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Automated interpretation of home blood pressure assessment (Hy-Result software) versus physician's assessment: a
Nicolas Postel-Vinay1, Guillaume Bobrie, Alan Ruelland
1aHypertension Unit, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, F-75015 Paris, France bINSERM UMRS1138, Centre de Recherche des Cordeliers, E22, Université Paris Descartes, Université Pierre et Marie Curie, Paris, France cUnité de Recherche Clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou.F-75015 Paris, France dUniversité Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, F-75006 Paris, France eThot e-santé, Paris fCHU de Quebec - Université Laval. Hôtel-Dieu de Québec. Quebec (QC) Canada G1R 2J6 gPole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium hDivision of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
Objective:
Hy-Result is the first software for self-interpretation of home blood pressure measurement results, taking into account both the recommended thresholds for normal values and patient characteristics. We compare the software-generated classification with the physician's evaluation.
Design Method:
The primary assessment criterion was whether algorithm classification of the blood pressure (BP) status concurred with the physician's advice (blinded to the software's results) following a consultation (n=195 patients). Secondary assessment was the reliability of text messages.
Results:
In the 58 untreated patients, the agreement between classification of the BP status generated by the software and the physician's classification was 87.9%. In the 137 treated patients, the agreement was 91.9%. The κ-test applied for all the patients was 0.81 (95% confidence interval: 0.73-0.89). After correction of errors identified in the algorithm during the study, agreement increased to 95.4% [κ=0.9 (95% confidence interval: 0.84-0.97)]. For 100% of the patients with comorbidities (n=46), specific text messages were generated, indicating that a physician might recommend a target BP lower than 135/85 mmHg. Specific text messages were also generated for 100% of the patients for whom global cardiovascular risks markedly exceeded norms.
Conclusion:
Classification by Hy-Result is at least as accurate as that of a specialist in current practice (http://www.hy-result.com).
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