David Hocker, Christine M Constantinople, Cristina Savin
Curriculum learning inspired by behavioral shaping trains neural networks to adopt animal-like decision making strategies
bioRxiv : the preprint server for biology
hypertension ht orchestrator atherosclerotic cardiovascular disease ascvd people living type 2 diabetes t2d control systolic blood pressure sbp ht whole suboptimal diabetes partly due scarcity doctors nurseled interventions pragmatic costeffective control ht primary health care effectiveness sbp control among patients t2d uganda scantly known evaluated effectiveness nurseled management intervention sbp among t2d patients high ascvd risk uganda twoarmed cluster randomized controlled trial compared nurseled management intervention usual doctorled care intervention involved training nurses provide structured health education protocolbased htcvd management 24h phone calls 2monthly text messages 6 months primary outcome mean difference sbp change among patients t2d high ascvd risk intervention control groups 6 months secondary outcome absolute difference number patients target sbp total cholesterol tc fasting blood glucose fbg glycated hemoglobin hba1c lowdensity lipoprotein ldl triglycerides tg body mass index bmi intervention study analyzed according intentiontotreat principle generalized estimating equations used assess intracluster effect modifiers statistical significance set 005 analyses eight clinics n 388 patients included intervention 4 clinics n 192 control 4 clinics n 196 nurseled intervention reduced sbp 1121 1602 mmhg mean difference groups 1375 mmhg 95 ci 1648 1102 p 0001 increase sbp 254 1095 mmhg observed control group diastolic blood pressure reduced 680 948 mmhg mean difference groups 720 mmhg 95 c1 887 548 p 0001 mean differences change ascvd score glycated hemoglobin 473 95 ci 595 351 p 0006 082 95 ci 130 035 p 0001 respectively significant absolute differences number patients target sbp p 0001 dbp p 0003 tc p 0008 nurseled management intervention reduces sbp ascvd risk among patients t2d intervention may pragmatic screening management htascvd uganda pan african clinical trial registry pactr202001916873358 registered 6th october 2019