Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jun 4, 2023
Date Accepted: Sep 26, 2023
Consideration of Sex, Gender, or Age on Outcomes of Digital Technologies for Treatment and Monitoring of Chronic Obstructive Pulmonary Disease: Overview of Systematic Reviews
ABSTRACT
Background:
Several systematic reviews have addressed digital technology use for treatment and monitoring of chronic obstructive pulmonary disease (COPD).
Objective:
This study aimed to assess if systematic reviews considered the effects of sex, gender, or age on the outcomes of digital technologies for treatment and monitoring of COPD through an overview of such systematic reviews. The objectives of this overview were (1) to describe the definitions of sex or gender used in reviews, (2) to determine whether the consideration of sex, gender, or age was planned in reviews, (3) to determine whether sex, gender, or age were reported in review results, (4) to determine whether sex, gender, or age were incorporated in implications for clinical practice in reviews, and (5) to create an evidence map for development of individualized clinical recommendations for COPD based on sex, gender, or age diversity.
Methods:
MEDLINE, Cochrane Library, Epistemonikos, Web of Science and the bibliographies of the included systematic reviews were searched through to June 2022. Inclusion was based on the PICOS framework: (1) Population (COPD), (2) Intervention (any digital technology), (3) Comparison (any), (4) Outcome (any), and (5) Study type (systematic review). Studies were independently selected by 2 authors based on title and abstract, and full-text screening. Data were extracted by 1 author and checked by another author. Data items included systematic review characteristics, PICOS criteria, and variables related to sex, gender, or age. Systematic reviews were appraised using A Measurement Tool to Assess Systematic Reviews, version 2 (AMSTAR 2). Data were synthesized using descriptive statistics.
Results:
Out of 1439 records, 30 systematic reviews published between 2010 – 2022 were included in this overview. The confidence in the results of 25/30 (83%) reviews was critically low according to AMSTAR 2. The reviews focused on user outcomes that potentially depend on sex, gender, or age, such as efficacy or effectiveness (25/30, 83%), and acceptance, satisfaction, or adherence (3/30, 10%) to digital technologies for COPD. Reviews reported sex or gender (in 19/30 systematic reviews), or age (in 25/30 systematic reviews) among primary study characteristics. However, only 1/30 reviews included age in a subgroup analysis and 3/30 reviews identified the effects of sex, gender, or age as evidence gaps.
Conclusions:
This overview shows that the effects of sex, gender, or age were rarely considered in 30 systematic reviews of digital technologies for treatment and monitoring of COPD. Furthermore, systematic reviews did not incorporate sex, gender, or age in their implications for clinical practice. We recommend that future systematic reviews should (1) evaluate the effects of sex, gender, or age on the outcomes of digital technologies for treatment and monitoring of COPD and (2) better adhere to reporting guidelines to improve the confidence in review results. Clinical Trial: International Registered Report Identifier (IRRID): RR1-10.2196/40538
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