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Clinical Evidence for High-risk Medical Devices Used to Manage Diabetes: Protocol for a Systematic Review and Meta-analysis

Overview
Journal BMJ Open
Specialty General Medicine
Date 2023 Apr 11
PMID 37041065
Authors
Affiliations
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Abstract

Introduction: Medical devices, including high-risk medical devices, have greatly contributed to recent improvements in the management of diabetes. However, the clinical evidence that is submitted for regulatory approval is not transparent, and thus a comprehensive summary of the evidence for high-risk devices approved for managing diabetes in Europe is lacking. In the framework of the Coordinating Research and Evidence for Medical Devices group, we will, therefore, perform a systematic review and meta-analysis, which will evaluate the efficacy, safety and usability of high-risk medical devices for the management of diabetes.

Method And Analysis: This study has been reported according to the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. We will search Embase (Elsevier), Medline All (Ovid), Cochrane Library (Wiley), Science Citation Index Expanded and Emerging Sources Citation Index (Web of Science) to identify interventional and observational studies that evaluate the efficacy and/or safety and/or usability of high-risk medical devices for the management of diabetes. No language or publication dates' limits will be applied. Animal studies will be excluded. In accordance with the Medical Device Regulation in European Union, high-risk medical devices are those in classes IIb and III. The following medical devices for diabetes management are considered as having a high risk: implantable continuous glucose monitoring systems, implantable pumps and automated insulin delivery devices. Selection of studies, data extraction and quality of evidence assessment will be performed independently by two researchers. Sensitivity analysis will be performed to identify and explain potential heterogeneity.

Ethics And Dissemination: No ethical approval is needed for this systematic review, as it is based in already published data. Our findings will be published in a peer-reviewed journal.

Prospero Registration Number: CRD42022366871.

References
1.
Weissberg-Benchell J, Shapiro J, Hood K, Laffel L, Naranjo D, Miller K . Assessing patient-reported outcomes for automated insulin delivery systems: the psychometric properties of the INSPIRE measures. Diabet Med. 2019; 36(5):644-652. PMC: 6593869. DOI: 10.1111/dme.13930. View

2.
Atkins D, Eccles M, Flottorp S, Guyatt G, Henry D, Hill S . Systems for grading the quality of evidence and the strength of recommendations I: critical appraisal of existing approaches The GRADE Working Group. BMC Health Serv Res. 2004; 4(1):38. PMC: 545647. DOI: 10.1186/1472-6963-4-38. View

3.
Fraser A, Nelissen R, Kjaersgaard-Andersen P, Szymanski P, Melvin T, Piscoi P . Improved clinical investigation and evaluation of high-risk medical devices: the rationale and objectives of CORE-MD (Coordinating Research and Evidence for Medical Devices). Eur Heart J Qual Care Clin Outcomes. 2021; 8(3):249-258. PMC: 9071523. DOI: 10.1093/ehjqcco/qcab059. View

4.
Sterne J, Hernan M, Reeves B, Savovic J, Berkman N, Viswanathan M . ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016; 355:i4919. PMC: 5062054. DOI: 10.1136/bmj.i4919. View

5.
Sims E, Carr A, Oram R, DiMeglio L, Evans-Molina C . 100 years of insulin: celebrating the past, present and future of diabetes therapy. Nat Med. 2021; 27(7):1154-1164. PMC: 8802620. DOI: 10.1038/s41591-021-01418-2. View