Rigor Reviewed

Rigor-Reviewed Manuscript

Home-Based Care for Hypertension in Rural South Africa.

Name: Adcurare Rigor Record — Home-Based Care for Hypertension in Rural South Africa.
Item: Home-Based Care for Hypertension in Rural South Africa.
Rating: 96
Author: Adcurare

Siedner MJ, Magula N, Mazibuko L, Sithole N, Castle A, Nxumalo S, Manyaapelo T, Abrahams-Gessel S, Gareta D, Orne-Gliemann J, Baisley K, Bachmann M, Gaziano TA

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Adcurare Rigor Review — 4.25★ (Strong), 0 critical, 8 high issues for “Home-Based Care for Hypertension in Rural South Africa.”

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Adcurare Editorial

This rigor review was examined and confirmed by Adcurare Editorial · July 7, 2026

Adcurare Rigor Review

Rigor Reviewed

4.25 / 5

Strong — minor issues to address

Interventional Study

Critical

High-priority

How this rating was calculated▸

Started at 5★ — deductions

IntegrityIntegrity concern−0.5★
ReportingData & code availability partially met−0.25★

Model-reported confidence: highReviewer agreement: moderateEngine: 7.6.0Source: full text

Problems surfaced2 types

Data/code availability incomplete
Data look implausibly clean

This Adcurare Rigor Review uses AI Rigor Reviewers trained on a curated corpus of high-fidelity and retracted papers, with expert supervision and curation. It can still make mistakes; verify each finding against the source before relying on it.

The manuscript describes a well-conducted, rigorously randomized controlled trial of home-based hypertension care in rural South Africa. Its main strengths are a clear design, complete ethics approvals, and thorough reporting of demographic and health variables. The primary weaknesses are missing documentation: no data availability statement, no code sharing, no CONSORT checklist reference, and some under-identification of key resources (drugs, software).

Evaluated as a human interventional RCT. All eight dimensions were applicable. The three independent rigor evaluations largely converged (high agreement on 6 dimensions, moderate divergence on study design and key resources). The statistics verification component checked 4 tests, all consistent; coverage is partial (see component note). No retracted or unresolvable references were found. The copyedit pass flagged minor grammatical/punctuation issues.

12 major claims checked against the paper's own evidence: all adequately supported.

Recomputed 4 tests: 4 consistent, 0 inconsistent, 4 via agent-written checks.

1 integrity concern flagged (0 high).

Reporting

Eight Dimensions7 pass · 1 warn

The background section cites multiple references to establish that hypertension control is poor globally, especially in low-resource settings, and identifies specific barriers in South Africa. It then proposes home-based management with remote monitoring as a solution, noting that data on such programs are scarce. The rationale linking the premise to the study objectives is clear. Limitations of prior research are implicitly addressed by the study's design, but not explicitly discussed in the introduction.

Sub-criteria

prior work citedADEQUATE

premise rationaleADEQUATE

limitations addressedINADEQUATE

Per reviewer (3) — the votes behind the verdict

PASSReviewer 1· 95% conf

The paper clearly establishes the scientific premise by citing prior work on the burden of hypertension and barriers to care, and provides a logical rationale for the intervention.

Evidence

direct quote[Background, paragraph 1]

“Although numerous low cost, effective therapies are available, disease control rates are poor, particularly among populations with structural barriers to healthcare.”

direct quote[Background, paragraph 2]

“Home-based BP management with remote monitoring has been proposed to address these barriers, but data on the efficacy of such programs are scarce.”

absence[Background]

The paper does not explicitly discuss how limitations of prior research are addressed.

PASSReviewer 2· 95% conf

The manuscript clearly establishes the scientific premise by citing well-documented gaps in hypertension control in low-resource settings and the lack of evidence for home-based programs.

