Evidence map›Paper›PMID 35418406›Full record

ArticleEmergency medicine journal : EMJ2022

Population-level impact of a pulse oximetry remote monitoring programme on mortality and healthcare utilisation in the people with COVID-19 in England: a national analysis using a stepped wedge design.

Thomas Beaney, Jonathan Clarke, Ahmed Alboksmaty, Kelsey Flott, Aidan Fowler, Jonathan Benger, Paul P Aylin, Sarah Elkin, Ana Luisa Neves, Ara Darzi

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Emergency medicine journal : EMJ, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
1.6field-weighted citation impact, top 15% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 16 citations in OpenAlex.

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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

10 authors at 4 institutions in 1 country.

Thomas BeaneyDepartment of Primary Care and Public Health, Imperial College London, London, UK thomas.beaney@imperial.ac.uk.ORCID http://orcid.org/0000-0001-9709-7264
Jonathan ClarkeCentre for Mathematics of Precision Healthcare, Department of Mathematics, Imperial College London, London, UK.ORCID http://orcid.org/0000-0003-1495-7746
Ahmed AlboksmatyDepartment of Primary Care and Public Health, Imperial College London, London, UK.
Kelsey FlottPatient Safety Translational Research Centre, Institute of Global Health Innovation, Imperial College London, London, UK.
Aidan FowlerNHS England and Improvement, London, UK.
Jonathan BengerNHS Digital, Leeds, UK.
Paul P AylinDepartment of Primary Care and Public Health, Imperial College London, London, UK.ORCID http://orcid.org/0000-0003-4589-1743
Sarah ElkinImperial College Healthcare NHS Trust, London, UK.
Ana Luisa NevesPatient Safety Translational Research Centre, Institute of Global Health Innovation, Imperial College London, London, UK.
Ara DarziPatient Safety Translational Research Centre, Institute of Global Health Innovation, Imperial College London, London, UK.
NIHR Imperial Biomedical Research Centre · GBImperial College Healthcare NHS Trust · GBNHS Digital · GBNHS England

Funding

Wellcome Trust
6 · The paper itself

Abstract

backgroundTo identify the population-level impact of a national pulse oximetry remote monitoring programme for COVID-19 (COVID Oximetry @home (CO@h)) in England on mortality and health service use.

methodsWe conducted a retrospective cohort study using a stepped wedge pre-implementation and post-implementation design, including all 106 Clinical Commissioning Groups (CCGs) in England implementing a local CO@h programme. All symptomatic people with a positive COVID-19 PCR test result from 1 October 2020 to 3 May 2021, and who were aged ≥65 years or identified as clinically extremely vulnerable were included. Care home residents were excluded. A pre-intervention period before implementation of the CO@h programme in each CCG was compared with a post-intervention period after implementation. Five outcome measures within 28 days of a positive COVID-19 test: (i) death from any cause; (ii) any ED attendance; (iii) any emergency hospital admission; (iv) critical care admission and (v) total length of hospital stay.

results217 650 people were eligible and included in the analysis. Total enrolment onto the programme was low, with enrolment data received for only 5527 (2.5%) of the eligible population. The period of implementation of the programme was not associated with mortality or length of hospital stay. The period of implementation was associated with increased health service utilisation with a 12% increase in the odds of ED attendance (95% CI: 6% to 18%) and emergency hospital admission (95% CI: 5% to 20%) and a 24% increase in the odds of critical care admission in those admitted (95% CI: 5% to 47%). In a secondary analysis of CO@h sites with at least 10% or 20% of eligible people enrolled, there was no significant association with any outcome measure.

conclusionAt a population level, there was no association with mortality before and after the implementation period of the CO@h programme, and small increases in health service utilisation were observed. However, lower than expected enrolment is likely to have diluted the effects of the programme at a population level.

Indexed as

COVID-19HospitalizationHumansOximetryPatient Acceptance of Health CareRetrospective StudiesCOVID-19

Identifiers

PMID35418406
PMCPMC9023854
OpenAlexW4226069022

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.