Technology-based comprehensive cardiac rehabilitation therapy for women in a middle-income setting: a randomized controlled trial
Bibliographic record
Abstract
AIMS: Women are under-represented in cardiac rehabilitation (CR), especially in lower-income settings. This study tested Technology-bAsed Cardiac rehabilitation Therapy (TaCT) on functional capacity, risk factors, quality of life (QoL; MacNew), heart-health behaviours (e.g. Global Physical Activity Questionnaire), cardiac symptoms (e.g. angina), and morbidity (e.g. hospitalization and procedure) in women. METHODS AND RESULTS: Single-centre, single-blind, two parallel arms (1:1 SNOSE) randomized superiority trial, undertaken in an Indian outpatient cardiology department, where women with stable cardiac disease and smartphone access were recruited. TaCT was compared with standard care (CR rare), with assessments conducted before the intervention, and 6 months later. The 6-month comprehensive intervention was delivered via several technologies. Exercise prescriptions were based on an Incremental Shuttle Walk Test (ISWT; primary outcome). Analyses were based on intention-to-treat. Fifty women were randomized to intervention, and 50 to control (n = 89; 89.0% retained). There were few tobacco users. Results for the following outcomes favoured intervention: functional capacity [ISWT effect size = 0.3 (95% confidence interval = 1.0 to -0.2), P = 0.002; Duke Activity Status Index P < 0.001; Sit-to-Stand P = 0.003], QoL (global and all subscale P's < 0.001), and heart-health behaviours (exercise P < 0.001; medication adherence P = 0.02), and anxiety (P = 0.002). There were no significant differences in blood pressure, waist circumference, or cardiac symptoms. Three participants in the intervention group experienced morbidity and 1 suffered mortality and 9 in controls experienced morbidity only. CONCLUSION: The TaCT program significantly improved functional capacity, QoL, heart-health behaviours and anxiety in women with cardiovascular disease in a middle-income country, demonstrating the potential of technology-based CR tailored for women in these settings. REGISTRATION: CTRI/2021/07/035197 URL: https://ctri.nic.in/Clinicaltrials/rmaindet.php?trialid=51810&EncHid=79231.15408&modid=1&compid=19.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.004 | 0.002 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".