Evidence map›Paper›PMID 39546442›Full record

ArticlePloS one2024

Patient use of pulse oximetry to support management of COVID-19 in Greater Manchester: A non-randomised evaluation using a target trial approach.

Fernando Rubinstein, Richard Williams, Jo Dumville, Binita Kane, William Whittaker, Peter Bower, Evangelos Kontopantelis

Abstract read
In one paragraph

Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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

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

1 citing paper in PubMed.

  1. 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.

Fernando RubinsteinThe Global Health Network, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom.ORCID 0000-0001-5653-5766
Richard WilliamsNIHR Applied Research Collaboration Greater Manchester, Division of Informatics, Imaging and Data Science, Faculty of Biology, Medicine and Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom.ORCID 0000-0002-0920-1103
Jo DumvilleNIHR Applied Research Collaboration Greater Manchester, Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom.
Binita KaneManchester University Foundation Trust, Manchester, United Kingdom.
William WhittakerNIHR Applied Research Collaboration Greater Manchester, Manchester Centre for Health Economics, Division of Population Health, Health Services Research and Primary Care, Faculty of Biology, Medicine and Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom.ORCID 0000-0003-2530-0360
Peter BowerNIHR Applied Research Collaboration Greater Manchester, Division of Population Health, Health Services Research and Primary Care, Faculty of Biology, Medicine and Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom.
Evangelos KontopantelisNIHR Applied Research Collaboration Greater Manchester, Division of Informatics, Imaging and Data Science, Faculty of Biology, Medicine and Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom.ORCID 0000-0001-6450-5815

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe pandemic saw widespread use of home pulse oximeters to patients diagnosed with COVID-19 to support early detection of low oxygen saturation levels and appropriate care. Rapid implementation made conventional evaluation challenging, highlighting the need for rigorous non-randomised methods to support decision-making about future use of these technologies. We used routine data to explore the benefits of pulse oximetry in Greater Manchester, under the 'COVID-19 oximetry at home' (CO@h) programme.

methodsWe used data from the Greater Manchester Secure Data Environment and defined study parameters using a 'target trial' model to compare patients receiving pulse oximetry under the CO@h programme, with matched controls using various comparator groups. Primary outcomes were unplanned hospitalisation and all-cause mortality. This study is based on data from the Greater Manchester Care Record (GMCR), using anonymised, routinely collected data provided in a de-identified format for research. Informed written consent is needed for primary care patient data to be collected for service improvement and research, before data extraction to the GMCR. The study was approved under protocol GMCR RQ-048, on 12/05/2022. As indicated by the University of Manchester ethics decision tool, formal ethical approval was not required for this study.

resultsThe adjusted odds ratios for an unplanned hospitalisation were higher among patients receiving pulse oximetry: OR 1.86 (95% CI 1.54-2.25) at 28 days, 1.5 (95% CI 1.3-1.74) at 90 days and 1.63 (95% CI 1.44-1.83) at 1 year. Overall odds of mortality were lower among patients receiving pulse oximetry: adjusted ORs of 0.5 (95% CI 0.25-0.98) at 28 days, 0.5 (95% CI 0.32-0.78) at 90 days and 0.58 (95% CI 0.44-0.76) at 1 year. The results were robust to different comparison groups.

conclusionUse of pulse oximetry at home under the CO@h programme, through the resulting prioritisation for appropriate care, was associated with a higher frequency of unplanned admissions and a reduction in the risk of mortality up to 1 year later. Therefore, it is likely effective for early detection of clinical deterioration and timely intervention among patients with COVID-19. Further research is needed to understand whether this is a cost-effective use of healthcare resources.

Indexed as

COVID-19HospitalizationOximetryAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedOxygen SaturationPandemicsSARS-CoV-2

Identifiers

PMID39546442
PMCPMC11567555

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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.