Table 4 Outcomes measured across included studies.

From: Mobile devices and wearable technology for measuring patient outcomes after surgery: a systematic review

Primary outcome

Author

Study design

Procedures

Patient number

Length of intervention

Main finding

Postoperative pain management

Campbell et al., 2019

RCT

Hip or knee replacement

159

42 days

Stopped taking narcotics 10 days sooner (P < 0.001)

Postoperative pain management

Hou et al., 2019

RCT

Lumbar spinal surgery

168

90 days

No difference in pain scores

Postoperative pain management

Khanwalkar et al., 2018

Prospective

Sinus surgery

288

14 days

Similar analgesic requirements across all included procedures

Postoperative pain management

Anthony et al., 2018

Prospective

Hand surgery

47

7 days

Pain trended down sequentially over the first week

Postoperative complications

Scheper et al., 2019

Prospective

Joint arthroplasty

69

30 days

80% patient-reported complications concorded with physician diagnosis.

Postoperative complications

Pozza et al., 2018

Prospective

Cosmetic surgery

57

7 days

All three complications were detected earlier in the postoperative period

Postoperative complications

Sosa et al., 2017

Prospective

Head and neck cancer resection

23

7 days

Patients with postoperative complications are more likely to use a platform (P < 0.001)

Postoperative complications

Carrier et al., 2016

Prospective

Major colorectal resections

111

7 days

Alerts led to early, timely detection of postoperative complications

Postoperative complications

Palombo et al., 2009

Prospective

Carotid endarterectomy

36

2 days

The intervention allowed safe early discharge in selected patients

Postoperative symptom monitoring

Graetz et al., 2018

RCT

Gynaecological cancer surgery

29 (pilot)

30 days

Feasible and acceptable to the patient population. Reminders increased use of a mobile application.

Postoperative symptom monitoring

Dabbs et al., 2016

RCT

Lung transplant

201

12 months

Self-monitoring increased with app use, with patients more likely to report critical indicators (OR 5.11; P < 0.001)

Postoperative recovery

GrƤfitsch et al., 2020

Prospective

Abdominal wall hernia repair

16

30 days

60% of patients regained preoperative activity levels within 3 weeks

Postoperative recovery

Panda et al., 2019

Prospective

Cancer surgery

62

6 weeks

Patients with postoperative complications showed lower activity and ability to achieve 60 min of exertional activity

Postoperative recovery

Campbell et al., 2019

RCT

Hip or knee replacement

159

42 days

Patients in the intervention group exercised for longer (8.6 min per day; P < 0.001)

Postoperative recovery

Hou et al., 2019

RCT

Lumbar spinal surgery

168

90 days

Disability improved in mHealth group

Postoperative recovery

Carmichael et al., 2019

Prospective

Inguinal hernia (most common), abdominal and thoracic procedures

175

30 days

Recovery trajectories have the potential to predict postoperative complications up to 3 days before readmission

Postoperative recovery

Thijs et al., 2019

Prospective

CABG

22

14 days

Higher physical activity has seen following minimally invasive procedures

Postoperative recovery

Cole et al., 2019

Prospective

Transsphenoidal surgery

7

Up to 13 days (average 8 days)

Step count fell by 45% following surgery

Postoperative recovery

van der Meij et al., 2018

RCT

Laparoscopic abdominal procedures

344

6 months

Five-day reduction in return to normal activities (21 days vs. 26 days; P = 0.007)

Postoperative recovery

Ghomrawi et al., 2018

Prospective

Range of elective paediatric surgical procedures

60

14 days

Different activity curves demonstrated for patients undergoing in-patient and out-patient procedures

Postoperative recovery

Agarwal et al., 2018

Prospective

Robotic laparoscopic prostatectomy

46

Up to 15 days

Greatest reduction in postoperative step count seen in obese and men aged >65 years old

