Effect of a digital health intervention on outpatients with heart failure: a randomized, controlled trial
Bibliographic record
Abstract
Abstract Aims Heart failure (HF) is associated with high mortality and reduced quality of life (QoL). Interventions encouraging a healthy lifestyle and self-care can reduce morbidity and HF-related hospitalizations. We conducted a randomized controlled trial (RCT) to assess the impact of a digital health programme on QoL and clinical outcomes of patients. The programme included remote patient monitoring (RPM), self-care, HF education, and empowered positive lifestyle changes. Methods and results Patients (n = 175) received standard-of-care (SoC) at a HF outpatient clinic (control, n = 89) or SoC plus a digital health programme (intervention, n = 86) for 6 months, followed by a 6-month maintenance period. Compliance with RPM was 93% at 6 months. No significant between-group difference was found in the primary endpoint (health-related QoL), except in an exploratory subgroup of New York Heart Association class III patients, where the intervention group had a significantly smaller QoL decline (P = 0.023). For secondary endpoints, the intervention group had significantly greater improvements in self-care at 6 months (P < 0.001) and 12 months (P = 0.003), and in disease-specific knowledge at 12 months (P = 0.001). Several exploratory endpoints favoured the intervention, with significant improvements in triglycerides (P = 0.012), HbA1c (P = 0.014), and fasting glucose (P = 0.010). The TG/HDL cholesterol ratio and TG/glucose index improved significantly at both 6 and 12 months in between-group comparisons. Conclusion Although the digital programme did not improve health-related QoL, it led to benefits in other important outcomes such as self-care, disease-specific knowledge, and several key metabolic parameters.
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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 | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.010 | 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".