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Clinical effectiveness of telemedicine for chronic heart failure: a systematic review and meta-analysis
  1. Mao-huan Lin,
  2. Wo-liang Yuan,
  3. Tu-cheng Huang,
  4. Hai-feng Zhang,
  5. Jing-ting Mai,
  6. Jing-feng Wang
  1. Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
  1. Correspondence to Dr Wo-liang Yuan, Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, Guangzhou 510120, People's Republic of China; dryuanwl{at}


Telemedicine interventions may be associated with reductions in hospital admission rate and mortality in patients with heart failure (HF). The present study is an updated analysis (as of June 30, 2016) of randomized controlled trials, where patients with HF underwent telemedicine care or the usual standard care. Data were extracted from 39 eligible studies for all-cause and HF-related hospital admission rate, length of stay, and mortality. The overall all-cause mortality (pooled OR=0.80, 95% CI 0.71 to 0.91, p<0.001), HF-related admission rate (pooled OR=0.63, 95% CI 0.53 to 0.76, p<0.001), and HF-related length of stay (pooled standardized difference in means=−0.37, 95% CI −0.72 to −0.02, p=0.041) were significantly lower in the telemedicine group (teletransmission and telephone-supported care), as compared with the control group. In subgroup analysis, all-cause mortality (pooled OR=0.69, 95% CI 0.56 to 0.86, p=0.001), HF-related admission rate (OR=0.61, 95% CI 0.42 to 0.88, p=0.008), HF-related length of stay (pooled standardized difference in means=−0.96, 95% CI −1.88 to −0.05, p=0.039) and HF-related mortality (OR=0.68, 95% CI 0.54 to 0.85, p=0.001) were significantly lower in the teletransmission group, as opposed to the standard care group, whereas only HF-related admission rate (OR=0.64, 95% CI 0.52 to 0.79, p<0.001) was lower in the telephone-supported care group. Overall, telemedicine was shown to be beneficial, with home-based teletransmission effectively reducing all-cause mortality and HF-related hospital admission, length of stay and mortality in patients with HF.

  • Heart Failure

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  • M-hL and W-lY, the first two authors, contributed equally to this study.

  • Contributors W-lY is the guarantor of integrity of the entire study. W-lY and J-fW were involved in study design. M-hL and T-cH were involved in definition of intellectual content; manuscript preparation; manuscript editing. H-fZ and J-tM were involved in literature research and statistical analysis. J-tM was involved in data acquisition. M-hL and W-lY were involved in manuscript review.

  • Funding This study was supported by the National Natural Science Foundation of China, 2014, No. 81470453 and the Nature and Science Fund of Guangdong Province, 2014, No. 2015A030313757.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.