Evidence map›Paper›PMID 34593374›Full record

Trial reportBMJ (Clinical research ed.)2021

Post-discharge after surgery Virtual Care with Remote Automated Monitoring-1 (PVC-RAM-1) technology versus standard care: randomised controlled trial.

Michael H McGillion, Joel Parlow, Flavia K Borges, Maura Marcucci, Michael Jacka, Anthony Adili, Manoj M Lalu, Carley Ouellette, Marissa Bird, Sandra Ofori and 53 more

3 registry-linked trialsOpen access · hybridAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 33 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 5 pooled it
10.2field-weighted citation impact, top 1% of its field
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.

NCT04344665 nacompletednot on this map

Post Discharge After Surgery Virtual Care With Remote Automated Monitoring Technology (PVC-RAM) Trial

TypeinterventionalSponsorPopulation Health Research InstituteRan2020 to 2021Enrolled905ConditionsSurgery, Perioperative Complication, COVIDArmsVirtual Care and Remote Automated Monitoring
NCT06537453 narecruitingnot on this mapstarted 2024, after this paper: background citation

Using Personalized Risk and Digital Tools to Guide Transitions Following Acute Kidney Events - Virtual Care: Virtual Home Hospital With Remote Monitoring to Reduce Acute Care Hospitalization

TypeinterventionalSponsorUniversity of CalgaryRan2024 to 2026Enrolled354ConditionsAcute Kidney InjuryArmsVirtual Care
NCT06980402 nanot yet recruitingnot on this mapstarted 2025, after this paper: background citation

Pragmatic Pilot Study of SKH@Home Post-discharge Monitoring Initiative on Outcomes of Surgical Patients

TypeinterventionalSponsorSengkang General HospitalRan2025 to 2029Enrolled1,000ConditionsLaparoscopy, Discharge PlanningArmsEarly post-surgical discharge with post-surgical home based monitoring, Standard inpatient care until deemed suitable for discharge
3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 5 syntheses or guidelines pooled it, 80 citations in OpenAlex.

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  6. Alert burden when monitoring patients' vital signs continuously at home.Journal of clinical monitoring and computing · 2026
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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

63 authors at 14 institutions in 2 countries.

