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Automated interpretation of home blood pressure assessment (Hy-Result software) versus physicians assessment: a validation study

Postel-Vinay, Nicolas; Bobrie, Guillaume; Ruelland, Alan; Oufkir, Majida; Savard, Sebastien; Persu, Alexandre; Katsahian, Sandrine; Plouin, Pierre F.

doi: 10.1097/MBP.0000000000000162
Devices and Technology

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).

aHypertension 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

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (www.bpmonitoring.com).

Correspondence to Nicolas Postel-Vinay, MD, Hypertension Unit, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, F-75015 Paris, France Tel: +33 1 56 09 37 71; fax: +33 1 56 09 20 40; e-mail: nicolas.postel-vinay@aphp.fr

Received April 25, 2015

Received in revised form September 5, 2015

Accepted September 8, 2015

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