Table 4.
Outcomes measured across included studies.
| Primary outcome | Author | Study design | Procedures | Patient number | Length of intervention | Main finding |
|---|---|---|---|---|---|---|
| Postoperative pain management | Campbell et al., 2019 | RCT | Hip or knee replacement | 159 | 42 days | Stopped taking narcotics 10 days sooner (P < 0.001) |
| Postoperative pain management | Hou et al., 2019 | RCT | Lumbar spinal surgery | 168 | 90 days | No difference in pain scores |
| Postoperative pain management | Khanwalkar et al., 2018 | Prospective | Sinus surgery | 288 | 14 days | Similar analgesic requirements across all included procedures |
| Postoperative pain management | Anthony et al., 2018 | Prospective | Hand surgery | 47 | 7 days | Pain trended down sequentially over the first week |
| Postoperative complications | Scheper et al., 2019 | Prospective | Joint arthroplasty | 69 | 30 days | 80% patient-reported complications concorded with physician diagnosis. |
| Postoperative complications | Pozza et al., 2018 | Prospective | Cosmetic surgery | 57 | 7 days | All three complications were detected earlier in the postoperative period |
| Postoperative complications | Sosa et al., 2017 | Prospective | Head and neck cancer resection | 23 | 7 days | Patients with postoperative complications are more likely to use a platform (P < 0.001) |
| Postoperative complications | Carrier et al., 2016 | Prospective | Major colorectal resections | 111 | 7 days | Alerts led to early, timely detection of postoperative complications |
| Postoperative complications | Palombo et al., 2009 | Prospective | Carotid endarterectomy | 36 | 2 days | The intervention allowed safe early discharge in selected patients |
| Postoperative symptom monitoring | Graetz et al., 2018 | RCT | Gynaecological cancer surgery | 29 (pilot) | 30 days | Feasible and acceptable to the patient population. Reminders increased use of a mobile application. |
| Postoperative symptom monitoring | Dabbs et al., 2016 | RCT | Lung transplant | 201 | 12 months | Self-monitoring increased with app use, with patients more likely to report critical indicators (OR 5.11; P < 0.001) |
| Postoperative recovery | Gräfitsch et al., 2020 | Prospective | Abdominal wall hernia repair | 16 | 30 days | 60% of patients regained preoperative activity levels within 3 weeks |
| Postoperative recovery | Panda et al., 2019 | Prospective | Cancer surgery | 62 | 6 weeks | Patients with postoperative complications showed lower activity and ability to achieve 60 min of exertional activity |
| Postoperative recovery | Campbell et al., 2019 | RCT | Hip or knee replacement | 159 | 42 days | Patients in the intervention group exercised for longer (8.6 min per day; P < 0.001) |
| Postoperative recovery | Hou et al., 2019 | RCT | Lumbar spinal surgery | 168 | 90 days | Disability improved in mHealth group |
| Postoperative recovery | Carmichael et al., 2019 | Prospective | Inguinal hernia (most common), abdominal and thoracic procedures | 175 | 30 days | Recovery trajectories have the potential to predict postoperative complications up to 3 days before readmission |
| Postoperative recovery | Thijs et al., 2019 | Prospective | CABG | 22 | 14 days | Higher physical activity has seen following minimally invasive procedures |
| Postoperative recovery | Cole et al., 2019 | Prospective | Transsphenoidal surgery | 7 | Up to 13 days (average 8 days) | Step count fell by 45% following surgery |
| Postoperative recovery | van der Meij et al., 2018 | RCT | Laparoscopic abdominal procedures | 344 | 6 months | Five-day reduction in return to normal activities (21 days vs. 26 days; P = 0.007) |
| Postoperative recovery | Ghomrawi et al., 2018 | Prospective | Range of elective paediatric surgical procedures | 60 | 14 days | Different activity curves demonstrated for patients undergoing in-patient and out-patient procedures |
| Postoperative recovery | Agarwal et al., 2018 | Prospective | Robotic laparoscopic prostatectomy | 46 | Up to 15 days | Greatest reduction in postoperative step count seen in obese and men aged >65 years old |
| Postoperative recovery | Jaensson et al., 2017 | RCT | Predominantly orthopaedic and general cases | 997 | 14 days | Improved recovery in several symptom domains |
| Postoperative recovery | Park et al., 2017 | RCT | Total knee replacement | 40 | 90 days | SMS messages achieved similar postoperative recovery compared to routine care |
