Advice
Search strategy and evidence selection
Search strategy
The following search strategy was used to search Ovid MEDLINE (R) 1946 to November Week 3 2015:
1 "Remote Monitoring Reduces Healthcare Use and Improves Quality of Care in Heart Failure Patients With Implantable Defibrillators".m_titl. (1)
2 "The Value of Wireless Remote Monitoring With Automatic Clinician Alerts".m_titl. (1)
3 Clinical Benefits of Remote Versus Transtelephonic Monitoring of Implanted Pacemakers.m_titl. (1)
4 "The MOnitoring Resynchronization dEvices and CARdiac patiEnts (MORE-CARE) randomized controlled trial: phase 1 results on dynamics of early intervention with remote monitoring.".m_titl. (1)
5 1 or 2 or 3 or 4 (4)
6 Telemedicine/ (13186)
7 Telemetry/ (8564)
8 Monitoring, Physiologic/ (47801)
9 Remote Consultation/ (3890)
10 6 or 7 or 8 or 9 (70728)
11 defibrillators, implantable/ or exp pacemaker, artificial/ (34302)
12 exp Cardiac Pacing, Artificial/ (21446)
13 11 or 12 (50131)
14 Coronary Artery Disease/ (43268)
15 Heart Failure/ (92598)
16 Cardiovascular Diseases/ (112154)
17 Arrhythmias, Cardiac/ (54372)
18 14 or 15 or 16 or 17 (293959)
19 10 and 13 and 18 (445)
20 Remote monitoring.ti,ab. (774)
21 (Telemedicine or telemetry).ti,ab. (10785)
22 20 or 21 (11465)
23 (cardiac resynchronization adj4 (device* or defibrillator*)).ab,ti. (785)
24 (implantable adj4 defibrillator*).ti,ab. (8920)
25 (pacemaker* or implantable loop recorder*).ti,ab. (29430)
26 23 or 24 or 25 (37455)
27 carelink.ti,ab. (49)
28 ((Heart or cardiac) adj failure).ab,ti. (119197)
29 (arrhythmia* or cardiovascular disease*).ab,ti. (166404)
30 28 or 29 (272228)
31 22 and 26 and 30 (144)
32 27 and 30 (9)
33 19 or 31 or 32 (553)
34 randomized controlled trial.pt. (417624)
35 controlled clinical trial.pt. (92270)
36 randomized.ab. (309508)
37 placebo.ab. (159698)
38 drug therapy.fs. (1862631)
39 randomly.ab. (219030)
40 trial.ab. (322047)
41 groups.ab. (1378466)
42 34 or 35 or 36 or 37 or 38 or 39 or 40 or 41 (3517639)
43 exp animals/ not humans.sh. (4156219)
44 42 not 43 (2999126)
45 33 and 44 (106)
46 limit 45 to english language (89)
The strategy was adapted for the following databases: Medline in Process, Embase, Cochrane Library (CENTRAL, CDSR, DARE, HTA, NHS EED), EconLit, Pubmed ('epub ahead of press').
The searches returned 656 references, which were reduced to 280 references after automatic and manual removal of duplications.
ClinicalTrials.gov and the International Clinical Trials Registry Platform (ICTRP) were searched to identify ongoing or in-development trials.
Evidence selection
Retrieved results were sifted using the selection criteria below:
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Population: People needing a cardiac device, for example, an implantable cardioverter defibrillator (ICD), a cardio resynchronisation therapy device (CRT), a cardio resynchronisation therapy with defibrillator device (CRT‑D), pacemakers, and implantable loop recorders.
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Setting: In the person's home.
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Intervention: Medtronic CareLink Network.
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Comparators: Other similar home monitoring devices (for example, Biotronik, Boston Scientific Latitude, St Jude Medical Merlin), transtelephonic monitoring, and face-to-face visits.
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Outcomes:
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time from device-detected events to clinical decisions
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number of events reported
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quality of life
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in-hospital visits (scheduled and unscheduled)
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hospital admissions
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death
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disease progression or clinical events
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improved long‑term clinical outcomes
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length of stay
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device malfunction
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user difficulties with system.
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Following the first sift, 75 references were obtained in full text because it was unclear from the title and abstract whether CareLink had been used. After reading the 75 full text references, 16 studies and 1 economic paper that matched our defined scope were identified.
The studies included in this briefing were prioritised if they were randomised controlled trials. One comparative paper was also included, because it compared outcomes from similar technologies, and 1 economic paper was also included.