Evidence

direct quote[Background, paragraph 1]

“Elevated blood pressure (BP) is the leading risk factor for preventable mortality, responsible for approximately 10 million deaths each year. Although numerous low cost, effective therapies are available, disease control rates are poor, particularly among populations with structural barriers to healthcare.”

direct quote[Background, paragraph 2]

“Home-based BP management with remote monitoring has been proposed to address these barriers, but data on the efficacy of such programs are scarce.”

paraphrase[Background, paragraph 2]

“The mention that prior data are scarce is the only direct commentary on the state of prior research; specific limitations of prior studies (e.g., lack of multi-component interventions) are not discussed in the Background but are touched upon later in the Discussion.”

PASSReviewer 3· 90% conf

The scientific premise is well-established through citations of global and local burden data, identified barriers, and gaps in prior home-based care evidence.

Evidence

direct quote[Background, paragraph 1]

“Elevated blood pressure (BP) is the leading risk factor for preventable mortality, responsible for approximately 10 million deaths each year.”

direct quote[Background, paragraph 1]

“Home-based BP management with remote monitoring has been proposed to address these barriers, but data on the efficacy of such programs are scarce.”

absence[Background, paragraph 1]

Limitations of prior work are not explicitly discussed in the introduction

The paper describes an open-label, individually-randomized trial with randomization in blocks of nine, stratified by clinic and current hypertension treatment. The randomization method (REDCap module) and unit (individual) are clearly stated. Blinding is described as open-label, which is appropriate for this type of intervention. A power analysis is provided with all key parameters. Inclusion and exclusion criteria are pre-specified. The analysis population (ITT) and handling of missing data (censoring) are defined. The comparator (SOC) is appropriate. Independent replication is not applicable for a single pivotal trial.

Sub-criteria

controlsN/A

power analysisADEQUATE

blinding levelsADEQUATE

outlier handlingADEQUATE

randomization unitADEQUATE

inclusion exclusionADEQUATE

randomization methodADEQUATE

replicate distinctionN/A

independent replicationN/A

Per reviewer (3) — the votes behind the verdict

PASSReviewer 1· 95% conf

The study design is rigorous for a human RCT, with clear randomization, stratification, a pre-specified sample size calculation, and well-defined inclusion/exclusion criteria.

Evidence

direct quote[Methods, Trial Design and Eligibility Criteria]

“Those eligible who provided informed consent were randomized 1:1:1 in blocks of nine to one of the three trial arms using the randomization module in REDCap.”

direct quote[Methods, Sample Size]

“With a target enrollment of 774 participants (258 per arm), we had >80% power to detect a 5 mmHg difference between arms in mean systolic BP at 6 months, allowing for 20% loss to follow-up, a correlation between baseline and follow-up measurements of 0.5, and a two-tailed alpha of 2.5% to account for multiple comparisons between the SOC and both intervention arms.”

direct quote[Methods, Trial Design and Eligibility Criteria]

“We excluded those who required immediate referral to a physician, according to South African Department of Health guidelines, including pregnancy or breast feeding; severely high BP (>180mmHg systolic or 100mmHg diastolic) accompanied by symptoms; reduced renal function, as determined by an estimated glomerular filtrate rate (GFR) <60ml/minute/1.73 m2 calculated using the CKD-EPI equation from a point-of-care creatinine test on the day of enrollment; or current use of three or more anti-hypertensives at maximal dose.”

PASSReviewer 2· 95% conf

The study design is robust: a three-arm parallel-group open-label RCT with pre-specified eligibility criteria, power analysis, and ITT analysis. Blinding of outcome assessment is present, and the trial is registered. Some user-facing elements are open-label by necessity (participants and clinic staff knew the assignment), which is acceptable.

Evidence

direct quote[Methods, Trial Design and Eligibility Criteria, paragraph 3]

“Those eligible who provided informed consent were randomized 1:1:1 in blocks of nine to one of the three trial arms using the randomization module in REDCap.”

direct quote[Methods, Sample Size]

direct quote[Methods, Data Collection and Study Outcomes]

“Study staff not involved with the intervention program and blinded to study arm conducted home visits at 6 and 12 months after enrollment in all three arms to collect outcome data.”

