The evolution of digital health technologies in cardiovascular disease research

Abstract

When implemented in practice, digital technologies have shown improvements in morbidity and mortality outcomes in patients with cardiovascular disease (CVD). For scholars, research into digital technologies in cardiovascular care has been relatively recent, thus it is important to understand the history of digital health technology in cardiovascular research-its emergence, rate of growth, hot topics, and its temporal evolution. The aim of this study was to analyse more than 16,000 articles in this domain based on their scientometric indicators. Web of Science (WoS) Core Collection was accessed and searched at several levels, including titles, abstracts, keywords, authors, sources and individual articles. Analysis examined the temporal shifts in research and scholarly focus based on keywords, networks of collaboration, topical divisions in relation to digital technologies, and influential publications. Findings showed this research area is growing exponentially. Co-citation analysis revealed twenty prominent research streams and identified variation in the magnitude of activities in each stream. A recent emergence of research activities in digital technology in cardiovascular rehabilitation (CR), out-of-hospital cardiac arrest (OHCA), and arrythmia research was also demonstrated. Conversely, wearable technologies, activity tracking and electronic medical records research are now past their peak of reported research activity. With increasing amounts of novel technologies becoming available and more patients taking part in remote health care monitoring, further evaluation and research into digital technologies, including their long-term effectiveness, is needed. Furthermore, emerging technologies, which are evaluated and/or validated should be considered for implementation into clinical practice as treatment and prevention modalities for CVD.

Fig. 1. Years of publication and major sources.

a Distribution of digital technology research articles (in cardiovascular medicine) from 1961 to 2021; b Major journals within the topic of digital technology applications in cardiovascular medicine.

Fig. 2. Patterns of scholarly collaborations between countries.

The strength of collaborations between researchers from different countries, defined by number of documents, is indicated by the width of the link.

Fig. 3. Network-view map of term co-occurrence in titles and abstracts of articles within digital health technologies in cardiovascular medicine.

Bottom left: map of average publication year; Bottom right: map of average number of citations. An interactive online map is available here: https://app.vosviewer.com/?json=https://drive.google.com/uc?id=1wo3ylYehGisHVX0CLM49voNitTjKsYOW.

Fig. 4. Clusters of author collaboration by total link strength.

Co-authorship link strength is used to provide an indication of how many publications two researchers have co-authored. Interactive map available here: https://app.vosviewer.com/?json=https://drive.google.com/uc?id=129YuMxn-9sn-ht5mCd88-ADpbh6nX0v5.

Fig. 5. Birds-eye view of the research areas that digital technologies have been applied in cardiovascular medicine.

A dynamic visualisation of the interplay between the research areas (from 1990 to 2021) is accessible via this link Temporal map_digital health_CVD.mp4.

Fig. 6. Number of citations (orange datapoints) and number of citing articles (blue datapoints) for each cluster.

Left axis: total number of citations; Right axis: total number of citing articles. Note: scale is different for each cluster.