性或可行性方面进行了评估,而没有评估所提出的临床益处。在结直肠(2)、肝胆胰手术(1)和减肥手术(1)领域确定了高质量证据的研究,报告了术后恢复、并发症和减肥方面的显著积极结果。
人们对应用程序及其在胃肠道手术中的应用越来越感兴趣。从我们的研究中可以看出,大多数使用应用程序的研究未能报告充分的临床评估,也没有提供应用程序有效性或安全性的证据。需要对客观结果进行临床评估,以评估在用户群体和环境中作为医疗器械使用的应用程序的疗效、质量和安全性。