LB03.06

Abstract

Objective: Hy-Result® software is designed to help patients to comply with the home blood pressure measurement (HBPM) protocol and self-interpret their results. We compare in a daily routine care setting, the classification generated by Hy-Result® with the physician's clinical evaluation. Design and method: The algorithm combines BP readings with patient's characteristics. According to the ESH guidelines, BP readings and automatically generated text messages are made available to the patient in a report. The primary assessment criterion was whether classification of the BP status generated by the software concurred with the physician's classification (blinded to the software's results) following a consultation (n = 195 patients) (gold standard). 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 kappa test applied for all the patients was 0.81 [95%CI: 0.73–0.89]. After correction of errors identified in the algorithm during the study, agreement increased to 95.4% (kappa 0.9[95% CI: 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 greatly exceeded norms relating to BMI, tobacco and/or alcohol consumption. Remaining discrepancies were more attributable to human error (physician), than software. The limitation is that the algorithm remains dependent on patient's capacity to complete their profile. Conclusions: Classification by Hy-Result® is at least as accurate as that of a specialist in current practice. Hy-Result® is the first validated free use software for self-interpretation of HBPM results, taking into account both the recommended thresholds for normal values and patient characteristics (www.hy-result.com). Hy-Result® will soon be available as a Smartphone application (Health Mate), accessible in an entirely automated format in conjunction with a validated wireless BP monitor (Withings BP-800).