Methods
For this scoping review, a systematic search of scientific literature
was executed.
Information sources and
search strategy
First, an explorative Cochrane search was performed on July 13, 2023 to
identify any existing reviews on noncontact respiration monitoring
methods in children. To this extent, the keywords “child*”
“monitor*” and “breath*” were used for a search in titles, abstracts
and keywords. No reviews focusing on noncontact respiration monitoring
methods in children were found.
Next, a systematic literature search in PubMed and EMBASE was performed
July 13, 2023. The search strings (E-text 1 and 2) included the same
terms as the Cochrane search, supplemented with similar terms and
synonyms. Terms regarding unobtrusiveness were also included. In this
process, a librarian specialized in medical sciences was consulted.
Inclusion and exclusion
criteria
For this review, ‘contactless’ also encompassed sensors embedded in
natural sleeping attributes, such as mattresses and pajamas. Studies had
to at least measure apneas and/or hypopneas or RR. Furthermore, studies
had to include, but were not restricted to, children who were
<12 years of age. Studies were excluded if obtrusive, contact,
prediction or indirect methods were used, if subjects were premature
infants, and if subjects were nonhuman. Reviews, conference abstracts,
questionnaires and commentaries were also excluded. Lastly, only
full-text articles written in English were eligible for inclusion.
Study selection
Following the search, EndNote10 (Clarivate Analytics,
London, UK) was used to remove duplicates, after which the remaining
studies were uploaded into Rayyan11 (Rayyan Systems,
Inc., Cambridge, MA). Study relevance was assessed by title and abstract
screening, after which full-text articles were read to determine
eligibility based on the inclusion and exclusion criteria. This was done
independently by two reviewers (ML and RG), and any disagreements were
discussed until consensus was reached. If no consensus was reached,
disagreements were resolved by discussing them with a third reviewer
(JD). This, however, did not occur. Finally, the reference lists as well
as the citations of all included papers were checked to identify
additional eligible studies.
Data extraction and
synthesis
Outcome data that was aimed to extract from the studies included data on
the accuracy, safety, and reliability of the proposed methods. The
results were summarized in a narrative synthesis.
Quality assessment
The quality of the included studies was assessed using the Quality
Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2)
tool12. The QUADAS-2 tool allows analysis of the risk
of bias and applicability specific to diagnostic accuracy reviews. Four
domains were included: patient selection, index test, reference
standard, and flow and timing. The risk of bias and applicability
concerns were reported as low, high or unclear. The tool was adapted to
fit the purposes of this review. The number of study participants was
taken into consideration in the quality assessment. If less than ten
study participants were included, the risk of bias caused by patient
selection was assessed to be high. A risk of bias was assessed to be
unclear if the researchers did not provide enough information to
evaluate the risk. If no reference standard was used, both the risk of
bias of the reference standard and of the flow and timing were assessed
to be high risk.