Abstract 4368504: Concordance Between In-Office versus At-Home Systolic Blood Pressure Reductions in RPM-Engaged Patients with Uncontrolled Hypertension
Bibliographic record
Abstract
Background: Remote patient monitoring (RPM) devices aim to improve hypertension management by providing frequent readings outside clinic, but validation comparing home versus in-office blood pressure (BP) reductions is needed to ensure clinical utility. We compared systolic BP (SBP) changes measured in-office versus at home among RPM-engaged patients with uncontrolled hypertension to validate device accuracy and assess durability of BP improvements via a retrospective, propensity-score matched cohort ensuring comparable baseline SBP and monitoring duration. Hypothesis: We hypothesize that mean SBP reductions will be nonsignificant between settings in the uncontrolled cohort. Methods: Medicare beneficiaries with uncontrolled hypertension enrolled in RPM from January to October 2024 were matched by baseline SBP and total monitoring duration: in-office readings (n=3,399) versus at-home readings (n=3,399). The primary cohort included patients with baseline SBP ≥130 mm Hg (in-office n=2,313; at-home n=2,271). In-office SBP change was defined as the difference between the last pre-RPM clinic measurement and the first in-office reading ≥90 days after RPM initiation. Home SBP change was defined as the difference between the mean of the first seven and last seven home readings during the RPM period. Independent t-tests compared mean changes, and chi-square tests compared proportions achieving a ≥10 mm Hg reduction. Results: In the uncontrolled cohort, mean in-office SBP decreased from 143.2 ± 14.7 mm Hg to 133.0 ± 17.6 mm Hg (−10.2 ± 20.4 mm Hg; n=2,313), while home SBP decreased from 143.5 ± 14.4 mm Hg to 133.6 ± 16.3 mm Hg (−9.8 ± 15.9 mm Hg; n=2,271). The between-group difference in mean SBP change was 0.4 mm Hg (95% CI: −0.6 to 1.4; p = 0.44). A ≥10 mm Hg reduction occurred in 49.3% of in-office patients versus 47.3% of home-measured patients (p = 0.19). The between-group difference was 4.1 mm Hg, favoring in-office measurements (p < 0.0001), with 70.5% of in-office versus 61.6% of home-measured patients achieving ≥10 mm Hg reduction (p < 0.0001). Conclusions: RPM-based SBP improvements at home demonstrate concordance with in-office readings among patients with uncontrolled hypertension, validating device accuracy and demonstrating durable BP improvements. These findings support clinical integration and payer reimbursement for RPM in hypertension management.
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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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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".