Critically appraised paper: Home-based versus centre-based cardiac rehabilitation have similar outcomes [synopsis]

Objective: To review the evidence of whether home-based and centrebased cardiac rehabilitation have similar outcomes in patients with heart disease. Data sources: Cochrane Central Register of Controlled Trials, MEDLINE, Embase, PsycINFO and CINAHL, searched up to September 2016. This search was supplemented by searching of trials registers and citation tracking. Study selection: Randomised controlled trials involving patients with recent myocardial infarction, revascularisation or heart failure, in which home-based and centre-based cardiac rehabilitation were compared. Outcome measures were mortality, cardiac events, exercise capacity, health-related quality of life, program completion, modifiable cardiac risk factors, adherence and cost. Data extraction: Two reviewers extracted data, and discrepancies were resolved by discussion. Methodological quality was assessed using the Cochrane Risk of Bias tool. Data synthesis: Of 10 482 studies initially identified by the search, 23with a total of 2890 patients were included in the review. A number of trials provided insufficient detail to assess methodological quality, contributing to a lowto-moderate level of evidence overall. The majority of home-based programs used walking with phone support, while centre-based programs typically incorporated supervised cycle and treadmill exercise. Based on the