Evidence map›Paper›PMID 39022171›Full record

ArticleCJC open2024

Assessing Machine Learning for Diagnostic Classification of Hypertension Types Identified by Ambulatory Blood Pressure Monitoring.

Tran Quoc Bao Tran, Stefanie Lip, Clea du Toit, Tejas Kumar Kalaria, Ravi K Bhaskar, Alison Q O'Neil, Beata Graff, Michał Hoffmann, Anna Szyndler, Katarzyna Polonis and 8 more

Abstract read
In one paragraph

Article in CJC open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. The role of artificial intelligence in hypertension management.Current opinion in nephrology and hypertension · 2026
    Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Tran Quoc Bao TranSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom.
Stefanie LipSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom.
Clea du ToitSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom.
Tejas Kumar KalariaUniversity Hospitals Birmingham NHS Foundation Trust, Heartlands Hospital, Bordesley Green East, Birmingham, United Kingdom.
Ravi K BhaskarMabgenex, Hyderabad, Telangana, India.
Alison Q O'NeilCanon Medical Research Europe, Bonnington Bond, Edinburgh, United Kingdom.
Beata GraffDepartment of Hypertension and Diabetology, Medical University of Gdańsk, Gdańsk, Poland.
Michał HoffmannDepartment of Hypertension and Diabetology, Medical University of Gdańsk, Gdańsk, Poland.
Anna SzyndlerDepartment of Hypertension and Diabetology, Medical University of Gdańsk, Gdańsk, Poland.
Katarzyna PolonisDepartment of Hypertension and Diabetology, Medical University of Gdańsk, Gdańsk, Poland.
Jacek WolfDepartment of Hypertension and Diabetology, Medical University of Gdańsk, Gdańsk, Poland.
Sandeep ReddySchool of Medicine, Deakin University, Geelong, Victoria, Australia.
Krzysztof NarkiewiczDepartment of Hypertension and Diabetology, Medical University of Gdańsk, Gdańsk, Poland.
Indranil DasguptaUniversity Hospitals Birmingham NHS Foundation Trust, Heartlands Hospital, Bordesley Green East, Birmingham, United Kingdom.
Anna F DominiczakSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom.
Shyam VisweswaranDepartment of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Linsay McCallumSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom.
Sandosh PadmanabhanSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom.

Funding

Development and Evaluation of a Learning Electronic Medical Record SystemR01LM012095 · NLM · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI VISWESWARAN, SHYAM · 2015 to 2018
$1.8M
NLM NIH HHS R01 LM012095
6 · The paper itself

Abstract

Background: Inaccurate blood pressure (BP) classification results in inappropriate treatment. We tested whether machine learning (ML), using routine clinical data, can serve as a reliable alternative to ambulatory BP monitoring (ABPM) in classifying BP status. Methods: This study employed a multicentre approach involving 3 derivation cohorts from Glasgow, Gdańsk, and Birmingham, and a fourth independent evaluation cohort. ML models were trained using office BP, ABPM, and clinical, laboratory, and demographic data, collected from patients referred for hypertension assessment. Seven ML algorithms were trained to classify patients into 5 groups, named as follows: Normal/Target; Hypertension-Masked; Normal/Target-White-Coat (WC); Hypertension-WC; and Hypertension. The 10-year cardiovascular outcomes and 27-year all-cause mortality risks were calculated for the ML-derived groups using the Cox proportional hazards model. Results: Overall, extreme gradient boosting (using XGBoost open source software) showed the highest area under the receiver operating characteristic curve of 0.85-0.88 across derivation cohorts, Glasgow (n = 923; 43% female; age 50.7 ± 16.3 years), Gdańsk (n = 709; 46% female; age 54.4 ± 13 years), and Birmingham (n = 1222; 56% female; age 55.7 ± 14 years). But accuracy (0.57-0.72) and F1 (harmonic mean of precision and recall) scores (0.57-0.69) were low across the 3 patient cohorts. The evaluation cohort (n = 6213; 51% female; age 51.2 ± 10.8 years) indicated elevated 10-year risks of composite cardiovascular events in the Normal/Target-WC and the Hypertension-WC groups, with heightened 27-year all-cause mortality observed in all groups, except the Hypertension-Masked group, compared to the Normal/Target group. Conclusions: ML has limited potential in accurate BP classification when ABPM is unavailable. Larger studies including diverse patient groups and different resource settings are warranted.

Identifiers

PMID39022171
PMCPMC11250845

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.