gms | German Medical Science

67. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e. V. (GMDS), 13. Jahreskongress der Technologie- und Methodenplattform für die vernetzte medizinische Forschung e. V. (TMF)

21.08. - 25.08.2022, online

Telemonitoring of real-world health data in cardiology: a systematic review

Meeting Abstract

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  • Benjamin Kinast - Institut für Medizinische Informatik und Statistik, Christian-Albrechts-Universität zu Kiel und Universitätsklinikum Schleswig-Holstein, Kiel, Germany
  • Matthias Lutz - Department of Cardiology and Angiology, University Hospital Schleswig-Holstein, Kiel, Germany
  • Björn Schreiweis - Institut für Medizinische Informatik und Statistik, Christian-Albrechts-Universität zu Kiel und Universitätsklinikum Schleswig-Holstein, Kiel, Germany

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie. 67. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e. V. (GMDS), 13. Jahreskongress der Technologie- und Methodenplattform für die vernetzte medizinische Forschung e.V. (TMF). sine loco [digital], 21.-25.08.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocAbstr. 3

doi: 10.3205/22gmds027, urn:nbn:de:0183-22gmds0278

Published: August 19, 2022

© 2022 Kinast et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at



Background: Technological innovations in sensor-based wearables and other consumer health devices open up promising opportunities to collect real-world data. As cardiovascular diseases still remain the number one cause for diseases and mortality worldwide, cardiology offers potent monitoring use cases with patients in their out-of-hospital daily routines [1], [2]. To explore this potential, the aim of this systematic review is to investigate the status quo of studies monitoring patients with cardiovascular risks and patients suffering from cardiovascular diseases in a telemedical setting using not only a smartphone-based app, but also consumer health devices such as wearables and other sensor-based devices.

Methods: We conducted a systematic literature search across the five databases PubMed, Web of Science, CINAHL, Cochrane Library, and Scopus with the intention to include articles matching the following criteria: (1) primary studies dealing with (2) telemedical concepts in (3) cardiovascular disease monitoring that used (4) consumer health devices such as wearables (5) or other noninvasive sensors to (6) track patients’ health data (7) with a smartphone app as a central user interface (for search strings look at original publication). The search identified and evaluated the available literature published between 1 January 2001 and 31 March 2021 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The results were examined according to the study protocols, technical approaches, qualitative and quantitative parameters measured.

Results: 166 articles met the search criteria, eight of these met the selection criteria. Six studies followed an interventional monitoring approach in the area of cardiovascular diseases, heart failure and atrial fibrillation [3], [4], [5], [6], [7], [8] while two studies used the applied app and technology to log cardiologic patients’ health status for further retrospective research [9], [10]. Two articles stated the use of smartwatches from Apple [5], [10], one article reported the use of a Fitbit wearable [6], one study relied on the use of a Withings smartwatch and Withings fitness tracker, while two articles reported the use of the Honor Band 4, the Honor Watch, and the Huawei Watch GT [3], [8] as wearable devices. Two study protocols did not plan the use of any wearables [4], [7]. We further found that five study protocols included different types of Bluetooth blood pressure monitors [6], [7], [9], [10], four involved the use of Bluetooth scales, and one study each included the use of a glucometer [6], a sleep tracking system [9], an electrocardiography device [4] and a pulse oximeter [4] while some studies used a combination of several of the aforementioned devices. Additionally, the survey of 17 Patient-reported outcome measures (PROM) could be identified, with two studies using one PROM [6], [9], five studies using two or more types of PROMs [3], [4], [7], [10], and no PROMs reported in one study [8].

Conclusions: The review identified various combinations of sensors in different application scenarios. Depending on the research objectives, a fusion of apps, patient-reported outcome measures, and non-invasive sensors can be orchestrated in a meaningful way gaining insights in patients out-of-hospital daily routines, becoming an integral part to monitoring concepts for both individual cardiovascular patients and research-driven observations of larger cohorts.

The authors declare that they have no competing interests.

The authors declare that an ethics committee vote is not required.

