Variation in Interpretation of 24-Hour Ambulatory Blood Pressure Monitoring (ABPM) in Children with Confirmed or Suspected Hypertension (HTN) by Canadian Pediatric Nephrologists and Cardiologists
Bibliographic record
Abstract
Background: ABPM is more accurate compared to a single office-based blood pressure (BP) measurement. However, it is unclear how physicians interpret ABPM and make management choices, especially where evidence supporting recommendations is limited. This survey's goal is to study ABPM interpretation variation by HTN category and disease among pediatric nephrologists and cardiologists. Methods: Survey content included physician demographics, ABPM indications, interpretation, and management. The same questions were asked of all respondents, except kidney-related conditions which were only shown to nephrologists. Results: The survey was sent to 196 physicians, with 69 (35.2%) responses. Most respondents were age 45+, in practice for 11+ years and university-based. Table shows significant differences in ABPM interpretation for BP load, isolated systolic and diastolic HTN, and between nephrologists and cardiologists for different conditions (not all data included in abstract table). Rates of HTN treatment are lower than guidelines recommendations. Conclusions: There is significant practice variation among physicians in ABPM interpretation and management. Gaps in guidelines create ambiguity regarding management decisions for different ABPM parameters. A more protocolized approach may help to standardize practice.Initiation or alteration of antihypertensive treatment with respective ABPM parameters in various conditions
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.030 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".