| Postoperative recovery | Chiang et al., 2017 | Prospective | Total knee replacement | 18 | 6 weeks | Postoperative range of motion improved if haemostatic agent used intra-operatively |
| Postoperative recovery | Sun et al., 2017 | Prospective | Major gastrointestinal resection | 20 | 14 days | Median step count at day 7 correlated with the Comprehensive Complication Index (CCI) |
| Postoperative recovery | Abraham et al., 2017 | Prospective | Breast reconstruction | 4 | 28 days | Variance in total sleep duration is a potential marker of recovery |
| Postoperative recovery | Toogood et al., 2016 | Prospective | Total hip arthroplasty | 33 | 30 days | Activity increased in a step-wise fashion post-discharge. Age and operative approach were associated with postoperative activity |
| Postoperative recovery | Debono et al., 2016 | Prospective | Lumbar discectomy | 60 | 16 days | Deviations in expected postoperative recovery were identified early, reducing emergency department admissions |
| Postoperative recovery | Mobbs et al., 2016 | Prospective | Lumbar spine surgery | 30 | 90 days | Daily mean step count and distance had improved at follow-up |
| Postoperative recovery | Dawes et al., 2015 | Prospective | Any colorectal procedure | 20 | 14 days | Patients felt more aware of the recovery process and connected with their surgical team |
| Surgical site infection | Mousa et al., 2019 | RCT | Infra-inguinal procedures | 30 | 30 days | No difference in 30-day surgical site infection rates |
| Surgical site infection | Gunter et al., 2018 | Prospective | Lower limb vascular surgery | 40 | 14 days | Surgical site infection correctly identified in 87% of cases |
| Surgical site infection | Castillo et al., 2017 | Prospective | C-section | 105 | 30 days | One surgical site infection identified through intervention |
| Surgical site infection | Semple et al., 2015 | Prospective | Breast reconstruction and ACL repair | 65 | 30 days | All wound complications were correctly identified |
| Surgical site infection | Martinez-Ramos et al., 2009 | Prospective | Range of ambulatory procedures | 96 | 14 days | Two-thirds of patients had their wound concerns successfully resolved without need for hospital review |
| Surgical site infection | Perez et al., 2006 | Prospective | Predominantly orthopaedic procedures | 49 | Not stated | Images modified original treatment plans and avoided emergency department attendance for 88% |
| Follow-up requirements | Mousa et al., 2019 | RCT | Infra-inguinal procedures | 30 | 30 days | No difference in 30-day readmission rates |
| Follow-up requirements | Felbaum et al., 2018 | Prospective | Spinal surgery | 56 | 30 days | Mobile application reduced hospital visits |
| Follow-up requirements | Armstrong et al., 2017 | RCT | Breast reconstruction | 65 | 30 days | Fewer in-person follow-up care visits in mHealth group (0.4; P < 0.001) |
| Follow-up requirements | Higgins et al., 2017 | Prospective | ACL reconstruction | 32 | 6 weeks | Intervention reduced the need for routine follow-up |
| Follow-up requirements | McElroy et al., 2016 | Prospective | Cardiac surgery | 27 | 30 days | Readmissions similar between intervention and control groups |
| Weight loss | Mangieri et al., 2019 | RCT | Laparoscopic sleeve gastrectomy | 56 | 24 months | Application aided longer-term weight loss at 12 months post-surgery |
| Weight loss | Tenhagen et al., 2016 | Prospective | Gastric sleeve or bypass | 14 | 1 year | Excess weight loss >40% in all patients |
| Feasibility | Jonker et al., 2021 | Prospective | Oncological procedures | 47 | 90 days | Older patients (≥65 years old) can successfully perform home monitoring using DHIs, with good usability and acceptability |
| Feasibility | Argent et al., 2019 | Prospective | Total knee replacement | 15 | 14 days | Biofeedback system improved rehabilitation experience for patients |
| Feasibility | Scott et al., 2017 | Prospective | Colorectal surgery | 20 | 14 days | Low use of mobile application associated with inappropriate emergency department presentation in 63% of cases |
| Feasibility | Symer et al., 2017 | Prospective | Open and laparoscopic abdominal surgery | 31 | 30 days | Patients generated an average of 1.1 alerts, but 50% of patients struggled to upload photographs |