Evidence mapPaperPMID 42234864Full record

ArticleJMIR mHealth and uHealth2026

Terminal Digit Preference and Threshold Avoidance in Digital Blood Pressure Measurements During Pregnancy: Secondary Analysis of Data From the CLIP and PRECISE Cohorts.

Peter von Dadelszen, Akshdeep Sandhu, Jeffrey N Bone, Rahat N Qureshi, Olukayode A Dada, Ashalata A Mallapur, Marleen Temmerman, Marie-Laure Volvert, Joseph Waiswa, Moses Mukhanya and 21 more

Abstract read
In one paragraph

Article in JMIR mHealth and uHealth, 2026. 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

31 authors.

Peter von DadelszenDepartment of Women and Children's Health, School of Life Course and Population Sciences, Faculty of Life Sciences and Medicine, King's College London, 6th Floor, Addison House, Guy's Campus, Great Maze Pond, London, SE1 1UL, United Kingdom, 44 7484163625.ORCID http://orcid.org/0000-0003-4136-3070
Akshdeep SandhuDepartment of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada.ORCID http://orcid.org/0000-0001-5194-7892
Jeffrey N BoneDepartment of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada.ORCID http://orcid.org/0000-0001-7704-1677
Rahat N QureshiCentre of Excellence for Women & Child Health, Aga Khan University, Karachi, Sindh, Pakistan.ORCID http://orcid.org/0000-0002-3215-3445
Olukayode A DadaCentre for Research in Reproductive Health, Sagamu, Ogun State, Nigeria.ORCID http://orcid.org/0000-0002-7119-4354
Ashalata A MallapurS Nijalingappa Medical College and HSK Hospital & Research Centre, Bagalkot, Karnataka, India.ORCID http://orcid.org/0000-0003-3779-189X
Marleen TemmermanCentre of Excellence in Women and Child Health (East Africa), Aga Khan University Nairobi, Nairobi, Kenya.ORCID http://orcid.org/0000-0001-9966-9000
Marie-Laure VolvertDepartment of Women and Children's Health, School of Life Course and Population Sciences, Faculty of Life Sciences and Medicine, King's College London, 6th Floor, Addison House, Guy's Campus, Great Maze Pond, London, SE1 1UL, United Kingdom, 44 7484163625.ORCID http://orcid.org/0000-0002-0527-4145
Joseph WaiswaMARCH Centre, London School of Hygiene & Tropical Medicine, London, United Kingdom.ORCID http://orcid.org/0000-0001-8221-902X
Moses MukhanyaCentre of Excellence in Women and Child Health (East Africa), Aga Khan University Nairobi, Nairobi, Kenya.ORCID http://orcid.org/0000-0002-3954-9426
Hiten D MistryDepartment of Women and Children's Health, School of Life Course and Population Sciences, Faculty of Life Sciences and Medicine, King's College London, 6th Floor, Addison House, Guy's Campus, Great Maze Pond, London, SE1 1UL, United Kingdom, 44 7484163625.ORCID http://orcid.org/0000-0003-2564-7348
Shivaprasad S GoudarWomen's and Children's Health Research Unit, KLE Academy of Higher Education and Research, Jawaharlal Nehru Medical College, Belagavi, India.ORCID http://orcid.org/0000-0002-8680-7053
Hawanatu JahMRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, Fajara, The Gambia.ORCID http://orcid.org/0000-0002-4347-5247
Angela KoechCentre of Excellence in Women and Child Health (East Africa), Aga Khan University Nairobi, Nairobi, Kenya.ORCID http://orcid.org/0000-0003-4838-3269
Charfudin SacoorCentro de Investigação em Saúde da Manhiça, Manhiça and Department of Clinical Pharmacology, Faculdade de Medicina, Universidade Eduardo Mondlane, Manhiça, Mozambique.ORCID http://orcid.org/0000-0002-8724-0319
Anifa ValaCentro de Investigação em Saúde da Manhiça, Manhiça and Department of Clinical Pharmacology, Faculdade de Medicina, Universidade Eduardo Mondlane, Manhiça, Mozambique.ORCID http://orcid.org/0000-0003-3229-0754
Khatia MunguambeCentro de Investigação em Saúde da Manhiça, Manhiça and Department of Clinical Pharmacology, Faculdade de Medicina, Universidade Eduardo Mondlane, Manhiça, Mozambique.ORCID http://orcid.org/0000-0003-3888-5126
Anna RocaMRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, Fajara, The Gambia.ORCID http://orcid.org/0000-0001-6034-1868
Olelekan O AdetoroCentre for Research in Reproductive Health, Sagamu, Ogun State, Nigeria.ORCID http://orcid.org/0000-0002-7413-8892
Esperanca SeveneCentro de Investigação em Saúde da Manhiça, Manhiça and Department of Clinical Pharmacology, Faculdade de Medicina, Universidade Eduardo Mondlane, Manhiça, Mozambique.ORCID http://orcid.org/0000-0001-9025-4052