WARNReviewer 3· 80% conf

The study design is generally sound with clear randomization and inclusion/exclusion criteria, but lacks description of blinding (open-label design not further justified) and does not report outlier handling or independent replication. Replicate distinction, controls (as wet-lab controls), and independent replication are not applicable for this type of human RCT.

Evidence

direct quote[Methods, Trial Design and Eligibility Criteria]

“randomized 1:1:1 in blocks of nine to one of the three trial arms using the randomization module in REDCap”

direct quote[Methods, Trial Design and Eligibility Criteria]

“After randomization, both participants and clinic staff were aware of treatment allocation.”

direct quote[Methods, Data Collection and Study Outcomes]

“Study staff not involved with the intervention program and blinded to study arm conducted home visits at 6 and 12 months after enrollment in all three arms to collect outcome data.”

The paper reports sex (76% women), age (mean 62 years), and health status (HIV, diabetes, BMI) for the study population. Since both sexes are enrolled, a justification for single-sex is not applicable. Species/strain/source and housing conditions are not applicable for a human trial. Demographics are adequately reported, including race/ethnicity (100% black African descent), employment, and water access.

Sub-criteria

demographicsADEQUATE

sex reportedADEQUATE

sex justifiedN/A

age weight healthADEQUATE

housing conditionsN/A

species strain sourceN/A

Per reviewer (3) — the votes behind the verdict

PASSReviewer 1· 95% conf

Key human demographic and health variables are well-reported, including sex, age, and comorbidities.

Evidence

direct quote[Results, paragraph 1]

“At enrollment, the mean age was 62 years (SD 12) and 76% (588/774) were women.”

direct quote[Results, paragraph 1]

“Forty-seven percent of participants (360/774) were living with HIV; whereas 14% (105/774) had diabetes and 45% (351/774) had a body mass index >30 kilogram/meter2.”

direct quote[Results, paragraph 1]

“One hundred percent of participants were of black African descent, reflecting the demographics of people with hypertension in this rural region South Africa.”

PASSReviewer 2· 95% conf

Key biological variables for a human trial (sex, age, health status including HIV and diabetes) are reported and balanced across arms. Single-sex enrollment (76% women) is not justified, but this is not a single-sex study; both sexes are included.

Evidence

direct quote[Results, paragraph 1]

“The mean age was 62 years (SD 12) and 76% (588/774) were women. The mean systolic BP was 147mm Hg (SD 17)... Forty-seven percent of participants (360/774) were living with HIV; whereas 14% (105/774) had diabetes and 45% (351/774) had a body mass index >30 kilogram/meter2.”

direct quote[Results, paragraph 2]

“Eleven percent (87/774) were employed and 15% (112/774) had access to running water in their household.”

PASSReviewer 3· 95% conf

Key biological variables for a human interventional study are well-reported, including sex, age, health status (HIV, diabetes, BMI), and comprehensive demographics. Sex is reported but not justified (both sexes enrolled, so not required).

Evidence

direct quote[Results, paragraph 1]

“the mean age was 62 years (SD 12) and 76% (588/774) were women.”

direct quote[Results, paragraph 1]

“One hundred percent of participants were of black African descent... Eleven percent (87/774) were employed and 15% (112/774) had access to running water in their household.”

direct quote[Results, paragraph 1]

“Forty-seven percent of participants (360/774) were living with HIV; whereas 14% (105/774) had diabetes and 45% (351/774) had a body mass index >30 kilogram/meter 2 .”

The trial was approved by the University of KwaZulu-Natal Biomedical Research Ethics Committee, the Mass General Brigham Institutional Review Board, and the South African Health Products Regulatory Authority. All participants provided signed informed consent. A data safety monitoring board conducted an interim assessment. This meets the highest standard for a clinical trial involving human subjects. Regulatory compliance is implied by the named approvals.

Sub-criteria

iacuc statementN/A

informed consentADEQUATE

irb ethics statementADEQUATE

regulatory complianceADEQUATE

Per reviewer (3) — the votes behind the verdict

PASSReviewer 1· 95% conf

Ethical approvals from named bodies and informed consent are clearly reported, along with regulatory compliance.

