Evidence map›Paper›PMID 37316919›Full record

ArticleTrials2023

Continuous monitoring of patients in and after the acute admission ward to improve clinical pathways: study protocol for a randomized controlled trial (Optimal-AAW).

Sjoerd H Garssen, Niels Kant, Carlijn A Vernooij, Gert-Jan Mauritz, Mark V Koning, Frank H Bosch, Carine J M Doggen

Registry-linked trialAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in Trials, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05181111 (Continuous Monitoring of Patients in and After the Acute Admission Ward to Optimize Clinical Pathways), which is not on this map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 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.

NCT05181111 nacompletednot on this map

Continuous Monitoring of Patients in and After the Acute Admission Ward to Optimize Clinical Pathways

TypeinterventionalSponsorRijnstate HospitalRan2021 to 2023Enrolled400ConditionsMonitoring, Clinical Deterioration, Acute DiseaseArmsWearable Sensor, Usual Care
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Article
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.

Sjoerd H Garssen *Clinical Research Center, Rijnstate Hospital, Arnhem, The Netherlands.
Niels Kant *Clinical Research Center, Rijnstate Hospital, Arnhem, The Netherlands.
Carlijn A VernooijDepartment of Patient Care and Monitoring, Philips Research, Eindhoven, The Netherlands.
Gert-Jan MauritzDepartment of Emergency Medicine, Rijnstate Hospital, Arnhem, The Netherlands.
Mark V KoningDepartment of Anesthesiology, Rijnstate Hospital, Arnhem, The Netherlands.
Frank H BoschDepartment of Internal Medicine, Rijnstate Hospital, Arnhem, The Netherlands.
Carine J M DoggenClinical Research Center, Rijnstate Hospital, Arnhem, The Netherlands. c.j.m.doggen@utwente.nl.ORCID http://orcid.org/0000-0003-4766-4333

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBecause of high demand on hospital beds, hospitals seek to reduce patients' length of stay (LOS) while preserving the quality of care. In addition to usual intermittent vital sign monitoring, continuous monitoring might help to assess the patient's risk of deterioration, in order to improve the discharge process and reduce LOS. The primary aim of this monocenter randomized controlled trial is to assess the effect of continuous monitoring in an acute admission ward (AAW) on the percentage of patients who are discharged safely.

methodsA total of 800 patients admitted to the AAW, for whom it is equivocal whether they can be discharged directly after their AAW stay, will be randomized to either receive usual care without (control group) or with additional continuous monitoring of heart rate, respiratory rate, posture, and activity, using a wearable sensor (sensor group). Continuous monitoring data are provided to healthcare professionals and used in the discharge decision. The wearable sensor keeps collecting data for 14 days. After 14 days, all patients fill in a questionnaire to assess healthcare use after discharge and, if applicable, their experience with the wearable sensor. The primary outcome is the difference in the percentage of patients who are safely discharged home directly from the AAW between the control and sensor group. Secondary outcomes include hospital LOS, AAW LOS, intensive care unit (ICU) admissions, Rapid Response Team calls, and unplanned readmissions within 30 days. Furthermore, facilitators and barriers for implementing continuous monitoring in the AAW and at home will be investigated. DISCUSSION: Clinical effects of continuous monitoring have already been investigated in specific patient populations for multiple purposes, e.g., in reducing the number of ICU admissions. However, to our knowledge, this is the first Randomized Controlled Trial to investigate effects of continuous monitoring in a broad patient population in the AAW.

trial registrationhttps://clinicaltrials.gov/ct2/show/NCT05181111 . Registered on 6 January 2022. Start of recruitment: 7 December 2021.

Indexed as

Critical PathwaysHospitalizationHospitalsHumansLength of StayPatient DischargeRandomized Controlled Trials as TopicAcute admission wardClinical decision rulesClinical deteriorationClinical trial protocolLength of stayMonitoring, physiologicPatient dischargeWearable electronic device

Identifiers

PMID37316919
PMCPMC10268470

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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.