Monitoring in Chronic Diseases (ChroMo): a scoping review of evaluation methods

Veronika Van Der Wardt, Carolin Gonschorek, Julia Heisig, Laura Rink, Lydia König, Lisette Warkentin, Susann Hueber, Annika Viniol

Keywords: Monitoring, chronic diseases, chronic conditions, evaluation methods, methodology

Background:

Monitoring includes repeated examinations to manage treatment of a chronic disease. It offers the opportunity to react to treatment responses and to changes of a condition at an early stage. Monitoring routines have often developed historically and consist of multiple tests with testing intervals following convention rather than being evidence-based. While randomized controlled trials are the gold standard for providing evidence, these might be difficult and costly to complete for the evaluation of monitoring routines.

Research questions:

Which methodological approaches should be used to evaluate monitoring routines in people with chronic conditions?

Method:

A scoping review was completed. Included were topic-related articles, books and book chapters; criteria for monitoring or monitoring programs; evidence reviews. The search was completed in Medline and Embase. Reference lists of identified literature were searched to identify publications. The search combined the keywords ‘monitoring’, ‘chronic conditions’ and ‘evaluation’ and respective equivalent terms. We extracted methodological strategies regarding the evaluation of monitoring routines. A narrative synthesis was completed.

Results:

We identified three peer-reviewed articles and one book chapter. These were synthesized into eight key questions that an evaluation would need to answer: 1) When is monitoring reasonable? 2) What outcome should be monitored? 3) Who should be monitored? 4) Which monitoring test(s) should be used? 5) What is the appropriate target range for test results? 6) When and at which intervals should monitoring take place? 7) Who should complete the monitoring routine? 8) What actions will follow the monitoring results? Furthermore, the findings indicated that cohort studies and routine data analyses might provide an alternative to randomized controlled trials, although these might be prone to bias.

Conclusions:

There is a lack of methodological research strategies to evaluate monitoring routines demonstrating the need for the development of feasible strategies to provide the evidence for monitoring routines.

Points for discussion:

Which methods might be considered valuate to evaluate monitoring routines?

Are there new digital data collection methods that could support the evaluation?

Which monitoring routines should be prioritized for evaluation?

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