Evidence map›Paper›PMID 40248449›Full record

ArticleGlobal heart2025

Community Health Workers Equipped with an mHealth Application Can Accurately Diagnose Hypertension in Rural Guatemala.

Sean Duffy, Taryn McGinn Valley, Alejandro Chavez, Valerie Aguilar, Juan Aguirre Villalobos, Kaitlin Tetreault, Guanhua Chen, Elizabeth White, Alvaro Bermudez-Cañete, Do Dang and 3 more

Abstract read
In one paragraph

Article in Global heart, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Trial
  2. Article
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

13 authors.

Sean DuffyUniversity of Wisconsin-Madison School of Medicine and Public Health Madison, Wisconsin, US.ORCID 0000-0002-1993-7835
Taryn McGinn ValleyDepartment of Anthropology, University of Wisconsin-Madison, Madison, WI, US.ORCID 0000-0003-2866-9518
Alejandro ChavezDepartment of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI, US.
Valerie AguilarDepartment of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI, US.
Juan Aguirre VillalobosDepartment of Family & Community Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, US.
Kaitlin TetreaultDepartment and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI, US.ORCID 0000-0003-3370-359X
Guanhua ChenDepartment of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI, US.ORCID 0000-0002-9314-2037
Elizabeth WhiteOperations Research Group, University of Toronto, Toronto, ON, CA.
Alvaro Bermudez-CañeteStanford University, Stanford, US.ORCID 0009-0007-5122-2016
Do DangDepartment of Family Medicine, University of Maryland Medical Center, Baltimore, MD, US.ORCID 0009-0006-7275-3134
Julie CornfieldDepartment of Foreign Languages, Federal University of Sergipe, Sergipe, BR.ORCID 0000-0003-0318-9614
Yoselin LetonaHospital Obras Sociales Monseñor Gregorio Schaffer, San Lucas Tolimán, GT.
Rafael TunHospital Obras Sociales Monseñor Gregorio Schaffer, San Lucas Tolimán, GT.

Funding

INTEGRATED TRAINING FOR PHYSICIAN-SCIENTISTST32GM008692 · NIGMS · UNIVERSITY OF WISCONSIN-MADISON · PI BURKARD, MARK E · 1998 to 2020
$10.3M
mHealth to Enable Task Sharing for Hypertension Care in LMICR21TW011891 · FIC · UNIVERSITY OF WISCONSIN-MADISON · PI DUFFY, SEAN MICHAEL · 2021 to 2022
$333k
FIC NIH HHS R21 TW011891NIGMS NIH HHS T32 GM008692
6 · The paper itself

Abstract

Background: Hypertension is a leading global cause of morbidity and mortality and is increasing in low- and middle-income countries, where unawareness of hypertension is a primary obstacle to management. Community health workers (CHWs) in combination with mobile health (mHealth) tools are increasingly used in LMIC health systems to strengthen primary care infrastructure. In this study, we applied this care model to hypertension in rural Guatemala by comparing the accuracy of CHWs equipped with an mHealth clinical decision support application in diagnosing hypertension to concurrent physician evaluation. Methods: We performed a prospective diagnostic accuracy study in which adults from rural Guatemalan communities were assessed independently by a CHW aided by a mHealth application and a physician. Assessment included medical history; measurement of blood pressure, height and weight; and determination of hypertension status. CHW-physician agreement on hypertension status and past medical history elements was assessed by Kappa analysis and proportional agreement, with Results: Of 359 participants enrolled, 47 (13%) were confirmed to have hypertension and another 11 (3%) had possible hypertension. CHW-physician agreement was high for hypertension diagnosis, with Kappa = 0.8 (95% CI = 0.72, 0.88) and overall agreement 92.8% (95% CI = 90.1%, 95.4%). Bland-Altman analysis showed small biases toward lower systolic blood pressure, higher height, and lower BMI measurements by CHWs. Most patient history characteristics showed moderate to almost perfect (Kappa: 0.41-1) agreement between physicians and CHWs. Conclusions: In this study based in rural Guatemala, CHWs using a mHealth clinical decision support application were found to screen adult patients for hypertension with similar accuracy to a physician. This approach could be adapted to other low-resource settings to reduce the burden of undiagnosed and untreated hypertension.

Indexed as

Community Health WorkersHypertensionRural PopulationTelemedicineAdultBlood PressureFemaleGuatemalaHumansMaleMiddle AgedProspective Studiescommunity health workersGuatemalaHypertensionmHealthtask sharing

Identifiers

PMID40248449
PMCPMC12005136

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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 Socratic graph.