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Cardiovascular

Phone telemonitoring after heart-failure flare

Scherr D, Kastner P, Kollmann A, et al. · Journal of medical Internet research · 2009

Open access · cc by · source: Europe PMC

Home mobile-phone telemonitoring after acute heart-failure decompensation cut primary events and hospital days versus usual care.

Study at a glance

Design
RCT — MOBITEL multicentre RCT; home telemonitoring via mobile phones vs control
N
N=120 · Stopped early at 120 of a planned 240 (eight centres; median age 66); many patients could not operate the phone
Population
Adults after acute heart-failure decompensation
Outcome
Cardiovascular death or HF re-hospitalisation over 6 months

Structured fields used in claim comparison tables when every cited study has a complete layer.

Key findings

ITT primary events 17% tele vs 33% control (RRR 50%, P=.06); per-protocol RRR 54% (P=.04); NYHA improved only in tele group; HF hospital stays shorter (median 6.5 vs 10 days).

Methodology

MOBITEL randomized 120 patients after acute decompensation to home telemonitoring via mobile phones versus control across eight centres, following primary death/HF hospitalization endpoints for 6 months.

Limitations

Whether modern smartphones change effect sizes, and some patients were “never beginners” unable to use equipment.

How this study connects

Role on claims

Each row is a claim on a concept or method page where this paper supports, challenges, or qualifies the statement. Roles are hand-checked — not a model guess.

  • SupportsCardiovascular Careconcept

    Multiple studies in this library examine cardiovascular care with empirical patient or population outcomes rather than opinion alone.

    Evidence for the claim as stated.

  • SupportsCardiovascular Careconcept

    ITT primary events 17% tele vs 33% control (RRR 50%, P=.06); per-protocol RRR 54% (P=.04); NYHA improved only in tele group; HF hospital stays shorter (median 6.5 vs 10 days).

    Evidence for the claim as stated.

  • SupportsCardiovascular Careconcept

    Effect sizes and settings differ across cardiovascular care studies — digital vs clinic, trial vs observational — so results should not be pooled casually.

    Evidence for the claim as stated.

  • MOBITEL randomised 120 patients after acute heart-failure decompensation to phone telemonitoring versus control. ITT primary events were 17% versus 33% (relative risk reduction 50%, P=.06); per-protocol RRR was 54% (P=.04). NYHA class improved only in the tele group, and HF hospital stays were shorter (median 6.5 versus 10 days). Some patients were 'never beginners' unable to use the equipment — exactly the people ITT keeps in the denominator.

    Evidence for the claim as stated.

  • ITT and per-protocol can disagree on whether a result 'counts.' MOBITEL's primary ITT contrast was P=.06 while per-protocol reached P=.04; the propofol–sevoflurane trial was null on both. Quoting only the significant per-protocol RRR in MOBITEL, or reading the anaesthetic HR near 1 as proven equivalence, treats two different estimands as if they were one.

    Evidence for the claim as stated.

Open questions

Tensions this paper is part of

From concept pages' “where studies disagree.” Disagreement means the same question; scope means different assays, populations, or outcomes.

  • Scope difference — different assays, populations, or outcomes

    Effect sizes and settings differ across cardiovascular care studies — digital vs clinic, trial vs observational — so results should not be pooled casually.

  • Scope difference — different assays, populations, or outcomes

    ITT and per-protocol can disagree on whether a result 'counts.' MOBITEL's primary ITT contrast was P=.06 while per-protocol reached P=.04; the propofol–sevoflurane trial was null on both. Quoting only the significant per-protocol RRR in MOBITEL, or reading the anaesthetic HR near 1 as proven equivalence, treats two different estimands as if they were one.

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Same topic cluster — not a recommendation engine.