Remote monitoring evidence and gap map: instructions for use & practice exercises

How to read the evidence and gap map (EGM):

Map view

The map can be viewed in your browser. We suggest using a computer or tablet to view the map as it is not currently optimised for use on mobile phones.

At the top of the browser, there is a tool bar with several options: to view Filters, Hide Headers, view the map in Fullscreen mode, read information About the map, and View Records. These elements can be selected and either provide additional information or change how you view the information in the map.

In the map itself, it is possible to scroll through the Header columns (OUTCOMES) and rows (INTERVENTIONS) to view all categories. You can also expand or minimise categories for each column and row (to view sub-categories). To do this, use the arrows << >> (only visible when ‘Hide Headers’ option has not been chosen).

Matrix

The rows in the map are intervention categories, while the columns indicate outcome categories. The cells in the table contain tiles – the number of these tiles indicates the number of reviews reporting that combination of intervention and outcome.

There are different colour tiles to indicate the overall quality of the included reviews, which has been assessed using the AMSTAR-2 tool. The map has been prepared to be colour-blind friendly. Dark green tiles indicate HIGH confidence in research quality, blue indicates MODERATE confidence, yellow LOW confidence, and pink CRITICALLY LOW confidence. A key can be seen in the bottom left corner of the map. PLEASE NOTE that lower quality/confidence systematic reviews may contain high quality research studies about remote monitoring.

Cells

There are four different styles available to display information in the cells of the map: bubble, heat, donut and mosaic. Mosaic is the default option and can be changed by clicking -> Filters (top left of map), and selecting your preferred Style.

Clicking on a cell provides a list of reviews which report on the intervention and outcome for that cell. Clicking on a review in the list leads to information on the review including the abstract, relevant summaries, and a link to view the original source, with access the full review where possible. There are options at the top of this list to ‘Group by segment’ which orders the reviews according to quality, and ‘Sort by title/author/date’.

Filters

The map includes a set of filters, including type of synthesis and patient population. Selecting a filter means the map will only display reviews containing evidence on the selected filter. To use this tool, click -> Filters on the top-left of the map, then select the category of interest. Once your chosen filters have been selected, click -> Update.

To search the included reviews using a specific keyword or topic, click ->View Records, and enter a search term, for example ‘heart failure’ into the top toolbar. This will display reviews with this keyword. You can choose to order by All, Title, Abstract or Author.

General use

This evidence and gap map shows recent available evidence on the effectiveness, acceptability, and implementation of remote monitoring for long-term physical health conditions. It also identifies ‘gaps’ or areas where no recent evidence has been identified – where cells do not have any bubbles, this indicates that no evidence was identified for these interventions/outcomes. It is important to note that while this EGM aims to show what evidence is available, is does not comment on what the evidence says.

Exercises to familiarise yourself with the map:

First experiment with options for viewing the map. Try using the buttons on the top tool bar. ‘Filters’ will display filtering options; ‘Hide headers’ hides the title and provides more space to navigate the map; ‘Fullscreen’ provides a larger view of the map; ‘About’ links to contextual information about the map; ‘View Records’ shows you all the systematic reviews included in the map.

Exercises:

  1. Use the View Records button (top right of screen) to identify how many reviews are included in the map.
  2. Use the map to find out what recent research has been identified on Remote Monitoring INTERVENTIONS including Symptom tracking with OUTCOMES that are indicators of Adherence/compliance with intervention.
    1. How many in total?
    2. How many with low risk of bias? [Hint: select ‘group by’ segment when viewing records for the cell]
  3. Use the Filters (top left of screen) to find out how many reviews using Meta-analysis with a Low Risk of Bias are included in this map. [Hint, once you have filtered the map to by Type of synthesis and Quality assessment, click ‘View Records’ (top right) to see all reviews].
    1. How many?
  4. Clear all Filters. Use the map to identify one area related to remote monitoring INTERVENTIONS that are Automatic for which no OUTCOMES are reported in the current map. [Hint, look for empty squares]
    1. Name of ‘gap’?
  5. You are only interested in the OUTCOMES of remote monitoring INTERVENTIONS for populations with kidney disease. How can you Filter the map to make sure you look at a map of recent research with this population?
    1. How many reviews (use View Records tab) are now visible on the map?
  6. You are only interested in evidence from 2021. How can you FILTER the map to make sure you look at a map of reviews from 2021 only?
    1. How many reviews (use View Records tab) are now visible on the map?