15 research outputs found

    Health care in a technological world

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    Ongoing innovation in the field of mobile health (mHealth) has the potential to change the landscape of healthcare practice both inside and outside formal clinical settings. mHealth could enhance patient education, prevent disease, improve diagnosis and research-based treatment, reduce healthcare costs and enable patients to manage long-term conditions. In addition, unimpeded by geographical distance, smartphone-linked wearable sensors, built around real-time connectivity, will improve communication between health professionals and improve the understanding of physiological variability, thereby improving clinical decisions and quality of care. However, despite the potential of mHealth, there are still significant information gaps regarding its long-term effects, acceptability, costs and risks. There is therefore a significant need for continued research to evaluate the functions and appropriateness of these medical devices that are slowly entering the healthcare arena, while not neglecting the rights of the individual

    Investigating clinical heterogeneity in systematic reviews: a methodologic review of guidance in the literature

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    <p>Abstract</p> <p>Background</p> <p>While there is some consensus on methods for investigating statistical and methodological heterogeneity, little attention has been paid to clinical aspects of heterogeneity. The objective of this study is to summarize and collate suggested methods for investigating clinical heterogeneity in systematic reviews.</p> <p>Methods</p> <p>We searched databases (Medline, EMBASE, CINAHL, Cochrane Library, and CONSORT, to December 2010) and reference lists and contacted experts to identify resources providing suggestions for investigating clinical heterogeneity between controlled clinical trials included in systematic reviews. We extracted recommendations, assessed resources for risk of bias, and collated the recommendations.</p> <p>Results</p> <p>One hundred and one resources were collected, including narrative reviews, methodological reviews, statistical methods papers, and textbooks. These resources generally had a low risk of bias, but there was minimal consensus among them. Resources suggested that planned investigations of clinical heterogeneity should be made explicit in the protocol of the review; clinical experts should be included on the review team; a set of clinical covariates should be chosen considering variables from the participant level, intervention level, outcome level, research setting, or others unique to the research question; covariates should have a clear scientific rationale; there should be a sufficient number of trials per covariate; and results of any such investigations should be interpreted with caution.</p> <p>Conclusions</p> <p>Though the consensus was minimal, there were many recommendations in the literature for investigating clinical heterogeneity in systematic reviews. Formal recommendations for investigating clinical heterogeneity in systematic reviews of controlled trials are required.</p
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