This contribution has already been published: [11]


Wright SP, Hall Brown TS, Collier SR, Sandberg K. How consumer physical activity monitors could transform human physiology research. Am J Physiol Regul Integr Comp Physiol. 2017 Mar;312(3):R358-R367. DOI: 10.1152/ajpregu.00349.2016 External link
Lobelo F, Kelli HM, Tejedor SC, Pratt M, McConnell MV, Martin SS, Welk GJ. The Wild Wild West: A Framework to Integrate mHealth Software Applications and Wearables to Support Physical Activity Assessment, Counseling and Interventions for Cardiovascular Disease Risk Reduction. Prog Cardiovasc Dis. 2016 May-Jun;58(6):584-94. DOI: 10.1016/j.pcad.2016.02.007 External link
Guo Y, Lane DA, Wang L, Chen Y, Lip GYH; mAF-App II Trial investigators. Mobile Health (mHealth) technology for improved screening, patient involvement and optimising integrated care in atrial fibrillation: The mAFA (mAF-App) II randomised trial. Int J Clin Pract. 2019 Jul;73(7):e13352. DOI: 10.1111/ijcp.13352 External link
Koehler F, Koehler K, Deckwart O, Prescher S, Wegscheider K, Kirwan BA, Winkler S, Vettorazzi E, Bruch L, Oeff M, Zugck C, Doerr G, Naegele H, Störk S, Butter C, Sechtem U, Angermann C, Gola G, Prondzinsky R, Edelmann F, Spethmann S, Schellong SM, Schulze PC, Bauersachs J, Wellge B, Schoebel C, Tajsic M, Dreger H, Anker SD, Stangl K. Efficacy of telemedical interventional management in patients with heart failure (TIM-HF2): a randomised, controlled, parallel-group, unmasked trial. Lancet. 2018 Sep;392(10152):1047-57. DOI: 10.1016/S0140-6736(18)31880-4 External link
Werhahn SM, Dathe H, Rottmann T, Franke T, Vahdat D, Hasenfuß G, Seidler T. Designing meaningful outcome parameters using mobile technology: a new mobile application for telemonitoring of patients with heart failure. ESC Heart Fail. 2019 Jun;6(3):516-25. DOI: 10.1002/ehf2.12425 External link
Wenger NK, Williams OO, Parashar S. SMARTWOMAN™: Feasibility assessment of a smartphone app to control cardiovascular risk factors in vulnerable diabetic women. Clin Cardiol. 2019 Feb;42(2):217-21. DOI: 10.1002/clc.23124 External link
Seto E, Ross H, Tibbles A, Wong S, Ware P, Etchells E, Kobulnik J, Chibber T, Poon S. A Mobile Phone-Based Telemonitoring Program for Heart Failure Patients After an Incidence of Acute Decompensation (Medly-AID): Protocol for a Randomized Controlled Trial. JMIR Res Protoc. 2020 Jan;9(1):e15753. DOI: 10.2196/15753 External link
Guo Y, Wang H, Zhang H, Liu T, Liang Z, Xia Y, Yan L, Xing Y, Shi H, Li S, Liu Y, Liu F, Feng M, Chen Y, Lip GYH; MAFA II Investigators. Mobile Photoplethysmographic Technology to Detect Atrial Fibrillation. J Am Coll Cardiol. 2019 Nov;74(19):2365-75. DOI: 10.1016/j.jacc.2019.08.019 External link
Modena BD, Bellahsen O, Nikzad N, Chieh A, Parikh N, Dufek DM, Ebner G, Topol EJ, Steinhubl S. Advanced and Accurate Mobile Health Tracking Devices Record New Cardiac Vital Signs. Hypertension. 2018 Aug;72(2):503-10. DOI: 10.1161/HYPERTENSIONAHA.118.11177 External link
McManus DD, Trinquart L, Benjamin EJ, Manders ES, Fusco K, Jung LS, Spartano NL, Kheterpal V, Nowak C, Sardana M, Murabito JM. Design and Preliminary Findings From a New Electronic Cohort Embedded in the Framingham Heart Study. J Med Internet Res. 2019 Mar;21(3):e12143. DOI: 10.2196/12143 External link
Kinast B, Lutz M, Schreiweis B. Telemonitoring of Real-World Health Data in Cardiology: A Systematic Review. Int J Environ Res Public Health. 2021 Aug 27;18(17):9070. DOI: 10.3390/ijerph18179070 External link