Evidence

direct quote[Methods, Ethical Considerations]

“The trial was approved by the University of KwaZulu-Natal Biomedical Research Ethics Committee, the Institutional Review Board of Mass General Brigham and by the South African Health Products Regulatory Authority.”

direct quote[Methods, Ethical Considerations]

“All participants provided signed informed consent.”

direct quote[Methods, Ethical Considerations]

“A data safety monitoring board conducted an interim assessment after 50% of study participants had completed 6 months of participation in the trial.”

PASSReviewer 2· 100% conf

Ethical approval from a named institutional review board, regulatory authority, and signed informed consent are explicitly stated. A data safety monitoring board oversaw the trial.

Evidence

direct quote[Methods, Ethical Considerations]

“All participants provided signed informed consent.”

direct quote[Methods, Ethical Considerations]

“A data safety monitoring board conducted an interim assessment after 50% of study participants had completed 6 months of participation in the trial.”

PASSReviewer 3· 95% conf

The paper explicitly names the approving ethics committees and states that all participants provided signed informed consent. Regulatory compliance is stated through approval by a national regulatory authority.

Evidence

direct quote[Methods, Ethical Considerations]

“All participants provided signed informed consent.”

direct quote[Methods, Ethical Considerations]

“A data safety monitoring board conducted an interim assessment after 50% of study participants had completed 6 months of participation in the trial.”

The paper identifies the three main anti-hypertensives (hydrochlorothiazide, lisinopril, amlodipine) and their source (Department of Health). The BP machines are identified by brand and model (Omron Digital M3, BlipCare). The mobile application developer is named (iMarketing Consultants). Software tools for analysis are not explicitly named with version, but the statistical methods are described. Antibodies, cell lines, and organisms are not applicable for this human trial.

Sub-criteria

mycoplasma testingN/A

reagents identifiedADEQUATE

organisms identifiedN/A

antibodies identifiedN/A

cell line authenticationN/A

software tools identifiedINADEQUATE

Per reviewer (3) — the votes behind the verdict

PASSReviewer 1· 95% conf

The investigational products (anti-hypertensives) and key devices/software are adequately identified.

Evidence

direct quote[Methods, Study Arms]

“The three principle anti-hypertensive therapies available in the public sector in South Africa and used in this study were hydrochlorothiazide, lisinopril, and amlodipine.”

direct quote[Methods, Study Arms]

“In the CHW arm, participants received an automated BP machine (Omron Digital M3. Kyoto, Japan)... In the second intervention arm (eCHW+), participants received a BP machine with short message service text message capability (BlipCare, Carematrix Inc, Chicago, IL).”

direct quote[Methods, Study Arms]

“CHWs visited participants within one week of enrollment and approximately monthly thereafter to record BP readings into a mobile health application on their phones (iMarketing Consultants, Windhoek, Namibia...”

PASSReviewer 2· 95% conf

The investigational product (BP machines, mobile health application) and therapies are identified. Software (REDCap) is identified, but custom code (statistical analysis code) is not shared. Given that the key resources are mainly devices and a commercial app, and the drugs are standard generics, the reporting is adequate for this type of trial.

Evidence

direct quote[Methods, Study Arms, paragraph 1 and 2]

direct quote[Methods, Trial Design, paragraph 3]

“...using the randomization module in REDCap.”

absence[Methods, Statistical Analyses]

Analytical software is not explicitly named (e.g., R, SAS, Stata version).

WARNReviewer 3· 80% conf

The investigational products (three antihypertensives) are named but not fully identified with manufacturer and lot numbers. The BP devices are identified but not with full detail (e.g., only vendor/city for BlipCare). Software is partially identified but the custom mobile app lacks a permanent identifier or version number.

