Cited by 327Telemedicine and Telehealth ImplementationHeart Failure Treatment and ManagementMobile Health and mHealth Applications

The DOI matches its Crossref record; 77 of the 79 references it cites were found in a registry or an index, and 2 are not checked yet; none of the 136 sources its claims cite is checked for support yet.

Effects of Home Telemonitoring Interventions on Patients With Chronic Heart Failure: An Overview of Systematic Reviews

Open access
Kitsiou, Spyros, Paré, Guy, Jaana, Mirou·2015·Journal of Medical Internet Research

Abstract

BACKGROUND: Growing interest on the effects of home telemonitoring on patients with chronic heart failure (HF) has led to a rise in the number of systematic reviews addressing the same or very similar research questions with a concomitant increase in discordant findings. Differences in the scope, methods of analysis, and methodological quality of systematic reviews can cause great confusion and make it difficult for policy makers and clinicians to access and interpret the available evidence and for researchers to know where knowledge gaps in the extant literature exist. OBJECTIVE: This overview aims to collect, appraise, and synthesize existing evidence from multiple systematic reviews on the effectiveness of home telemonitoring interventions for patients with chronic heart failure (HF) to inform policy makers, practitioners, and researchers. METHODS: A comprehensive literature search was performed on MEDLINE, EMBASE, CINAHL, and the Cochrane Library to identify all relevant, peer-reviewed systematic reviews published between January 1996 and December 2013. Reviews were searched and screened using explicit keywords and inclusion criteria. Standardized forms were used to extract data and the methodological quality of included reviews was appraised using the AMSTAR (assessing methodological quality of systematic reviews) instrument. Summary of findings tables were constructed for all primary outcomes of interest, and quality of evidence was graded by outcome using the GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) system. Post-hoc analysis and subgroup meta-analyses were conducted to gain further insights into the various types of home telemonitoring technologies included in the systematic reviews and the impact of these technologies on clinical outcomes. RESULTS: A total of 15 reviews published between 2003 and 2013 were selected for meta-level synthesis. Evidence from high-quality reviews with meta-analysis indicated that taken collectively, home telemonitoring interventions reduce the relative risk of all-cause mortality (0.60 to 0.85) and heart failure-related hospitalizations (0.64 to 0.86) compared with usual care. Absolute risk reductions ranged from 1.4%-6.5% and 3.7%-8.2%, respectively. Improvements in HF-related hospitalizations appeared to be more pronounced in patients with stable HF: hazard ratio (HR) 0.70 (95% credible interval [Crl] 0.34-1.5]). Risk reductions in mortality and all-cause hospitalizations appeared to be greater in patients who had been recently discharged (≤28 days) from an acute care setting after a recent HF exacerbation: HR 0.62 (95% CrI 0.42-0.89) and HR 0.67 (95% CrI 0.42-0.97), respectively. However, quality of evidence for these outcomes ranged from moderate to low suggesting that further research is very likely to have an important impact on our confidence in the observed estimates of effect and may change these estimates. The post-hoc analysis identified five main types of non-invasive telemonitoring technologies included in the systematic reviews: (1) video-consultation, with or without transmission of vital signs, (2) mobile telemonitoring, (3) automated device-based telemonitoring, (4) interactive voice response, and (5) Web-based telemonitoring. Of these, only automated device-based telemonitoring and mobile telemonitoring were effective in reducing the risk of all-cause mortality and HF-related hospitalizations. More research data are required for interactive voice response systems, video-consultation, and Web-based telemonitoring to provide robust conclusions about their effectiveness. CONCLUSIONS: Future research should focus on understanding the process by which home telemonitoring works in terms of improving outcomes, identify optimal strategies and the duration of follow-up for which it confers benefits, and further investigate whether there is differential effectiveness between chronic HF patient groups and types of home telemonitoring technologies.

Checked 2026-10-06 · 2 references not checked yet

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This overview of 15 systematic reviews found that home telemonitoring for chronic heart failure was associated with reduced all-cause mortality and HF-related hospitalizations versus usual care, but the quality of evidence was moderate to low. Post-hoc analyses suggested only automated device-based and mobile telemonitoring were effective, while other technologies lacked robust data.

Key findings

  • Across high-quality reviews with meta-analysis, home telemonitoring reduced the relative risk of all-cause mortality (0.60 to 0.85) and HF-related hospitalizations (0.64 to 0.86) compared with usual care; absolute risk reductions ranged from 1.4%-6.5% and 3.7%-8.2%, respectively.
  • The strongest evidence (moderate quality) came from a Cochrane review: all-cause mortality RR 0.66 (95% CI 0.54-0.81) in 2710 patients/11 RCTs, ARR 5.2%, number needed to treat 19; HF-related hospitalizations RR 0.79 (95% CI 0.67-0.94) in 1570 patients/4 RCTs, ARR 6%.
  • Recently discharged patients (≤28 days) showed greater reductions in mortality and all-cause hospitalizations: HR 0.62 (95% CrI 0.42-0.89) and HR 0.67 (95% CrI 0.42-0.97), respectively, but quality of evidence was low.
  • Post-hoc analyses found automated device-based telemonitoring reduced all-cause mortality (RR 0.65 [0.54-0.79]) and HF-related hospitalizations (RR 0.77 [0.64-0.91]); mobile telemonitoring showed beneficial but statistically inconclusive trends; interactive voice response and video-consultation were not associated with benefit.

