Effectiveness, Efficacy, and Safety of Home-Based Cardiac Rehabilitation Following Valve Replacement or Repair: Protocol for a Systematic Review (Preprint)
Notice bibliographique
Résumé
BACKGROUND: Cardiac rehabilitation (CR) is recommended following valve replacement or repair procedures (VRPs), yet participation remains suboptimal among patients undergoing VRPs. Home-based CR (HBCR), including both fully digital and hybrid (mix of HBCR and center-based CR [CBCR]) models, may improve access and uptake. Although prior systematic reviews have examined HBCR in general populations receiving CR, none have specifically considered HBCR among patients who have undergone VRPs-an expanding but under-studied group with distinct rehabilitation needs. OBJECTIVE: We aim to perform a systematic review that will evaluate the effectiveness, efficacy, and safety of HBCR compared with CBCR and usual care or no CR in adults following VRPs. METHODS: This systematic review protocol follows guidance from the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols) 2015 statement. We will conduct a systematic search in bibliographic databases (MEDLINE, Embase, CENTRAL, CINAHL, and core databases of Web of Science) and ClinicalTrials.gov. Eligible study designs include randomized and nonrandomized controlled trials, controlled observational studies, and single-group cohort or intervention studies. Primary outcomes are major adverse cardiac events, all-cause mortality, and health system resource use. Secondary outcomes are program adherence, quality of life, and patient satisfaction. Two reviewers will independently screen studies for eligibility. One reviewer will perform data extraction using a predefined template, and a second reviewer will independently verify all extracted data for accuracy and completeness. Risk of bias will be assessed using version 2 of the Cochrane risk-of-bias tool for randomized trials, the Risk of Bias in Nonrandomized Studies of Interventions tool, and the National Institutes of Health quality assessment tool for before-and-after (pretest-posttest) studies with no control group. The certainty of evidence will be evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool. Where appropriate, findings will be synthesized narratively and through meta-analysis. RESULTS: The review formally began in May 2025 and will be conducted and reported according to the protocol; any changes to this protocol will be documented, updated in the PROSPERO registration, and reported alongside the review findings. As of August 2025, the search identified 398 records, of which 156 (39.2%) were assessed for eligibility, and 21 (5.3%) studies met the inclusion criteria and were retained for data extraction. The results of the review are expected to be published in the first quarter of 2027. CONCLUSIONS: The review aims to focus on clinical-, patient-, and system-important outcomes, which, as a secondary objective, will provide input parameters for planned economic modeling. The findings of this systematic review will inform both practice and policy and provide a foundation for health system-level feasibility assessment, economic modeling, and policy planning related to HBCR in this population. TRIAL REGISTRATION: PROSPERO CRD420251066703; https://www.crd.york.ac.uk/PROSPERO/view/CRD420251066703. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/86832.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,049 | 0,106 |
| Méta-épidémiologie (sens strict) | 0,005 | 0,006 |
| Méta-épidémiologie (sens large) | 0,016 | 0,021 |
| Bibliométrie | 0,006 | 0,006 |
| Études des sciences et des technologies | 0,004 | 0,004 |
| Communication savante | 0,007 | 0,005 |
| Science ouverte | 0,003 | 0,004 |
| Intégrité de la recherche | 0,007 | 0,008 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,074 | 0,007 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».