家庭监测小儿哮喘的电子健康技术:范围综述。
eHealth Technologies for Monitoring Pediatric Asthma at Home: Scoping Review.
机构信息
Pediatric Department, Medisch Spectrum Twente, Enschede, Netherlands.
Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands.
出版信息
J Med Internet Res. 2023 Jul 21;25:e45896. doi: 10.2196/45896.
BACKGROUND
eHealth monitoring technologies offer opportunities to more objectively assess symptoms when they appear in daily life. Asthma is the most common chronic disease in childhood with an episodic course, requiring close follow-up of pediatric asthma control to identify disease deterioration, prevent exacerbations, and enhance quality of life. eHealth technologies in pediatric asthma care show promising results regarding feasibility, acceptability, and asthma-related health outcomes. However, broad systematic evaluations of eHealth technologies in pediatric asthma are lacking.
OBJECTIVE
The objective of this scoping review was to identify the types and applications of eHealth technologies for monitoring and treatment in pediatric asthma and explore which monitoring domains show the most relevance or potential for future research.
METHODS
A scoping review was conducted using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. A systematic and comprehensive search was performed on English papers that investigated the development, validation, or application of eHealth technologies for home monitoring or treatment of pediatric asthma in the following databases: PubMed, Cochrane Library, IEEE, Scopus, CINAHL, PsycINFO, and ACM Digital Library. Two authors independently assessed eligibility and extracted data. Data were presented by a descriptive analysis of characteristics and a narrative report for each eHealth domain.
RESULTS
The review included 370 manuscripts. The following 10 monitoring domains were identified: air quality, airway inflammation markers, lung function, physical activity, sleep, audiovisual, other physiological measurements, questionnaires, medication monitoring, and digital environment (ie, digital platforms, applications, websites, and software tools to monitor or support monitoring). Rising numbers of studies were seen, and the numbers accelerated in the last few years throughout most domains, especially medication monitoring and digital environment. Limited studies (35/370, 9.5%) of multiparameter monitoring strategies, using three or more domains, were found. The number of monitoring validation studies remained stable, while development and intervention studies increased. Intervention outcomes seemed to indicate the noninferiority and potential superiority of eHealth monitoring in pediatric asthma.
CONCLUSIONS
This systematic scoping review provides a unique overview of eHealth pediatric asthma monitoring studies, and it revealed that eHealth research takes place throughout different monitoring domains using different approaches. The outcomes of the review showed the potency for efficacy of most monitoring domains (especially the domains of medication monitoring, lung function, and digital environment). Future studies could focus on modifying potentially relevant hospital-based diagnostics for the home setting to investigate potential beneficial effects and focus on combining home-monitoring domains to facilitate multiparameter decision-making and personalized clinical decision support.
背景
电子健康监测技术为在日常生活中更客观地评估症状提供了机会。哮喘是儿童中最常见的慢性疾病,具有发作性病程,需要密切监测小儿哮喘控制情况,以识别疾病恶化、预防恶化和提高生活质量。电子健康技术在儿科哮喘护理中的应用具有可行性、可接受性和与哮喘相关的健康结果。然而,缺乏对儿科哮喘电子健康技术的广泛系统评估。
目的
本范围综述的目的是确定监测和治疗儿科哮喘的电子健康技术的类型和应用,并探讨哪些监测领域具有最相关或最有潜力的未来研究。
方法
根据 PRISMA-ScR(系统评价和荟萃分析扩展的首选报告项目用于范围综述)指南进行范围综述。在以下数据库中对研究开发、验证或应用电子健康技术进行家庭监测或治疗儿科哮喘的英文论文进行了系统和全面的搜索:PubMed、Cochrane 图书馆、IEEE、Scopus、CINAHL、PsycINFO 和 ACM 数字图书馆。两名作者独立评估了入选标准并提取了数据。通过对每个电子健康领域的特征和叙述报告进行描述性分析来呈现数据。
结果
综述共纳入 370 篇论文。确定了以下 10 个监测领域:空气质量、气道炎症标志物、肺功能、体力活动、睡眠、视听、其他生理测量、问卷、药物监测和数字环境(即用于监测或支持监测的数字平台、应用程序、网站和软件工具)。大多数领域,尤其是药物监测和数字环境,都有越来越多的研究,且近几年数量加速增长。发现的多参数监测策略的研究较少(35/370,9.5%),使用了三个或更多领域。监测验证研究的数量保持稳定,而开发和干预研究有所增加。干预结果似乎表明,电子健康监测在儿科哮喘中的非劣效性和潜在优越性。
结论
本系统范围综述提供了电子健康儿科哮喘监测研究的独特概述,并且表明电子健康研究在不同的监测领域中使用不同的方法进行。综述的结果表明,大多数监测领域(尤其是药物监测、肺功能和数字环境领域)具有潜在的功效。未来的研究可以集中于修改潜在相关的基于医院的诊断方法,以研究潜在的有益效果,并集中于结合家庭监测领域,以促进多参数决策和个性化临床决策支持。