To the Editor Dr Chow and colleagues1 reported the results of a randomized clinical trial, the Tobacco, Exercise, and Diet Messages (TEXT ME) trial, in which large effects on cardiovascular risk factors were found for a modest text message intervention in a sample of patients with coronary heart disease. The authors conveyed the impression that they analyzed changes over time in risk factors, as when they reported “concurrent reductions” in risk factors or “change” in low-density lipoprotein cholesterol (LDL-C) level, systolic blood pressure, or body mass index. This language is misleading, as the data analyses focused on differences between intervention and control groups in 6-month risk factor levels rather than on treatment-related changes over time. For example, the “change in systolic blood pressure” of −7.6 mm Hg was not a change over time but a difference between the mean blood pressure readings taken between the intervention and control groups at 6 months. The only change over time in blood pressure was an increase in blood pressure in the control group. Comparing the data in Tables 1 and 2 in the article, the control group appeared to have a mean increase in systolic blood pressure of 7.3 mm Hg, whereas the experimental group showed a decrease of about 0.8 mm Hg. Targeted text message interventions may have a promising future, but it will be difficult to make progress unless findings are accurately depicted in the scientific literature.
Kamarck T. Targeted Text Messaging Support for Patients With Coronary Heart Disease. JAMA. 2016;315(10):1056. doi:10.1001/jama.2016.0031