Dynamic triage in hypertension: a quantitative framework for follow-up scheduling based on clinician heuristics and home blood pressure data - Summary - MDSpire
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Adaptive Triage in Hypertension Management: A Quantitative Approach for Follow-Up Scheduling Utilizing Clinician Insights and Home Blood Pressure Measurements
To elicit and characterise clinician scheduling preferences for follow-up appointments in newly diagnosed hypertensive patients, using simulated home BP data.
Approach:
Study Design: An online questionnaire with 15 simulated clinical scenarios was distributed to physicians, who indicated their preferred timing for follow-up appointments.
Data Analysis: 555 scheduling decisions from 37 physicians were analyzed using a linear mixed-effects model.
Key Findings:
Predictions correlated with stated decisions (Pearson r = 0.83; median absolute difference 0.1 weeks).
The most recent follow-up BP was the dominant driver of scheduling.
Higher BP above the 140 mmHg systolic threshold was associated with earlier follow-up.
Consultants and non-consultants differed in scheduling preferences based on BP levels.
Interpretation:
Clinicians use a small set of interpretable rules, primarily the recent BP value relative to 140 mmHg, for follow-up timing preferences.
Limitations:
The scenarios were simplified and not tested out of sample.
Findings should be considered hypothesis-generating.
Conclusion:
The study provides a methodological basis for mHealth scheduling tools, but further evaluation in real-world settings is needed.