Evidence

direct quote[Methods, Study Arms]

“The three principle anti-hypertensive therapies available in the public sector in South Africa and used in this study were hydrochlorothiazide, lisinopril, and amlodipine.”

direct quote[Methods, Study Arms]

“Participants received an automated BP machine (Omron Digital M3. Kyoto, Japan)”

direct quote[Methods, Study Arms]

“mobile health application (iMarketing Consultants, Windhoek, Namibia)”

The paper names the statistical tests used (linear regression, logistic regression with marginal standardization). The primary analysis uses an ITT approach. Exact p-values and 95% CIs are reported for the primary outcome. Effect sizes (mean differences, risk ratios) are reported with CIs. The statistical software is not explicitly named, but the methods are standard. Data presentation includes per-group n, means, and CIs. Mathematical plausibility checks are not applicable for continuous outcomes with large N.

Sub-criteria

tests namedADEQUATE

exact p valuesADEQUATE

effect sizes ciADEQUATE

data presentationADEQUATE

software identifiedNOT REPORTED

assumptions verifiedINADEQUATE

mathematical plausibilityN/A

Per reviewer (3) — the votes behind the verdict

PASSReviewer 1· 95% conf

Statistical methods are well-described, tests are named, and exact p-values and confidence intervals are reported for primary and secondary outcomes.

Evidence

direct quote[Methods, Statistical Analyses]

“For the primary outcome, we fit linear regression models to estimate the difference between arms in mean systolic BP at 6 months.”

direct quote[Results, paragraph 2]

“difference vs SOC −7.9mmHg, 95%CI −10.5, −5.3, P-value<0.001”

absence[Methods, Statistical Analyses]

The statistical software used is not reported.

PASSReviewer 2· 95% conf

Statistical analyses are appropriate and well-described. Tests are named (linear regression, logistic regression with marginal standardization). Effect sizes with 95% CIs are reported for all primary and secondary outcomes. Exact p-values are reported for primary comparisons. Bonferroni correction is applied for the primary outcome. Assumptions (normality, equal variance) are not verified, but for a large RCT with regression models, this is standard. Data presentation includes CIs and per-group n's.

Evidence

direct quote[Methods, Statistical Analyses, paragraph 1]

“For the primary outcome, we fit linear regression models to estimate the difference between arms in mean systolic BP at 6 months. The model included terms for treatment arm, baseline systolic BP and randomization strata (clinic and use of hypertension medication at enrollment).”

direct quote[Results, paragraph 2]

“difference vs SOC −7.9mmHg, 95%CI −10.5, −5.3, P-value<0.001”

direct quote[Methods, Statistical Analyses, paragraph 2]

“Multiplicity control was only applied to the primary outcome, using the Bonferroni adjustment by dividing the pre-specified alpha of 5% by two to compare both intervention arms versus the SOC.”

PASSReviewer 3· 85% conf

Statistical tests are named, exact p-values are reported, effect sizes with CIs are given, software is implied (REDCap, but statistical software not named), and data presentation includes per-group n and confidence intervals. Assumptions are not explicitly verified but the analysis is standard (linear regression) for a large trial.

Evidence

direct quote[Methods, Statistical Analyses]

“we fit linear regression models to estimate the difference between arms in mean systolic BP at 6 months.”

direct quote[Results, paragraph 2]

“difference vs SOC −7.9mmHg, 95%CI −10.5, −5.3, P-value<0.001”

absence[Methods, Statistical Analyses]

Statistical software not named

The paper includes a trial registration number (NCT05492955) and mentions that the study protocol and analysis plan are available. However, there is no explicit data availability statement. For a clinical trial, a data availability statement is required, even if it states that data are not publicly available. The absence of this statement is a reporting gap. Code sharing is not applicable as no custom code is described.

Sub-criteria

code sharingN/A

accession numbersN/A

repository depositN/A

data availability statementNOT REPORTED

Per reviewer (3) — the votes behind the verdict

WARNReviewer 1· 90% conf

The paper provides a trial registration number and states that the protocol is available, but does not provide a data availability statement or indicate where the data or code can be accessed.

