Innovative E-Health Technologies for Cardiovascular Disease Treatment: A 2024 Updated Systematic Review and Meta-Analysis

Abstract

AbstractBackground and Objectives:Cardiovascular disease (CVD) remains the leading cause of death globally, with an estimated 18.6 million deaths in 2021. E-health interventions have the potential to improve CVD management by providing remote monitoring, patient education, and support. This updated systematic review and meta-analysis aimed to synthesize the evidence on the effectiveness of innovative e-health technologies for CVD treatment, including studies published up to November 2023.Methods:A comprehensive literature search was conducted in MEDLINE, Embase, Cochrane Central Register of Controlled Trials, CINAHL, and PsycINFO from inception to November 2023. Randomized controlled trials (RCTs) comparing an innovative e-health technology to usual care or another intervention in adults with CVD or at risk of CVD were included. The risk of bias was assessed using the Cochrane Collaboration’s risk of bias tool. A meta-analysis was conducted for outcomes with sufficient studies and similar interventions and outcomes. For other outcomes, a narrative synthesis was performed. The certainty of evidence for each outcome was assessed using the GRADE approach.Findings:Thirty studies met the inclusion criteria, with a total of 10,234 participants. The interventions included artificial intelligence, machine learning, wearable devices, mobile health, telehealth, virtual reality, augmented reality, blockchain technology, Internet of Things (IoT), and big data analytics. The outcomes assessed were blood pressure, cholesterol levels, medication adherence, cardiovascular events, and quality of life. The meta-analysis showed that innovative e-health technologies were effective in improving blood pressure (mean difference: -5.7 mmHg; 95% CI: -7.3 to -4.1), cholesterol levels (mean difference: -10.8 mg/dL; 95% CI: -13.9 to -7.7), and medication adherence (odds ratio: 1.48; 95% CI: 1.31 to 1.67). The certainty of evidence for these outcomes was moderate. The narrative synthesis indicated that innovative e-health technologies were also effective in reducing cardiovascular events and improving quality of life. However, the evidence for these outcomes was limited, and more research is needed.Conclusions:The findings from this systematic review and meta-analysis provide robust evidence that innovative e-health technologies significantly enhance the management of cardiovascular disease (CVD). The included interventions, spanning artificial intelligence (AI), machine learning (ML), wearable devices, mobile health (mHealth), telehealth, virtual reality (VR), augmented reality (AR), blockchain technology, Internet of Things (IoT), and big data analytics, have demonstrated substantial improvements in key clinical outcomes. However, limitations such as variability in study design and the need for more high-quality RCTs highlight areas for further research. In clinical practice, these technologies offer promising avenues for improving patient outcomes and optimizing CVD management strategies.