TY - JOUR AU - Kitsiou, Spyros AU - Paré， Guy AU - Jaana, Mirou PY - 2013 DA - 2013/07/23 TI -慢性疾病患者家庭远程监护干预的系统综述和meta分析:他们方法学质量的关键评估JO - J医学互联网Res SP - e150 VL - 15 IS - 7kw -元分析作为主题KW -系统评价作为主题KW -家庭远程监护KW -远程医疗KW -遥测KW -质量评估KW -偏倚风险KW -慢性疾病KW -心力衰竭KW -糖尿病KW -高血压KW -肺病AB -背景:对慢性疾病患者家庭远程监测干预措施的系统综述和荟萃分析在过去十年中有所增加，对广泛的临床医生、政策制定者和其他卫生保健利益相关者越来越重要。虽然最近出现了对其方法严谨性和综合方法的一些批评，但尚未对其质量进行正式评估。目的:这项批判性综述的主要目的是评估之前研究慢性疾病背景下家庭远程监护干预措施效果的综述的方法、质量和报告特征。方法:电子检索Ovid MEDLINE、Cochrane图书馆的疗效文摘数据库(DARE)和健康技术评估数据库(HTA)，检索1966年1月至2012年12月发表的相关系统综述。三位审稿人对潜在的评论进行了独立筛选和评估。从每篇纳入的综述中提取与所用方法相关的数据，并由两名审稿人检查其准确性。一个经过验证的质量评估工具，R-AMSTAR，被用作指导评估过程的框架。结果:24篇综述，其中9篇是荟萃分析，从200多篇引用中确定。 The bibliographic search revealed that the number of published reviews has increased substantially over the years in this area and although most reviews focus on studying the effects of home telemonitoring on patients with congestive heart failure, researcher interest has extended to other chronic diseases as well, such as diabetes, hypertension, chronic obstructive pulmonary disease, and asthma. Nevertheless, an important number of these reviews appear to lack optimal scientific rigor due to intrinsic methodological issues. Also, the overall quality of reviews does not appear to have improved over time. While several criteria were met satisfactorily by either all or nearly all reviews, such as the establishment of an a priori design with inclusion and exclusion criteria, use of electronic searches on multiple databases, and reporting of studies characteristics, there were other important areas that needed improvement. Duplicate data extraction, manual searches of highly relevant journals, inclusion of gray and non-English literature, assessment of the methodological quality of included studies and quality of evidence were key methodological procedures that were performed infrequently. Furthermore, certain methodological limitations identified in the synthesis of study results have affected the results and conclusions of some reviews. Conclusions: Despite the availability of methodological guidelines that can be utilized to guide the proper conduct of systematic reviews and meta-analyses and eliminate potential risks of bias, this knowledge has not yet been fully integrated in the area of home telemonitoring. Further efforts should be made to improve the design, conduct, reporting, and publication of systematic reviews and meta-analyses in this area. SN - 14388871 UR - //www.mybigtv.com/2013/7/e150/ UR - https://doi.org/10.2196/jmir.2770 UR - http://www.ncbi.nlm.nih.gov/pubmed/23880072 DO - 10.2196/jmir.2770 ID - info:doi/10.2196/jmir.2770 ER -