Michael H McGillionSchool of Nursing, McMaster University, Hamilton, Ontario, Canada.
Joel ParlowDepartment of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ontario, Canada.
Flavia K BorgesPopulation Health Research Institute, Hamilton, Ontario, Canada.
Maura MarcucciDepartment of Medicine, McMaster University, Hamilton, Ontario, Canada.
Michael JackaDepartments of Critical Care and Anesthesiology, University of Alberta, Edmonton, Alberta, Canada.
Anthony AdiliDepartment of Surgery, McMaster University, Hamilton, Ontario, Canada.
Manoj M LaluDepartment of Anesthesiology and Pain Medicine, The University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada.
Carley OuelletteSchool of Nursing, McMaster University, Hamilton, Ontario, Canada.
Marissa BirdSchool of Nursing, McMaster University, Hamilton, Ontario, Canada.
Sandra OforiPopulation Health Research Institute, Hamilton, Ontario, Canada.
Pavel S RoshanovDepartment of Medicine, Schulich School of Medicine, University of Western Ontario, London, Ontario, Canada.
Ameen PatelDepartment of Medicine, McMaster University, Hamilton, Ontario, Canada.
Homer YangDepartment of Anesthesia and Perioperative Medicine, Schulich School of Medicine, University of Western Ontario, London, Ontario, Canada.
Susan O'LearyCentre for Data Science and Digital Health, Hamilton Health Sciences, Hamilton, Ontario, Canada.
Vikas TandonDepartment of Medicine, McMaster University, Hamilton, Ontario, Canada.
Gavin M HamiltonDepartment of Anesthesiology and Pain Medicine, The University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada.
Marko MrkobradaDepartment of Medicine, Schulich School of Medicine, University of Western Ontario, London, Ontario, Canada.
David ConenPopulation Health Research Institute, Hamilton, Ontario, Canada.
Valerie HarveyPopulation Health Research Institute, Hamilton, Ontario, Canada.
Jennifer LounsburySchool of Nursing, McMaster University, Hamilton, Ontario, Canada.
Rajibul MianPopulation Health Research Institute, Hamilton, Ontario, Canada.
Shrikant I BangdiwalaPopulation Health Research Institute, Hamilton, Ontario, Canada.
Ramiro ArellanoDepartment of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ontario, Canada.
Ted ScottCentre for Data Science and Digital Health, Hamilton Health Sciences, Hamilton, Ontario, Canada.
Gordon H GuyattDepartment of Medicine, McMaster University, Hamilton, Ontario, Canada.
Peggy GaoPopulation Health Research Institute, Hamilton, Ontario, Canada.
Michelle GrahamDepartment of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Rahima NenshiDepartment of Surgery, McMaster University, Hamilton, Ontario, Canada.
Alan J ForsterThe Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Mahesh NagappaDepartment of Anesthesia and Perioperative Medicine, Schulich School of Medicine, University of Western Ontario, London, Ontario, Canada.
Kelsea LevesqueSchool of Nursing, McMaster University, Hamilton, Ontario, Canada.
Kristen MarosiDepartment of Medicine, Queen's University, Kingston, Ontario, Canada.
Sultan ChaudhryDepartment of Medicine, McMaster University, Hamilton, Ontario, Canada.
Shariq HaiderDepartment of Medicine, McMaster University, Hamilton, Ontario, Canada.
Lesly DeucharAlberta Health Services, Alberta, Canada.
Brandi LeBlancSt Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.
Colin J L McCartneyDepartment of Anesthesiology and Pain Medicine, The University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada.
Emil H SchemitschDepartment of Surgery, University of Western Ontario and London Health Sciences Centre, London, Ontario, Canada.
Jessica VincentPopulation Health Research Institute, Hamilton, Ontario, Canada.
Shirley M PettitCentre for Data Science and Digital Health, Hamilton Health Sciences, Hamilton, Ontario, Canada.
Deborah DuMertonDepartment of Anesthesiology and Perioperative Medicine, Kingston Health Sciences Centre, Kingston, Ontario, Canada.
Angela Djuric PaulinCentre for Data Science and Digital Health, Hamilton Health Sciences, Hamilton, Ontario, Canada.
Marko SimunovicDepartment of Surgery, McMaster University, Hamilton, Ontario, Canada.
David C WilliamsDepartment of Surgery, University of Alberta, Edmonton, Alberta, Canada.
Samantha HalmanThe Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
John HarlockDepartment of Surgery, McMaster University, Hamilton, Ontario, Canada.
Ralph M MeyerCentre for Data Science and Digital Health, Hamilton Health Sciences, Hamilton, Ontario, Canada.
Dylan A TaylorDepartment of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Harsha ShanthannaDepartment of Anesthesia, McMaster University, Hamilton, Ontario, Canada.
Christopher M SchlachtaDepartment of Surgery, University of Western Ontario and London Health Sciences Centre, London, Ontario, Canada.
Neil ParryDepartment of Surgery, University of Western Ontario and London Health Sciences Centre, London, Ontario, Canada.
David R PichoraDepartment of Surgery, Queen's University and Kingston Health Sciences Centre, Kingston, Ontario, Canada.
Haroon YousufDepartment of Medicine, McMaster University, Hamilton, Ontario, Canada.
Elizabeth PeterLawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
Andre LamyPopulation Health Research Institute, Hamilton, Ontario, Canada.
Jeremy PetchCentre for Data Science and Digital Health, Hamilton Health Sciences, Hamilton, Ontario, Canada.
Husein MolooThe Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Herman SehmbiDepartment of Medicine, Schulich School of Medicine, University of Western Ontario, London, Ontario, Canada.
Melissa WaggottThe Ottawa Hospital, Ottawa, Ontario, Canada.
Jessica ShelleyDepartment of Anesthesiology and Perioperative Medicine, Kingston Health Sciences Centre, Kingston, Ontario, Canada.
Emilie P Belley-CotePopulation Health Research Institute, Hamilton, Ontario, Canada.
P J DevereauxPopulation Health Research Institute, Hamilton, Ontario, Canada philipj@mcmaster.ca.ORCID 0000-0003-2935-637X
PVC-RAM-1 Investigators
Population Health Research Institute · CAMcMaster University · CAHamilton Health Sciences · CAWestern University · CAUniversity of Ottawa · CAQueen's University · CASt. Joseph’s Healthcare Hamilton · CAUniversity of Alberta · CAImpact · CAKingston Health Sciences Centre · CAAlberta Health Services · CAOttawa Hospital · CAUniversity of Port Harcourt · NGUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine if virtual care with remote automated monitoring (RAM) technology versus standard care increases days alive at home among adults discharged after non-elective surgery during the covid-19 pandemic.

designMulticentre randomised controlled trial.

setting8 acute care hospitals in Canada.

participants905 adults (≥40 years) who resided in areas with mobile phone coverage and were to be discharged from hospital after non-elective surgery were randomised either to virtual care and RAM (n=451) or to standard care (n=454). 903 participants (99.8%) completed the 31 day follow-up.

interventionParticipants in the experimental group received a tablet computer and RAM technology that measured blood pressure, heart rate, respiratory rate, oxygen saturation, temperature, and body weight. For 30 days the participants took daily biophysical measurements and photographs of their wound and interacted with nurses virtually. Participants in the standard care group received post-hospital discharge management according to the centre's usual care. Patients, healthcare providers, and data collectors were aware of patients' group allocations. Outcome adjudicators were blinded to group allocation.

main outcome measuresThe primary outcome was days alive at home during 31 days of follow-up. The 12 secondary outcomes included acute hospital care, detection and correction of drug errors, and pain at 7, 15, and 30 days after randomisation.

resultsAll 905 participants (mean age 63.1 years) were analysed in the groups to which they were randomised. Days alive at home during 31 days of follow-up were 29.7 in the virtual care group and 29.5 in the standard care group: relative risk 1.01 (95% confidence interval 0.99 to 1.02); absolute difference 0.2% (95% confidence interval -0.5% to 0.9%). 99 participants (22.0%) in the virtual care group and 124 (27.3%) in the standard care group required acute hospital care: relative risk 0.80 (0.64 to 1.01); absolute difference 5.3% (-0.3% to 10.9%). More participants in the virtual care group than standard care group had a drug error detected (134 (29.7%)

conclusionVirtual care with RAM shows promise in improving outcomes important to patients and to optimal health system function.

trial registrationClinicalTrials.gov NCT04344665.

Indexed as

AftercareAgedCanadaCOVID-19FemaleHumansMaleMedication ErrorsMiddle AgedMonitoring, AmbulatoryPandemicsPatient DischargePostoperative PainPostoperative PeriodSurgical Procedures, OperativeTelemedicine

Identifiers

PMID34593374
PMCPMC8477638
OpenAlexW3201873331

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

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.