Faculdade de Medicina da
Faculdade de Medicina da
Faculdade de Medicina da
Faculdade de Medicina da
Faculdade de Medicina da
Faculdade de Medicina da
Faculdade de Medicina da
Faculdade de Medicina da
Universidade do Porto
Universidade do Porto
Universidade do Porto
Universidade do Porto
Universidade do Porto
Universidade do Porto
Universidade do Porto
Universidade do Porto
Introdu
Introdu
ç
ç
ão
ão
à
à
Medicina
Medicina
–
–
1.
1.
º
º
ano
ano
2005/2006
Home monitoring for heart
Home monitoring for heart
Home monitoring for heart
Home monitoring for heart
Home monitoring for heart
Home monitoring for heart
Home monitoring for heart
Home monitoring for heart
failure patients
failure patients
failure patients
failure patients
failure patients
failure patients
failure patients
failure patients
Systematic
Systematic
review
review
Which
Which
type
type
of
of
monitoring
monitoring
(
(
home
home
monitoring
monitoring
/
/
health
health
care
care
system
system
monitoring
monitoring
)
)
is
is
more
Introduction
Introduction
Introduction
Introduction
Introduction
Introduction
Introduction
Introduction
Congestive heart failure is a condition in
Congestive heart failure is a condition in
which the heart can't pump enough blood
which the heart can't pump enough blood
to the other organs
to the other organs
Heart failure is a serious condition and
Heart failure is a serious condition and
unfortunately there's usually no cure
The causes of heart
The causes of heart
The causes of heart
The causes of heart
The causes of heart
The causes of heart
The causes of heart
The causes of heart
failure
failure
failure
failure
failure
failure
failure
failure
Coronary artery disease
Coronary artery disease
High blood pressure (hypertension)
High blood pressure (hypertension)
Diabetes
Diabetes
Cardiomyopathy
Cardiomyopathy
(heart muscle disease)
(heart muscle disease)
Abnormal heart valves
Abnormal heart valves
Congenital heart disease
Congenital heart disease
Past heart attacks (myocardial infarction)
Past heart attacks (myocardial infarction)
“
“
Most people with heart failure also have
Most people with heart failure also have
high blood pressure and about 1 in 3 has
high blood pressure and about 1 in 3 has
diabetes
diabetes
”
”
National heart, lung
National heart, lung
and blood institute
and blood institute
(
Signs and symptoms
Signs and symptoms
Signs and symptoms
Signs and symptoms
Signs and symptoms
Signs and symptoms
Signs and symptoms
Signs and symptoms
Shortness of breath (also called
Shortness of breath (also called
dyspnea
dyspnea
)
)
Tiredness; fatigue
Tiredness; fatigue
Buildup of excess fluid in body tissues
Buildup of excess fluid in body tissues
Persistent coughing or wheezing
Persistent coughing or wheezing
Lack of appetite; nausea
Lack of appetite; nausea
Treatment
Treatment
Treatment
Treatment
Treatment
Treatment
Treatment
Treatment
More common forms of heart failure can't
More common forms of heart failure can't
be cured, but they can be treated, quite
be cured, but they can be treated, quite
often with improvement in symptoms
often with improvement in symptoms
The main objective is to improve
The main objective is to improve
everyday life
everyday life
Patients accompaniment can be
Patients accompaniment can be
achieved by home or clinical monitoring
Our objective
Our objective
Our objective
Our objective
Our objective
Our objective
Our objective
Our objective
Systematic review about heart failure
Systematic review about heart failure
home monitoring
home monitoring
Verification of the efficacy of this type of
Verification of the efficacy of this type of
heart failure control
heart failure control
Methods
Methods
Methods
Methods
Methods
Methods
Methods
Methods
Systematic review
Consists in a bibliographic and cientific review concerning a certain
issue; and trying to minimize possible bias. So, it presents formal
and precise objectives; inferring inclusion and exclusion criteria in
detail.
Meta- analysis
Statistical technique that allows a combination of results from
different studies in a systematic review; owning two types of
structural components, qualitative and quantitative.
Methods
Methods
Methods
Methods
Methods
Methods
Methods
Methods
Study participants
Target population
Manuscripts concerning systematic reviews and randomized
controlled trials in PubMed
Heart failure, congestive; Monitoring, Ambulatory; Delivery
of Health Care; Oximetry; Blood Pressure Monitoring,
Ambulatory; Blood Pressure Monitoring, Ambulatory; Quality
of Life
Query
"Heart Failure, Congestive"[MeSH] AND (("Monitoring,
Ambulatory"[MeSH] AND("Oximetry"[MeSH] OR "Blood
Pressure Monitoring, Ambulatory"[MeSH] OR "Blood
Pressure Monitors Blood Pressure Monitors "[MeSH]
OR "Quality of Life"[MeSH])) OR ("Delivery of Health
Care"[MeSH] AND ("Oximetry"[MeSH] OR "Blood
Pressure Monitoring, Ambulatory"[MeSH] OR "Blood
Pressure Monitors"[MeSH]OR "Quality of
Methods
Methods
Methods
Methods
Methods
Methods
Methods
Methods
Limits
• Humans
• Randomized controlled trials
• Reviews
Methods
Methods
Methods
Methods
Methods
Methods
Methods
Methods
Inclusion criteria
Randomized controlled trials of patients with heart failure using
home or clinical monitoring
Comparison between the two types of monitoring
Studies about blood pressure, heart rate and oximetry monitoring
Those which mention the quality of life of patients with heart
failure
Exclusion criteria
Beginning
Query with limits
(87 articles)
Reading of title
and abstract by
3 reviewers
(48 reviews)
Reading of title
and abstract by
3 reviewers (39
randomized
controlled trials)
No
Excluded?
