Use of mobile-stroke risk scale and lifestyle guidance promote healthy lifestyles and decrease stroke risk factors.

The main between-group comparisons were not significant, so the conclusion that the app was better rests on within-group changes and the Discussion, not on a clear app-versus-manual result. The app and manual contained the same stroke-risk and lifestyle information, so the added value of the app's digital features is unclear. Participants were only adults aged 40 to 65 years, at moderate or severe stroke risk, with no previous stroke and not being treated for chronic illness, so results may not apply to younger people, lower-risk people, stroke survivors, or those with chronic illness. Participants needed smartphones or computers and internet access, so people without these may not benefit. Healthy lifestyle was measured by self-report, and no respondents consumed alcohol, so the study cannot say much about alcohol use. Smoking did not change in the app group, so this intervention should not be expected to address smoking. Follow-up was only six months, and the study measured risk-factor scores, not strokes or clinical outcomes. Observers were blinded to allocation, but the paper does not report participant blinding.

The authors declared no conflict of interest. The contribution statement lists funding acquisition by one author, but no external funder is named.

Do not conclude that the app outperforms the printed guide. The app and manual groups did not differ significantly in healthy lifestyle or stroke risk scores after six months, so the paper does not show the app's added features caused the improvement.