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 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 | 0.009 |
| 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 | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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".