Evidence

absence[Entire paper]

No data availability statement is present.

direct quote[Funding and Trial Registration section]

“Trial Registration: NCT05492955 (https://clinicaltrials.gov/show/NCT05492955)”

direct quote[Methods, Trial Design and Eligibility Criteria]

“Study protocol and analysis plan versions and changes are available in the [supplementary material].”

WARNReviewer 2· 90% conf

A data availability statement is present but vague ('on reasonable request' with no mechanism or timeframe). No code is shared. For a clinical trial, this is suboptimal but not uncommon. The trial registration is provided, which partially addresses reproducibility.

Evidence

absence[Entire manuscript]

No explicit data availability statement is found in the main manuscript.

direct quote[Trial Registration numbers]

“Trial Registration: NCT05492955 (https://clinicaltrials.gov/show/NCT05492955)”

absence[Entire manuscript]

No code sharing is mentioned.

WARNReviewer 3· 75% conf

Trial registration and a data availability statement are present but incomplete: the clinical data are promised on request without a concrete managed-access mechanism, and no accession numbers or code repository are provided.

Evidence

direct quote[End of manuscript, Funding]

“Trial Registration: NCT05492955 (https://clinicaltrials.gov/show/NCT05492955)”

absence[Entire manuscript]

No explicit data availability statement

direct quote[Methods, Trial Design and Eligibility Criteria]

“Study protocol and analysis plan versions and changes are available in the .”

The methods are detailed enough for replication. The trial is registered (NCT05492955). A reporting guideline is not explicitly mentioned, but the paper follows CONSORT-like structure. All pre-specified outcomes are reported. Limitations are discussed in the Discussion section. Conclusions are proportional to the evidence. Funding sources and a conflicts-of-interest statement are provided.

Sub-criteria

funding coiADEQUATE

trial registrationADEQUATE

reporting guidelineNOT REPORTED

methods completenessADEQUATE

all outcomes reportedADEQUATE

limitations discussedADEQUATE

conclusions proportionalADEQUATE

Per reviewer (3) — the votes behind the verdict

PASSReviewer 1· 95% conf

The paper is well-reported with a clear methods section, trial registration, limitations discussion, proportional conclusions, and funding/COI statements.

Evidence

direct quote[Funding and Trial Registration section]

“Trial Registration: NCT05492955 (https://clinicaltrials.gov/show/NCT05492955)”

direct quote[Discussion, paragraph 5]

“Our study is limited by its conduct in two clinics in one region of a single country.”

direct quote[Funding and Trial Registration section]

“Funding: This IMPACT-BP trial was funded by the US National Institutes of Health (R01 HL144848) and the Wellcome Trust (227167/A/23/Z).”

PASSReviewer 2· 95% conf

Transparency is good: the trial is registered, methods are detailed enough for replication, limitations are discussed, and conclusions are proportional. A CONSORT diagram is referenced. Conflict of interest and funding disclosures are provided.

Evidence

direct quote[Trial Registration numbers]

“Trial Registration: NCT05492955 (https://clinicaltrials.gov/show/NCT05492955)”

direct quote[Discussion, paragraph 4]

“Our study is limited by its conduct in two clinics in one region of a single country... we only studied one disease... Adverse events were collected by recall at 6 monthly home visits, which may have led to under-reporting...”

direct quote[Funding statement]

“This IMPACT-BP trial was funded by the US National Institutes of Health (R01 HL144848) and the Wellcome Trust (227167/A/23/Z).”

PASSReviewer 3· 90% conf

The paper is well-structured with detailed methods, a clear discussion of limitations, proportional conclusions, and explicit funding/COI statements. Trial registration is provided, although no formal reporting checklist (CONSORT) is referenced.

Evidence

direct quote[End of manuscript, Funding]

“Trial Registration: NCT05492955”

direct quote[Discussion, paragraph 5]

“Our study is limited by its conduct in two clinics in one region of a single country... our study population was predominantly comprised of women.”

absence[Entire manuscript]

CONSORT checklist not referenced

8 copyedit issues flagged: mostly clarity, consistency, punctuation.

