Evidence mapPaperPMID 40545207Full record

Trial reportAmerican heart journal2025

A mobile relational agent to enhance atrial fibrillation self-care: Primary and secondary outcomes of a randomized controlled trial.

Jared W Magnani, Christina M Lalama, Kaleab Z Abebe, Danielle Ferry, Bruce L Rollman, Michelle Q Lancet, Everlyne Kimani, Stefán Ólafsson, Timothy Bickmore, Michael K Paasche-Orlow

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in American heart journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04075994 (A Mobile Relational Agent to Enhance Atrial Fibrillation Self-care), which is not on this map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing 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.

NCT04075994 nacompletednot on this map

A Mobile Relational Agent to Enhance Atrial Fibrillation Self-care

TypeinterventionalSponsorUniversity of PittsburghRan2020 to 2023Enrolled243ConditionsAtrial Fibrillation, Familial Atrial Fibrillation, Arrythmia, Cardiac, Heart DiseasesArmsRelational Agent and heart rate and rhythm monitor, Usual Care
3 · Its place in the literature

Who cites it

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

  1. Pooled it
  2. Trial
  3. Article
  4. 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

10 authors.

Jared W MagnaniDepartment of Medicine, University of Pittsburgh, Pittsburgh, PA; Center for Research on Health Care, University of Pittsburgh School of Medicine, Pittsburgh, PA. Electronic address: magnanij@pitt.edu.
Christina M LalamaCenter for Biostatistics & Qualitative Methodology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA.
Kaleab Z AbebeDepartment of Medicine, University of Pittsburgh, Pittsburgh, PA; Center for Research on Health Care, University of Pittsburgh School of Medicine, Pittsburgh, PA; Center for Biostatistics & Qualitative Methodology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA.
Danielle FerryDepartment of Medicine, University of Pittsburgh, Pittsburgh, PA.
Bruce L RollmanDepartment of Medicine, University of Pittsburgh, Pittsburgh, PA; Center for Research on Health Care, University of Pittsburgh School of Medicine, Pittsburgh, PA.
Michelle Q LancetCenter for Biostatistics & Qualitative Methodology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA.
Everlyne KimaniKhoury College of Computer Sciences, Northeastern University, Boston, MA.
Stefán ÓlafssonKhoury College of Computer Sciences, Northeastern University, Boston, MA; Department of Computer Science, Reykjavik University, Iceland.
Timothy BickmoreKhoury College of Computer Sciences, Northeastern University, Boston, MA.
Michael K Paasche-OrlowDepartment of Medicine, Tufts University School of Medicine and Tufts Medical Center, Boston, MA.

Funding

NHLBI NIH HHS R33 HL144669
6 · The paper itself

Abstract

backgroundAtrial fibrillation (AF) requires long-term adherence to oral anticoagulation and self-care.

methodsWe conducted a randomized controlled trial of a smartphone-based relational agent and heart rhythm monitor with the primary outcome of anticoagulation adherence and secondary outcomes of quality of life (QOL) and health care utilization. The trial enrolled individuals with Atrial fibrillation (AF) taking anticoagulation. Intervention participants received a smartphone-based relational agent for disease education, adherence monitoring, and self-care, and a heart rate and rhythm monitor. Attention control participants received a smartphone health education application and the same heart monitor. Participants had baseline and 4-, 8-, and 12-month visits. The primary outcome was 12-month proportion of days covered (PDC) ascertained with pharmacy claims.

resultsFrom January, 2020 to April, 2022, the trial enrolled 243 participants (age 70.8 ± 9.8 years; 64.2% female; 30.5% Black race). The adjusted mean PDC at 12 months in the intervention arm was 0.88 (95% Confidence Interval [CI], 0.84-0.93) and in the attention control 0.85 (95% CI, 0.81-0.90) with no difference in odds of PDC ≥ 0.80 in intervention compared to the control (Odds Ratio, 1.26 [95% CI, 0.66-2.38]). Self-reported nonadherence and QOL did not differ by study arm. The event rates for health care utilization were significantly less for intervention than attention control participants as measured by emergency room visits and hospitalizations (P < .001) and number of days hospitalized (P = .004).

conclusionThe smartphone-based relational agent intervention did not achieve its primary endpoint of increased anticoagulation adherence but did yield decreased health care utilization.

trial registrationClinicalTrials.gov Identifier: NCT04075994.

Indexed as

AnticoagulantsAtrial FibrillationMobile ApplicationsSelf CareSmartphoneAgedFemaleHumansMaleMedication AdherenceMiddle AgedPatient Acceptance of Health CareQuality of LifeAnticoagulantsanticoagulationAtrial fibrillationhuman-computer interactionmedication adherenceProportion of Days Coveredself-care

Identifiers

PMID40545207
PMCPMC13382527

What Socratic holds

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Registered trials

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.