Marianne VidlerDepartment of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada.ORCID http://orcid.org/0000-0002-7633-8812
Mrutyunjaya B BelladWomen's and Children's Health Research Unit, KLE Academy of Higher Education and Research, Jawaharlal Nehru Medical College, Belagavi, India.ORCID http://orcid.org/0000-0003-0460-1439
John SotunsaDepartment of Obstetrics and Gynaecology, Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, Nigeria.ORCID http://orcid.org/0000-0002-3588-9255
Hannah J BlencoweMARCH Centre, London School of Hygiene & Tropical Medicine, London, United Kingdom.ORCID http://orcid.org/0000-0003-1556-3159
Zulfiqar A BhuttaCentre for Global Child Health, Hospital for Sick Children, Toronto, ON, Canada.ORCID http://orcid.org/0000-0003-0637-599X
Umberto d'AlessandroMRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, Fajara, The Gambia.ORCID http://orcid.org/0000-0001-6341-5009
John Mark AnserminoBC Children's Hospital Research Institute, Vancouver, BC, Canada.ORCID http://orcid.org/0000-0001-8427-2035
Guy A DumontDepartment of Electrical and Computer Engineering, University of British Columbia, Vancouver, BC, Canada.ORCID http://orcid.org/0000-0003-2048-4391
Laura A MageeDepartment of Women and Children's Health, School of Life Course and Population Sciences, Faculty of Life Sciences and Medicine, King's College London, 6th Floor, Addison House, Guy's Campus, Great Maze Pond, London, SE1 1UL, United Kingdom, 44 7484163625.ORCID http://orcid.org/0000-0002-1355-610X
CLIP Trials Study GroupSee Acknowledgments.
PRECISE NetworkSee Acknowledgments.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Screening for, detecting, and managing pregnancy hypertension is a core function of antenatal care. To reduce both training requirements and the risks of measurement error in blood pressure (BP) values, automated and semiautomated BP devices have been validated in pregnant women with normal BP and pregnant women with hypertension and introduced for serial antenatal measurement of BP. objectives: The study aimed to (1) determine whether or not repeated BP measurements reduced the presence of terminal digit preference and (2) discern whether or not there was evidence of threshold avoidance in the Community-Level Interventions for Preeclampsia (CLIP) trials compared with the purely observational Pregnancy Care Integrating Translational Science, Everywhere (PRECISE) cohorts. Methods: The BP 3AS1-2 and CRADLE Vital Signs Alert low-cost Microlife BP devices were used by trained research staff in the CLIP trials conducted in India, Mozambique, Nigeria (pilot trial only), and Pakistan and the PRECISE cohorts of unselected pregnant women and nonpregnant women of reproductive age recruited in the Gambia, Kenya, and Mozambique. Both devices algorithmically calculate systolic blood pressure and diastolic blood pressure values displayed on digital read-outs. All BP readings were entered manually into a digital platform, which averaged them as the BP for that visit; the first and second readings were averaged unless they were more than 10 mm Hg different, which triggered a third reading, and the second and third readings were averaged. Results: A total of 51,875 participants had their BP measured 438,404 times. Using raw BP values, there was terminal digit preference (129,539/911,500, 14.21% vs 10%; P<.001 values ended in zero). A total of 28,929 out of 437,446 (6.61%) dBP values were 62 mm Hg, compared with 9310 of 195,349 (4.77%) from the averaged values (P<.001); errors were obviated by averaging BP values. There was evidence of both threshold preference and avoidance in the CLIP trials and the PRECISE cohort. Conclusions: Given the excess of 62 mm Hg values, there is a shared inherent algorithmic error in the calculation of dBP in the BP 3AS1-2 and CRADLE Vital Signs Alert devices. Averaged BP measurements are important to reduce the impact of user errors in manually recording BP values. We recommend that automated and semiautomated BP devices should be connected wirelessly to automatically transfer readings to digital health records to further optimize care.

Indexed as

Blood Pressure DeterminationAdultBlood PressureCohort StudiesFemaleHumansPregnancyAfricablood pressure devicespregnancySouth Asiaterminal digit preferencethreshold avoidancewomen of reproductive age

Identifiers

PMID42234864
PMCPMC13232918

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.