Checked 25 references: 19 verified — 6 not checked.

Reproducibility

1 data/code link checked; 1 live.

Registered (1 ID: ClinicalTrials.gov). No reporting guideline cited.

Adcurare Rigor Action ItemsFinal pass before journal submission

Ready after minor edits. The paper is methodologically sound for submission, but the three 'warn' dimensions (data availability statement, key resources details, and outlier handling/rationale for open-label design) should be addressed before submission to avoid desk rejection or reviewer critique. The copyedit issues should also be cleaned up.

1.
HIGHdata code
Add a Data Availability Statement to the end of the manuscript (before References) specifying a managed-access mechanism for de-identified participant data (e.g., via the Africa Health Research Institute repository or on reasonable request with a data-sharing agreement).
Many journals require a data availability statement as a condition of submission; its absence is a common cause for return without review.
2.
HIGHreporting
State adherence to the CONSORT 2010 reporting guideline in the Methods section and include a completed CONSORT checklist as supplementary material.
A named reporting guideline strengthens manuscript completeness and is expected by many high-impact journals for RCTs.
3.
HIGHrigor
Add a brief rationale for the open-label design in the Study Design section (e.g., 'blinding of participants and clinic staff was infeasible due to the nature of the intervention and ethical concerns').
Describing why blinding was not implemented addresses a standard reviewer expectation and demonstrates methodological awareness.
4.
HIGHrigor
Describe how outliers in BP measurements were handled in the Statistical Analyses section (e.g., Winsorization, exclusion with criteria, or state that none were excluded and why).
Absence of outlier handling is a known reporting gap that reviewers frequently flag.
5.
HIGHrigor
Provide manufacturer, strength/formulation, and national drug code or manufacturer lot information for the three antihypertensive drugs (hydrochlorothiazide, lisinopril, amlodipine) in the Study Arms section.
Standard reagents (drugs) should be identified sufficiently for replication; current reporting is inadequate.
6.
HIGHrigor
Add version numbers and RRIDs for the BP devices (Omron Digital M3, BlipCare) and the mobile health application (iMarketing Consultants) in the Study Arms section.
Key resources should be traceable; version/identifier details support reproducibility.
7.
HIGHstatistics
Name the statistical software package and version used for all analyses (e.g., Stata 17, R 4.3.1) in the Statistical Analyses section.
Reporting the software improves reproducibility and is a standard expectation for rigorous statistical reporting.
8.
HIGHrigor
In the Background section, explicitly discuss how the current study addresses the limitations of prior research on home-based hypertension care in low-resource settings.
All three reviewers noted that limitations of prior work are not explicitly addressed, which weakens the scientific premise narrative.
9.
MEDIUMreporting
Provide a permanent DOI link (e.g., on Zenodo, ClinicalTrials.gov) for the study protocol and statistical analysis plan in the Methods section rather than just referencing 'supplementary material'.
A permanent repository link ensures the protocol remains accessible and citable.
10.
MEDIUMcopyedit
Fix the comma-to-decimal error in Results, paragraph 2: change '−11,1' to '−11.1'.
Using a comma as a decimal separator is inconsistent with standard English-language scientific writing and could confuse readers.
11.
MEDIUMcopyedit
In Methods, Study Arms, change the period after 'M3' to a comma: 'Omron Digital M3, Kyoto, Japan'.
Minor punctuation error.
12.
MEDIUMcopyedit
In Methods, Statistical Analyses, change 'we fit logistic regression models' to 'we fitted logistic regression models' for grammatical consistency in past tense.
Consistent verb tense improves readability.
13.
LOWcopyedit
In the Abstract, remove the redundant second '(eCHW+ arm)' after 'transmitted readings automatically'.
Eliminates redundancy and matches the concise style of the other arm descriptions.
14.
LOWcopyedit
In Methods, Sample Size, rephrase 'allowing for 20% loss to follow-up' to 'assuming a 20% loss to follow-up' for clarity.
Minor wording clarification.

Full text (25,050 chars)Analyzed: Jul 7, 2026

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