Agile evaluation including two pragmatic trials on the uptake of a digital screening service.

Taavi Tillmann, Andrew Copas, Paul Stokes, Nick Udell, Jo Stead, Jin Lim, Gene Libow

Abstract read

In one paragraph

Article in NPJ digital medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it

0cells of the map it votes in

0citing papers in PubMed

–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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

7 authors.

Taavi TillmannInstitute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia. taavi.tillmann@ut.ee.

Andrew CopasInstitute for Global Health, University College London, London, UK.

Paul StokesDepartment of Public Health, London Borough of Southwark Council, London, UK.

Nick UdellFreelance Software Developer, Dorset, UK.

Jo SteadDepartment of Public Health, London Borough of Southwark Council, London, UK.

Jin LimDepartment of Public Health, London Borough of Southwark Council, London, UK.

Gene LibowFreelance Service Designer, London, UK.

Funding

Estonian Ministry of Education and Research TK218 (EstWell)Estonian Research Council PSG809UK National Institute for Health and Care Research Clinical Lectureship

6 · The paper itself

Abstract

Digital screening may divert lower-risk persons to lower-cost online screening, or offer higher-risk non-responders a more acceptable alternative. Population-based uptake estimates are lacking. We conducted four studies within four weeks by inviting 1700 Londoners (40-74 years, without cardiovascular disease) to a digital Health Check. A six-arm pragmatic unregistered randomised controlled trial (RCT) tested different Short Message Service (SMS) invitations. Uptake varied from 12% (standard SMS) to 20% (shortest SMS, P = 0.009). We tested three sequential reminders (an SMS, a second pragmatic trial [SMS vs postal reminder], and a final SMS). The first SMS reminder increased uptake by +3%. The postal reminder (+7%) was twice as effective as the SMS reminder (+3%, P < 0.0001). The "final reminder" SMS added +7%. Altogether, shorter invites, multi-modal reminders, and a "final reminder" all increased uptake. Adding digital care to in person care may raise uptake from 50 to 60%. Agile evaluations can rapidly improve invitation systems.

Identifiers

PMID40419699

DOI10.1038/s41746-025-01672-5

PMCPMC12106754

What OpenQuestion holds

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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.