The Health and Economic Impact of Expanding Home Blood Pressure Monitoring

Yan, Li; Zhang, Donglan; Li, Weixin; Chen, Zhuo; Rajbhandari‐Thapa, Janani; Mu, Lan; Zhu, Haidong; Dong, Yanbin; Pagán, José A.

doi:10.1016/j.amepre.2023.05.010

Cited by 2 publications

(1 citation statement)

References 24 publications

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“…Assessments should (1) be self-administrable; (2) be brief; (3) use standardized instructions that are simple to understand; (4) include a tutorial and set of practice trials before test trials; (5) present results that are easily interpretable; (6) minimize or eliminate culture-specific references to the extent possible (eg, letters or numbers); (7) present task instructions in multiple languages; and (8) allow access across devices, including the web, iOS, and Android [ 3 ]. This would accommodate routine self-testing for brain health, analogous to at-home blood pressure monitoring for heart health to reduce patient morbidity and mortality [ 52 ]. Furthermore, test batteries should be customizable by a clinician, allowing for the use of test batteries ranging from brief screening batteries to deep investigations of target cognitive or neurological domains to broad assessments across multiple functions, much in the same way that a blood panel can be customized to comprise a standard panel of metabolites or specific tests relevant to potential conditions.…”

Section: Introductionmentioning

confidence: 99%

The Real-World Usability, Feasibility, and Performance Distributions of Deploying a Digital Toolbox of Computerized Assessments to Remotely Evaluate Brain Health: Development and Usability Study

Attarha,

Mahncke,

Merzenich

2024

JMIR Form Res

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Background An ongoing global challenge is managing brain health and understanding how performance changes across the lifespan. Objective We developed and deployed a set of self-administrable, computerized assessments designed to measure key indexes of brain health across the visual and auditory sensory modalities. In this pilot study, we evaluated the usability, feasibility, and performance distributions of the assessments in a home-based, real-world setting without supervision. Methods Potential participants were untrained users who self-registered on an existing brain training app called BrainHQ. Participants were contacted via a recruitment email and registered remotely to complete a demographics questionnaire and 29 unique assessments on their personal devices. We examined participant engagement, descriptive and psychometric properties of the assessments, associations between performance and self-reported demographic variables, cognitive profiles, and factor loadings. Results Of the 365,782 potential participants contacted via a recruitment email, 414 (0.11%) registered, of whom 367 (88.6%) completed at least one assessment and 104 (25.1%) completed all 29 assessments. Registered participants were, on average, aged 63.6 (SD 14.8; range 13-107) years, mostly female (265/414, 64%), educated (329/414, 79.5% with a degree), and White (349/414, 84.3% White and 48/414, 11.6% people of color). A total of 72% (21/29) of the assessments showed no ceiling or floor effects or had easily modifiable score bounds to eliminate these effects. When correlating performance with self-reported demographic variables, 72% (21/29) of the assessments were sensitive to age, 72% (21/29) of the assessments were insensitive to gender, 93% (27/29) of the assessments were insensitive to race and ethnicity, and 93% (27/29) of the assessments were insensitive to education-based differences. Assessments were brief, with a mean duration of 3 (SD 1.0) minutes per task. The pattern of performance across the assessments revealed distinctive cognitive profiles and loaded onto 4 independent factors. Conclusions The assessments were both usable and feasible and warrant a full normative study. A digital toolbox of scalable and self-administrable assessments that can evaluate brain health at a glance (and longitudinally) may lead to novel future applications across clinical trials, diagnostics, and performance optimization.

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Section: Introductionmentioning

confidence: 99%

The Real-World Usability, Feasibility, and Performance Distributions of Deploying a Digital Toolbox of Computerized Assessments to Remotely Evaluate Brain Health: Development and Usability Study

Attarha,

Mahncke,

Merzenich

2024

JMIR Form Res

View full text Add to dashboard Cite

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Evaluation and management of hypertensive emergency

Miller,

Hrabec,

Krishnamoorthy

et al. 2024

BMJ

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Hypertensive emergencies cause substantial morbidity and mortality, particularly when acute organ injury is present. Careful and effective strategies to reduce blood pressure and diminish the effects of pressure-mediated injury are essential. While the selection of specific antihypertensive medications varies little across different forms of hypertensive emergencies, the intensity of blood pressure reduction to the target pressure differs substantially. Treatment hinges on balancing the positive effects of lowering blood pressure with the potential for negative effects of organ hypoperfusion in patients with altered autoregulatory mechanisms. When patients do not have acute organ injury in addition to severe hypertension, they benefit from a conservative, outpatient approach to blood pressure management. In all cases, long term control of blood pressure is paramount to prevent recurrent hypertensive emergencies and improve overall prognosis. This review discusses the current evidence and guidelines on the evaluation and management of hypertensive emergency.

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The Health and Economic Impact of Expanding Home Blood Pressure Monitoring

Cited by 2 publications

References 24 publications

The Real-World Usability, Feasibility, and Performance Distributions of Deploying a Digital Toolbox of Computerized Assessments to Remotely Evaluate Brain Health: Development and Usability Study

The Real-World Usability, Feasibility, and Performance Distributions of Deploying a Digital Toolbox of Computerized Assessments to Remotely Evaluate Brain Health: Development and Usability Study

Evaluation and management of hypertensive emergency

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