ESCAPE-ancillary blood pressure measurement study

Abstract

The observed differences in BP between the groups are partly explained by the impact of EDP. Compared with the manual, oscillometric measurement may reduce EDP.

An Example of End-Digit Preference in Physiotherapy Practice

“…Our findings were consistent with studies on end-digit preference in BP measurement, [1][2][3] in that raters in our study displayed a substantial preference for the end-digits 0 and 5. Although we were unable to find ROM studies addressing end-digit preference, raw data for elbow flexion and wrist extension ROM measurements were reported in a study by Low (1976), in which 50 experienced raters assessed the same person's elbow and wrist ROM.…”

“…The terminal digits most often implicated in end-digit preference are 0 and 5. 2,3 Although measurement studies appear frequently in the physical therapy literature, 4,5 reference to the phenomenon of end-digit preference is virtually absent. In contrast, end-digit preference is well documented in the medical literature, particularly as it applies to the measurement of blood pressure (BP).…”

“…In contrast, end-digit preference is well documented in the medical literature, particularly as it applies to the measurement of blood pressure (BP). [1][2][3][6][7][8] Paralleling the prominence of BP measurement in the day-to-day practice of physicians is the regular assessment of range of motion (ROM) by physiotherapists. Given that both BP and ROM assessments require clinicians to read and record analogue values, it seems reasonable to conjecture that end-digit preference may affect ROM measurements; however, our literature searches (PubMed, CINAHL, EMBASE) combining the terms ''range of motion'' and ''end-digit'' failed to identify a single publication.…”

Effects of a multifaceted intervention on cardiovascular risk factors in high-risk hypertensive patients: the ESCAPE trial, a pragmatic cluster randomized trial in general practice

“…During the training seminar, prior to the inclusion of patients, the GPs were given an electronic measurement device and were asked to report the exact values on the case report forms, which almost certainly improved the accuracy of their BP measurements by reducing substantially end-digit preference [27,28]. The BP was shown to be underestimated in the usual care group because of a much higher end-digit preference [27]. GPs tend to round down BP results to the lower 0 mmHg or 5 mmHg values systematically because it is considered better for the physician, as well as for the patient, to have a lower value under treatment.…”

General practitioners’ justifications for therapeutic inertia in cardiovascular prevention: an empirically grounded typology

“…The first one is the end-digit preference, or tendency of physicians to round down the results of measurement. 41 For BP measurement, the results are usually rounded to the lower multiple 10 or 5. Although the use of an electronic device reduces this tendency, it still exists and can significantly delay the initiation or reinforcement of a recommended treatment.…”