Abstract P311: Revisiting unattended vs attended automated office blood pressure measurements: A systematic review and meta-analysis
Bibliographic record
Abstract
Background: Standardized automated office blood pressure (AOBP) measurement is now widely accepted as the preferred method for monitoring blood pressure (BP). However, disagreements persist amongst expert societies as to the need to perform AOBP in an unattended manner, where the patient is left alone in a quiet room. In 2019, two meta-analyses aiming to quantify the differences between unattended and attended BP showed opposite results. prompting the publication of several more studies on this subject. Our objective was thus to reassess the BP differences between unattended and attended AOBP when performed with the same device and an identical measurement protocol. Methods: This systematic review with meta-analysis was conducted according to the PRISMA guidelines and is registered on PROSPERO. Studies were included if both unattended and attended AOBP were measured on the same participants in a randomized or alternating sequence manner during a single visit with the same device and an identical measurement protocol apart from attendance status. Four databases were searched (Embase, Medline, Web of Science, Google Scholar). The primary outcome was the difference between unattended and attended systolic (SBP) and diastolic (DBP) BP, expressed as weighted mean differences (95% confidence interval) using random-effects models. Results: From 8,088 screened studies, data was extracted from 15 studies which met the inclusion criteria (n=1,747 participants). In the pooled analysis, the attended compared with unattended BP was higher for SBP by 2.7 mmHg (95%CI 0.6 to 4.7) and DBP by 0.9 mmHg (95%CI 0.1 to 1.8). In leave-one out analyses, results were similar except when excluding the study with the most extreme BP difference (Chotruangnapa 2023) where the difference became non-significant. Conclusion: Standardized attended AOBP measurements result in slightly higher readings than unattended AOBP. Whether such small differences translate into clinically significant changes in management of BP remains uncertain. Therefore, standardized attended AOBP could be viewed as a reasonable option for BP measurement in a real-life clinical setting.
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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 | 0.029 | 0.074 |
| Meta-epidemiology (narrow) | 0.004 | 0.002 |
| Meta-epidemiology (broad) | 0.023 | 0.036 |
| Bibliometrics | 0.009 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.005 | 0.003 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
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".