Review question
Can digital technology identify chest infections in people with cystic fibrosis (CF) earlier than with standard care and how does this affect clinical outcomes?
What is cystic fibrosis?
CF is a life-limiting condition affecting several body organs, especially the lungs. Chest infections can worsen the damage in the lungs of people with CF. Identifying chest infections early and treating them quickly is very important. Digital technology, such as smartphone applications (apps) and devices to measure breathing to track symptoms may allow us to identify chest infections earlier in people with CF and start treatment with antibiotics quicker.
What did we want to find out?
We want to know if early identification of chest infections can help slow down how quickly the condition of the lungs worsens.
What did we do?
We searched medical databases for well-designed clinical trials in people with CF. People taking part in the studies had the same chance of being in either the treatment group (who used the digital technology) or the usual care group.
What did we find?
We found three studies with 415 people with CF aged 15 to 41 years. All the treatment groups used a technology to track their breathing problems, two studies also asked their treatment groups to do regular breathing tests with special devices. All studies followed people in their groups for one year.
Key results
The studies that asked people to do regular breathing tests with special devices and track breathing problems were able to identify chest infections earlier than people in the usual care groups. However, at the end of the study, their breathing tests were similar to the groups that did not use digital technology.
There were few differences between the groups when we looked at how they felt in their day-to-day life (quality of life), the number of hospital visits or costs. People who took part in the studies did not have any serious issues or problems that arose because of the digital technology they were using, but people were generally not very good at providing data regularly, and did find it quite a burden.
What are the limitations of the evidence?
We can only be moderately sure of these results from the studies we found. In all the studies, the people who took part will have known whether they were in the digital intervention group or the standard care group. This may have affected how they behaved, and what they thought of their breathing problems. In two studies, the teams running the study would have also known which group the person belonged to. This might have affected their choice on whether to start antibiotics, and whether to give the antibiotics by drip into a vein in hospital, or if they could take them as tablets or liquid medicine at home. Two studies did not recruit enough people, so we are less certain about how trustworthy those results are.
Some types of digital technology can detect chest infections sooner. However, when compared to relying on usual care, technology does not seem to change the rate at which the lungs in people with CF worsen over time.
Search date
The evidence is current to 13 October 2022.
