Evidence map›Paper›PMID 26052944›Full record

SynthesisPloS one2015

Efficacy of Hospital at Home in Patients with Heart Failure: A Systematic Review and Meta-Analysis.

Amro Qaddoura, Payam Yazdan-Ashoori, Conrad Kabali, Lehana Thabane, R Brian Haynes, Stuart J Connolly, Harriette Gillian Christine Van Spall

Registry-linked trialAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04330378 (A Hospital-at-Home Pilot in Singapore), which is not on this map. Cited by 54 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
54citing papers in PubMed, 13 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04330378 completednot on this mapstarted 2021, after this paper: background citation

A Hospital-at-Home Pilot in Singapore: A Prospective Quasi-Experimental Cohort Study

TypeobservationalSponsorNational University Health System, SingaporeRan2021 to 2023Enrolled378ConditionsHospital-at-homeArmsHospital-at-home, Usual in-hospital care
3 · Its place in the literature

Who cites it

54 citing papers in PubMed, 13 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Admission avoidance hospital at home.The Cochrane database of systematic reviews · 2024
    Pooled it
  4. The Cost-Effectiveness of Homecare Services for Adults and Older Adults: A Systematic Review.International journal of environmental research and public health · 2023
    Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. Pooled it
  11. Pooled it
  12. Pooled it
  13. Early discharge hospital at home.The Cochrane database of systematic reviews · 2017
    Pooled it
  14. Trial
  15. Observational
  16. Article
  17. Article
  18. Article
  19. Article
  20. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Amro QaddouraDepartment of Medicine, Queen's University, Kingston, Ontario, Canada.
Payam Yazdan-AshooriDepartment of Medicine, McMaster University, Hamilton, Ontario, Canada.
Conrad KabaliDalla Lana School of Public Health, Division of Epidemiology, University of Toronto, Toronto, Ontario, Canada.
Lehana ThabaneDepartment of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada; Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
R Brian HaynesDepartment of Medicine, McMaster University, Hamilton, Ontario, Canada; Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
Stuart J ConnollyDepartment of Medicine, McMaster University, Hamilton, Ontario, Canada; Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
Harriette Gillian Christine Van SpallDepartment of Medicine, McMaster University, Hamilton, Ontario, Canada; Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHeart failure (HF) is the commonest cause of hospitalization in older adults. Compared to routine hospitalization (RH), hospital at home (HaH)--substitutive hospital-level care in the patient's home--improves outcomes and reduces costs in patients with general medical conditions. The efficacy of HaH in HF is unknown. METHODS AND

resultsWe searched MEDLINE, Embase, CINAHL, and CENTRAL, for publications from January 1990 to October 2014. We included prospective studies comparing substitutive models of hospitalization to RH in HF. At least 2 reviewers independently selected studies, abstracted data, and assessed quality. We meta-analyzed results from 3 RCTs (n = 203) and narratively synthesized results from 3 observational studies (n = 329). Study quality was modest. In RCTs, HaH increased time to first readmission (mean difference (MD) 14.13 days [95% CI 10.36 to 17.91]), and improved health-related quality of life (HrQOL) at both, 6 months (standardized MD (SMD) -0.31 [-0.45 to -0.18]) and 12 months (SMD -0.17 [-0.31 to -0.02]). In RCTs, HaH demonstrated a trend to decreased readmissions (risk ratio (RR) 0.68 [0.42 to 1.09]), and had no effect on all-cause mortality (RR 0.94 [0.67 to 1.32]). HaH decreased costs of index hospitalization in all RCTs. HaH reduced readmissions and emergency department visits per patient in all 3 observational studies.

conclusionsIn the context of a limited number of modest-quality studies, HaH appears to increase time to readmission, reduce index costs, and improve HrQOL among patients requiring hospital-level care for HF. Larger RCTs are necessary to assess the effect of HaH on readmissions, mortality, and long-term costs.

Indexed as

Emergency Service, HospitalFollow-Up StudiesHeart FailureHospitalsHumansLength of StayPatient ReadmissionQuality of LifeRandomized Controlled Trials as TopicReproducibility of ResultsTreatment Outcome

Identifiers

PMID26052944
PMCPMC4460137

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.