Digital health interventions for postoperative recovery in children: a systematic review

Background: Digital health interventions offer a promising approach for monitoring during postoperative recovery. However, the effectiveness of these interventions remains poorly understood, particularly in children. The objective of this study was to assess the efficacy of digital health interventions for postoperative recovery in children. Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines, with the use of automation tools for searching and screening. We searched five electronic databases for randomised controlled trials or non-randomised studies of interventions that utilised digital health interventions to monitor postoperative recovery in children. The study quality was assessed using Cochrane Collaboration's Risk of Bias tools. The systematic review protocol was prospectively registered with PROSPERO (CRD42022351492). Results: The review included 16 studies involving 2728 participants from six countries. Tonsillectomy was the most common surgery and smartphone apps (WeChat) were the most commonly used digital health interventions. Digital health interventions resulted in significant improvements in parental knowledge about the child's condition and satisfaction regarding perioperative instructions (standard mean difference=2.16, = 2.16, 95% confidence interval 1.45-2.87; z=5.98, = 5.98, P<0.001; < 0.001; I2=88%). 2 = 88%). However, there was no significant effect on children's pain intensity (standard mean difference=0.09, = 0.09, 95% confidence interval-0.95 to 1.12; z=0.16, = 0.16, P=0.87; = 0.87; I-2=98%). 2 = 98%). Conclusions: Digital health interventions hold promise for improving parental postoperative knowledge and satisfaction. However, more research is needed for child-centric interventions with validated outcome measures. Future work should focus development and testing of user-friendly digital apps and wearables to ease the healthcare burden and improve outcomes for children.