X
articles
Reading
of 48-X
articles
Excluded?
No
Y
articles
Reading
of 39-Y
articles
Aplication of
new criteria
Excluded?
Excluded?
No
Yes
No
Yes
Yes
Yes
ID Nome da Tarefa Duração Início Conclusão PredecessorasNomes de Recursos 1 entrega do tema 0 dias 23-11-05 23-11-05
2 1ª fase 10 dias 30-11-05 13-12-05
3 planeamento do trabalho 1 dia 30-11-05 30-11-05 Maria, Joana Maria
4 pesquisa bibliográfica 1 dia 01-12-05 01-12-05 3 Joana Neves, Joana Moreira, Sofia, Joana Isabel 5 definição de termos mesh e do query 2 dias 02-12-05 05-12-05 4 Sofia, Joana Lima, Filipe
6 elaboração da introdução 2 dias 06-12-05 07-12-05 5 Joana Maria, Joana Neves, Joana Isabel
7 definição dos objectivos 1 dia 06-12-05 06-12-05 Cristiana, Joana Francisca, Joana Raquel, Joana Moreira 8 definição dos métodos e material 3 dias 07-12-05 09-12-05 7 Joana Maria, Maria
9 elaboração do mapa de Gantt e do fluxograma 2 dias 12-12-05 13-12-05 8 Joana Lima, Joana Moreira, Filipe, Joana Francisca 10 apresentação da 1ª fase 0 dias 13-12-05 13-12-05 9
11 2ª Fase 18 dias 06-02-06 01-03-06
12 determinação dos grupos responsáveis pela selecção de artigos 1 dia 06-02-06 06-02-06 Joana Maria, Maria
13 leitura do "abstract" e primeira selecção de artigos (2 grupos de 3) 3 dias 07-02-06 09-02-06 12 Filipe, Joana Raquel, Cristiana, Joana Isabel, Joana Francisca, Sofia 14 adaptação dos critérios de inclusão e exclusão 2 dias 10-02-06 13-02-06 13 Filipe, Joana Raquel, Cristiana, Joana Isabel, Joana Francisca, Sofia 15 leitura integral dos artigos e segunda selecção 7 dias 14-02-06 22-02-06 14 Filipe, Joana Raquel, Cristiana, Joana Isabel, Joana Francisca, Sofia 16 definição de métodos de resoluçao de divergências e avaliar reprodutibilidade do processo2 dias 23-02-06 24-02-06 15 Joana Lima, Joana Moreira, Joana Neves
17 registo dos motivos de exclusão 2 dias 27-02-06 28-02-06 16 Filipe, Joana Raquel, Cristiana, Joana Isabel, Joana Francisca, Sofia 18 lista final de artigos incluidos 1 dia 01-03-06 01-03-06 17 Maria, Joana Maria
19 apresentação da 2ª fase 0 dias 01-03-06 01-03-06 18 20 3ª fase 113 dias 23-11-05 01-05-06
21 produção do texto de discussão 1 sem 23-11-05 29-11-05 Joana Neves, Joana Moreira, Joana Maria 22 produção do artigo em inglês 4 sems 30-11-05 27-12-05 21 Joana Isabel, Cristiana, Maria
Gantt Chart
Gantt Chart
Gantt Chart
Gantt Chart
Gantt Chart
Gantt Chart
Gantt Chart
Gantt Chart
ID Nome da Tarefa 1 entrega do tema 2 1ª fase
3 planeamento do trabalho 4 pesquisa bibliográfica
5 definição de termos mesh e do query 6 elaboração da introdução
7 definição dos objectivos
8 definição dos métodos e material
9 elaboração do mapa de Gantt e do fluxograma 10 apresentação da 1ª fase
11 2ª Fase
12 determinação dos grupos responsáveis pela selecção de artigos 13 leitura do "abstract" e primeira selecção de artigos (2 grupos de 3) 14 adaptação dos critérios de inclusão e exclusão
15 leitura integral dos artigos e segunda selecção
16 definição de métodos de resoluçao de divergências e avaliar reprodutibilidade do processo 17 registo dos motivos de exclusão
18 lista final de artigos incluidos 19 apresentação da 2ª fase 20 3ª fase
21 produção do texto de discussão 22 produção do artigo em inglês 23 produção do Site
23-11
Maria, Joana Maria
Joana Neves, Joana Moreira, Sofia, Joana Isabel Sofia, Joana Lima, Filipe
Joana Maria, Joana Neves, Joana Isabel
Cristiana, Joana Francisca, Joana Raquel, Joana Moreira Joana Maria, Maria
Joana Lima, Joana Moreira, Filipe, Joana Francisca 13-12
Joana Maria, Maria
Filipe, Joana Raquel, Cristiana, Joana Isabel, Joana Francisca, Sofia Filipe, Joana Raquel, Cristiana, Joana Isabel, Joana Francisca, Sofia
Filipe, Joana Raquel, Cristiana, Joana Isabel, Joana Franc Joana Lima, Joana Moreira, Joana Neves
Filipe, Joana Raquel, Cristiana, Joana Isabel, Jo Maria, Joana Maria
31-03
Joana Neves, Joana Moreira, Joana Maria Joana Isabel, Cristiana, Maria Joana Lima, Sofia, Joana T S Q D Q S S T S Q D Q S S T S Q D Q S S T S Q D Q S S T S Q D Q S S T S Q D Q S S T S Q D Q S S T S Q D 07 Nov '0521 Nov '0505 Dez '0519 Dez '0502 Jan '0616 Jan '0630 Jan '0613 Fev '0627 Fev '0613 Mar '0627 Mar '0610 Abr '0624 Abr '0608 Mai '0622 Mai '0605 Jun '06