Methods

  • Overview of systematic reviews: searched MEDLINE, EMBASE, CINAHL, and the Cochrane Library through December 2013, updated December 2014; included 15 peer-reviewed systematic reviews published 2003-2013 (18 references), covering 105 primary HT studies.
  • Data extraction, AMSTAR quality appraisal, GRADE evidence grading, summary-of-findings tables, citation overlap analysis, and a taxonomy classifying reviews by PICO characteristics.
  • Post-hoc subgroup meta-analyses of RCTs by home telemonitoring technology used risk ratios, intention-to-treat analysis, Mantel-Haenszel method, and random-effects models; some included reviews used Bayesian credible intervals.

Limitations

  • The paper states overviews are constrained by the quality and reporting of included reviews, publication lag, and overlap between reviews; only 3/15 reviews were high quality (AMSTAR ≥8), 4 were moderate, and 8 were low quality.
  • The paper states evidence quality was moderate to low due to risk of bias, imprecision, and heterogeneity; most trials lacked details on randomization, allocation concealment, and blinding, and one third of trials contributing data received commercial funding.
  • Evident from the text: the post-hoc technology analyses were exploratory, often based on few RCTs, and should be considered hypothesis-generating; the overview found no high-quality evidence for or against home telemonitoring effectiveness.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.2196/jmir.4174

Cites

77 of 79 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

0 of 136 cited sources checked · 0 supported · 0 flagged

Show all 122 claims

  • Probably not a substantial claim. 42
  • It may state two separate claims as one. 40
  • The quote only partly states this claim. 2
69 of 69
  • The paper relies on this without support.

    Systematic reviews of home telemonitoring for heart failure have produced discordant findings in terms of direction and magnitude of home telemonitoring effects.

    “Growing interest on the effects of home telemonitoring on patients with HF has led to a rise in the number of reviews addressing the same or very similar research questions with a concurrent increase in discordant findings in terms of direction and magnitude of HT effects.”
  • The paper relies on this without support.

    Differences in scope, methods of analysis, results, and quality of systematic reviews make it difficult for policy makers to access and interpret review-level evidence and for researchers to identify evidence gaps.

    “Differences in scope, methods of analysis, results, and quality of systematic reviews can cause great confusion and make it difficult for policy makers to access the review-level evidence, and for researchers to know where gaps in the evidence exist.”
  • The paper relies on this without support.

    Home telemonitoring enables early detection of clinical decompensation in patients with heart failure, allowing timely intervention to prevent mortality events or further deterioration necessitating hospitalization.

    “By allowing clinical data to be remotely collected on a regular basis, HT can enable early detection of clinical decompensation in patients with HF, allowing for timely intervention to prevent mortality events or further deterioration of the patient’s condition necessitating hospitalization and use of more resources.”
3 of 3

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Conclusion calls mobile telemonitoring effective despite inconclusive results

    Major

    The conclusion says mobile telemonitoring is effective at reducing mortality and HF-related hospitalizations, whereas the mobile-telemonitoring results explicitly say both outcomes were statistically inconclusive.

  • Conflicting counts of reviews reporting costs

    Minor

    The outcomes section says 12 reviews reported costs, while the cost-savings section says 11 examined that outcome.

  • Conflicting counts of reviews reporting length of stay

    Minor

    The outcomes section reports nine reviews for length of stay, but the dedicated section reports eight.

  • Louis review study-design counts do not total 24

    Minor

    The listed 6 RCTs and 12 observational studies total 18, not the stated 24 studies. The remaining six studies are not accounted for in this breakdown.

    Reported 24 · recomputed 18

  • All-cause hospitalization confidence-limit percentage is tenfold too small

    Minor

    The table's lower confidence limit of 181 fewer per 1000 is 18.1% fewer, not the 1.8% given in the prose for the same 5.7% reduction.

5 of 5

Citations

Cites

Flagged first, then by citations

Show all 79 references

Research works printed but not linked: 2

  1. Jadad, A R, 1997, CMAJ, 156, 1411
  2. ESC Press OfficeIndividualised treatment for heart failure is rarely available outside hospital - New telemonitoring systems could ‘radically’ change the situation200905302014-09-20http://www.escardio.org/about/press/press-releases/pr-09/Pages/Individualised-treatment-HF-hospital.aspxESC Press release Heart Failure Congress 2009http://www.escardio.org/about/press/press-releases/pr-09/Pages/Individualised-treatment-HF-hospital.aspx6WaYcS3L3

Cited by

Sorted by citations

Items 201–300 of 326

Metadata

Authors
Kitsiou, S., Paré, G., & Jaana, M.
Affiliations
  • University of Illinois Chicago (US)
  • HEC Montréal (CA)
  • University of Ottawa (CA)
Corresponding author
Kitsiou, Spyros
Venue
Journal of Medical Internet Research
Published
2015-03-12
Volume
17
Issue
3
Pages
e63
ISSN
1438-8871 (ISSN-L)
OpenAlex
W2074454475
Cited by
327
References
79
Citations by year
2026: 26 · 2025: 28 · 2024: 23 · 2023: 39 · 2022: 23 · 2021: 40 · 2020: 38 · 2019: 19 · 2018: 26 · 2017: 39 · 2016: 15 · 2015: 11
FWCI
4.37
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Journal of Medical Internet Research (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • McMaster University
  • Canada Research Chairs
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Keywords
home health monitoring, chronic heart failure, heart failure hospitalization, all-cause mortality, methodological quality of systematic reviews, AMSTAR, GRADE quality of evidence, heart failure exacerbation, patient-reported outcomes, quality of life, health-related quality of life, patient satisfaction
MeSH terms
Chronic Disease, Heart Failure, Hospitalization, Humans, Monitoring, Physiologic, Review Literature as Topic, Telemetry, Meta-Analysis as Topic, Telemedicine

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

A language model drew the claims from the paper on 2026-10-06, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).

A second model labelled each claim on 2026-10-06 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review