Current Evidence for Continuous Vital Signs Monitoring by Wearable Wireless Devices in Hospitalized Adults: Systematic Review

Abstract

Background Continuous monitoring of vital signs by using wearable wireless devices may allow for timely detection of clinical deterioration in patients in general wards in comparison to detection by standard intermittent vital signs measurements. A large number of studies on many different wearable devices have been reported in recent years, but a systematic review is not yet available to date. Objective The aim of this study was to provide a systematic review for health care professionals regarding the current evidence about the validation, feasibility, clinical outcomes, and costs of wearable wireless devices for continuous monitoring of vital signs. Methods A systematic and comprehensive search was performed using PubMed/MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials from January 2009 to September 2019 for studies that evaluated wearable wireless devices for continuous monitoring of vital signs in adults. Outcomes were structured by validation, feasibility, clinical outcomes, and costs. Risk of bias was determined by using the Mixed Methods Appraisal Tool, quality assessment of diagnostic accuracy studies 2nd edition, or quality of health economic studies tool. Results In this review, 27 studies evaluating 13 different wearable wireless devices were included. These studies predominantly evaluated the validation or the feasibility outcomes of these devices. Only a few studies reported the clinical outcomes with these devices and they did not report a significantly better clinical outcome than the standard tools used for measuring vital signs. Cost outcomes were not reported in any study. The quality of the included studies was predominantly rated as low or moderate. Conclusions Wearable wireless continuous monitoring devices are mostly still in the clinical validation and feasibility testing phases. To date, there are no high quality large well-controlled studies of wearable wireless devices available that show a significant clinical benefit or cost-effectiveness. Such studies are needed to help health care professionals and administrators in their decision making regarding implementation of these devices on a large scale in clinical practice or in-home monitoring.

Feasibility of continuous monitoring of vital signs in surgical patients on a general ward: an observational cohort study

“… 23 30 31 However, there is still insufficient insight regarding the feasibility of using such a continuous monitoring device on a general ward, especially because continuous monitoring can be defined as a complex intervention with many interacting components and behaviour change of healthcare professionals. 32 As recommended by the Medical Research Council framework, feasibility testing and piloting are needed before larger scale clinical implementation of such an intervention can be undertaken. 33 The aim of the study was to determine the feasibility, in terms of acceptability and system fidelity, of continuous vital signs monitoring with the SensiumVitals device among abdominal surgery patients on a general surgery ward.…”

Expectations of Continuous Vital Signs Monitoring for Recognizing Complications After Esophagectomy: Interview Study Among Nurses and Surgeons

“…By allowing continuous vital signs monitoring even while mobilizing, these technologies may aid early recognition of clinical deterioration in ward patients [ 14 - 18 ] and could therefore be of interest for patients undergoing esophagectomy. However, despite the potential promises, the technology is still immature, and further developments are needed to facilitate optimal implementation [ 19 , 20 ]. Furthermore, it is as of yet unclear how continuous monitoring should be integrated in current routines to promote effective care escalation.…”

An Evaluation of Biometric Monitoring Technologies for Vital Signs in the Era of COVID‐19

“…The authors argue the need for large well-controlled studies to guide implementation of vital sign monitoring devices on a large scale in clinical practice or in-home monitoring. 136 New generations of BioMeT have form factors and body placements that allow for continuous real-time monitoring of vital signs. For example, a patch worn for multiple days can collect temperature, heart rate, or RR.…”

“…Because many BioMeT types do not have well‐established validation protocols, it is not possible to gather validation information for every BioMeT described in this paper. As highlighted in a recent systematic review of evidence for validation, feasibility, clinical outcomes, and costs of wearables for early detection of patient deterioration, guidelines for the acceptable mean differences, and limits of agreement for continuous monitoring of vital signs are unfortunately lacking 136 . BP is the only measure with internationally accepted validation protocols and a conduct of independent validation studies as a routine practice.…”