gms | German Medical Science

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]