Postoperative recovery

Jaensson et al., 2017

RCT

Predominantly orthopaedic and general cases

997

14 days

Improved recovery in several symptom domains

Postoperative recovery

Park et al., 2017

RCT

Total knee replacement

40

90 days

SMS messages achieved similar postoperative recovery compared to routine care

Postoperative recovery

Chiang et al., 2017

Prospective

Total knee replacement

18

6 weeks

Postoperative range of motion improved if haemostatic agent used intra-operatively

Postoperative recovery

Sun et al., 2017

Prospective

Major gastrointestinal resection

20

14 days

Median step count at day 7 correlated with the Comprehensive Complication Index (CCI)

Postoperative recovery

Abraham et al., 2017

Prospective

Breast reconstruction

4

28 days

Variance in total sleep duration is a potential marker of recovery

Postoperative recovery

Toogood et al., 2016

Prospective

Total hip arthroplasty

33

30 days

Activity increased in a step-wise fashion post-discharge. Age and operative approach were associated with postoperative activity

Postoperative recovery

Debono et al., 2016

Prospective

Lumbar discectomy

60

16 days

Deviations in expected postoperative recovery were identified early, reducing emergency department admissions

Postoperative recovery

Mobbs et al., 2016

Prospective

Lumbar spine surgery

30

90 days

Daily mean step count and distance had improved at follow-up

Postoperative recovery

Dawes et al., 2015

Prospective

Any colorectal procedure

20

14 days

Patients felt more aware of the recovery process and connected with their surgical team

Surgical site infection

Mousa et al., 2019

RCT

Infra-inguinal procedures

30

30 days

No difference in 30-day surgical site infection rates

Surgical site infection

Gunter et al., 2018

Prospective

Lower limb vascular surgery

40

14 days

Surgical site infection correctly identified in 87% of cases

Surgical site infection

Castillo et al., 2017

Prospective

C-section

105

30 days

One surgical site infection identified through intervention

Surgical site infection

Semple et al., 2015

Prospective

Breast reconstruction and ACL repair

65

30 days

All wound complications were correctly identified

Surgical site infection

Martinez-Ramos et al., 2009

Prospective

Range of ambulatory procedures

96

14 days

Two-thirds of patients had their wound concerns successfully resolved without need for hospital review

Surgical site infection

Perez et al., 2006

Prospective

Predominantly orthopaedic procedures

49

Not stated

Images modified original treatment plans and avoided emergency department attendance for 88%

Follow-up requirements

Mousa et al., 2019

RCT

Infra-inguinal procedures

30

30 days

No difference in 30-day readmission rates

Follow-up requirements

Felbaum et al., 2018

Prospective

Spinal surgery

56

30 days

Mobile application reduced hospital visits

Follow-up requirements

Armstrong et al., 2017

RCT

Breast reconstruction

65

30 days

Fewer in-person follow-up care visits in mHealth group (0.4; P < 0.001)

Follow-up requirements

Higgins et al., 2017

Prospective

ACL reconstruction

32

6 weeks

Intervention reduced the need for routine follow-up

Follow-up requirements

McElroy et al., 2016

Prospective

Cardiac surgery

27

30 days

Readmissions similar between intervention and control groups

Weight loss

Mangieri et al., 2019

RCT

Laparoscopic sleeve gastrectomy

56

24 months

Application aided longer-term weight loss at 12 months post-surgery

Weight loss

Tenhagen et al., 2016

Prospective

Gastric sleeve or bypass

14

1 year

Excess weight loss >40% in all patients

Feasibility

Jonker et al., 2021

Prospective

Oncological procedures

47

90 days

Older patients (≄65 years old) can successfully perform home monitoring using DHIs, with good usability and acceptability

Feasibility

Argent et al., 2019

Prospective

Total knee replacement

15

14 days

Biofeedback system improved rehabilitation experience for patients

Feasibility

Scott et al., 2017

Prospective

Colorectal surgery

20

14 days

Low use of mobile application associated with inappropriate emergency department presentation in 63% of cases

Feasibility

Symer et al., 2017

Prospective

Open and laparoscopic abdominal surgery

31

30 days

Patients generated an average of 1.1 alerts, but 50% of patients struggled to upload photographs