Interrogating the promise of technology in epilepsy care: systematic, hermeneutic review.

Papoutsi, Chrysanthi; Collins, Christian D E; Christopher, Alexandra; Shaw, Sara E; Greenhalgh, Trisha

Technology development is gathering pace in epilepsy with seizure detection devices promising to transform self-care and service provision. However, such accounts often neglect the uncertainties, displacements and responsibilities that technology-supported care generates. This review brings together a heterogeneous literature, identified through systematic searches in 8 databases and snowball searching, to interrogate how technology becomes positioned in epilepsy care. We took a hermeneutic approach in our analysis of the 206 included articles, which resulted in the development of a conceptual framework surfacing the underlying logics by which technology-supported epilepsy care is organised. Each of these logics enacts different techno-scientific futures and carries specific assumptions about how (often imagined) 'users' and their bodies become co-constituted. Our review shows that studies in this area remain primarily deterministic and technology-focused. Few draw phenomenological insights on lived experiences with epilepsy or use social theory to problematise the role of technology. We propose future directions for sociotechnical, theory-driven studies of technology in epilepsy care and offer a framework transferable across other long-term conditions.