{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:07:21Z","timestamp":1777936041003,"version":"3.51.4"},"reference-count":30,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T00:00:00Z","timestamp":1743120000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Telemed Telecare"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Heart failure (HF) patients are frequently rehospitalized shortly after discharge. Telemonitoring and clinical decision support systems (CDSS) health alert follow-up may reduce the mortality and hospitalization in HF patients following discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) from PubMed, Web of Science, Scopus, Embase, and Cochrane Central Register of Controlled Trial until May 2024. Dichotomous data were pooled using risk ratio (RR) and continuous data using mean difference. This systematic review and meta-analysis was registered with PROSPERO ID: CRD42024555577.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We included eight RCTs with a total of 7661 patients. Patients managed by CDSS were at lower risk of all-cause mortality than those who received usual care [RR: 0.64 with 95% confidence interval [CI] (0.45, 0.92),\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.01]. However, there was no difference in all-cause hospitalization [RR: 0.99 with 95% CI (0.88, 1.11),\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.84] between both groups. Additionally, CDSS led to a significant increase in mineralocorticoid antagonist (MRA) prescription compared to usual care [RR: 1.77 with 95% CI (1.48, 2.11),\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.00001], but there was no difference in addition of all-class guideline-directed medical therapy (GDMT) [RR: 1.23 with 95% CI (1.00, 1.52),\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.05] between the both groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Clinical decision support systems significantly reduced all-cause mortality and increased MRA prescription. Still, there was no difference in all-cause hospitalization and the addition of all-class GDMT. More robust studies with longer follow-ups are therefore required to thoroughly examine the efficacy of CDSS in optimizing HF management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1357633x251323489","type":"journal-article","created":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T17:47:17Z","timestamp":1743184037000},"page":"85-100","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical decision support systems for heart failure management optimization: A systematic review and meta-analysis of randomized controlled trials"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3216-6323","authenticated-orcid":false,"given":"Ubaid","family":"Khan","sequence":"first","affiliation":[{"name":"Division of Cardiology, University of Maryland School of Medicine, Baltimore, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed Mazen","family":"Amin","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Mansoura University, Mansoura, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yehya","family":"Khlidj","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Algiers University, Algiers, Algeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7674-4436","authenticated-orcid":false,"given":"Zuhair","family":"Majeed","sequence":"additional","affiliation":[{"name":"King Edward Medical University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9772-2365","authenticated-orcid":false,"given":"Mohammed","family":"Ayyad","sequence":"additional","affiliation":[{"name":"Rutgers New Jersey Medical School"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali Saad","family":"Al-shammari","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Baghdad, Baghdad, \rIraq"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad","family":"Imran","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University College of Medicine and Dentistry, The University of Lahore, Lahore, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3534-4826","authenticated-orcid":false,"given":"Junaid","family":"Ali","sequence":"additional","affiliation":[{"name":"Saint Peter's University Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2514-0689","authenticated-orcid":false,"given":"Mohamed","family":"Abuelazm","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Tanta University, Tanta, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,3,28]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/cvac013"},{"key":"e_1_3_2_3_2","doi-asserted-by":"crossref","unstructured":"Bozkurt B Ahmad T Alexander K et al. 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