Improved agreement and diagnostic accuracy of a cuffless 24-h blood pressure measurement device in clinical practice.
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ABSTRACT:
SUBMITTER: Socrates T
PROVIDER: S-EPMC7806663 | biostudies-literature | 2021 Jan
REPOSITORIES: biostudies-literature
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Improved agreement and diagnostic accuracy of a cuffless 24-h blood pressure measurement device in clinical practice.
Socrates Thenral T Krisai Philipp P Vischer Annina S AS Meienberg Andrea A Mayr Michael M Burkard Thilo T
Scientific reports 20210113 1
A cuffless blood pressure (BP) device (TestBP) using pulse transit time is in clinical use, but leads to higher BP values compared to a cuff-based 24 h-BP reference device (RefBP). We evaluated the impact of a recent software update on BP results and TestBP's ability to differentiate between normo- and hypertension. 71 individuals had TestBP (Somnotouch-NIBP) and RefBP measurements simultaneously performed on either arm. TestBP results with software version V1.5 were compared to V1.4 and RefBP. ...[more]
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Project description:Repeated cuff-based blood pressure (BP) measurements may cause discomfort resulting in stress and erroneous recording values. SOMNOtouch NIBP is an alternative cuff-less BP measurement device that calculates changes in BP based on changes in pulse transit time (PTT) and a software algorithm. The device is calibrated with a single upper arm cuff-based BP measurement. We tested the device against a validated 24-h ambulatory BP monitoring (ABPM) device using both the previous (SomBP1) and the current software algorithm (SomBP2). In this study, 51 patients (mean age ± SD 61.5 ± 13.0 years) with essential hypertension underwent simultaneous 24-h ABPM with the SOMNOtouch NIBP on the left arm and a standard cuff-based oscillometric device on the right arm (OscBP). We found that mean daytime systolic BP (SBP) with OscBP was 140.8 ± 19.7 compared to 148.0 ± 25.2 (P = .008) and 146.9 ± 26.0 mmHg (P = .034) for SomBP1 and SomBP2, respectively. Nighttime SBP with OscBP was 129.5 ± 21.1 compared with 146.1 ± 25.8 (P < .0001) and 141.1 ± 27.4 mmHg (P = .001) for SomBP1 and SomBP2, respectively. Ninety-five% limits of agreement between OscBP and SomBP1 were ± 36.6 mmHg for daytime and ± 42.6 mmHg for nighttime SBP, respectively. Agreements were not improved with SomBP2. For SBP, a nocturnal dipping pattern was found in 33% of the study patients when measured with OscBP but only in 2% and 20% with SomBP1 and -2, respectively. This study demonstrates that BP values obtained with the cuff-less PTT-based SOMNOtouch device should be interpreted with caution as these may differ substantially from what would be obtained from a validated cuff-based BP device.
| S-EPMC8030014 | biostudies-literature
Project description:ObjectiveThere is an increasing number of cuffless blood pressure (BP) measurement (BPM) devices. Despite promising results when comparing single measurements, the ability of these devices to track changes in BP levels over 24 h related to an initial calibration BP (CalibBP) is unknown. Our aim was to analyse this ability in a cuffless device using pulse transit time.MethodsWe prospectively enrolled 166 participants for simultaneously performed cuffless (Somnotouch-NIBP) and cuff-based (Spacelabs 90217A/IEM Mobil-O-graph) 24 h BPM. As CalibBP for the cuffless device, first cuff-based BP was used. As surrogate for changes in BP levels after the CalibBP, we used the difference between the CalibBP and mean 24 h, awake and asleep BP measured by the two devices. In addition, we analysed the relationship between the difference of the CalibBP and the cuff-based BPM versus the difference between the cuff-based and the cuffless BPM devices.ResultsMean(SD) difference between the CalibBP and mean 24hBP by the cuff-based or cuffless BP device were 7.4 (13.2) versus 1.8 (8.3) mmHg for systolic ( P < 0.0001) and 6.6 (6.8) versus 1.6 (5.8) mmHg for diastolic ( P < 0.0001). A near linear relationship was seen among the difference between the CalibBP and the cuff-based BPM values and the difference between the cuff-based and cuffless BPM device.ConclusionOur data indicate a lower ability of the cuffless BPM device to track changes of BP levels after CalibBP. In addition, cuffless device accuracy was associated with the changes in BP levels after the initial CalibBP - the larger the BP level change, the larger the difference between the devices.Registrationhttps://www.clinicaltrials.gov ; Unique identifier: NCT03054688; NCT03975582.
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| S-EPMC10789523 | biostudies-literature
Project description:Backgrounds and objectivesThis study aimed to evaluate the applicability and precision of a ring-type cuffless blood pressure (BP) measurement device, CART-I Plus, compared to conventional 24-hour ambulatory BP monitoring (ABPM).MethodsForty patients were recruited, and 33 participants were included in the final analysis. Each participant wore both CART-I Plus and ABPM devices on the same arm for approximately 24 hours. BP estimation from CART-I Plus, derived from photoplethysmography (PPG) signals, were compared with the corresponding ABPM measurements.ResultsThe CART-I Plus recorded systolic blood pressure (SBP)/diastolic blood pressure (DBP) values of 131.4±14.1/81.1±12.0, 132.7±13.9/81.9±11.9, and 128.7±14.6/79.3±12.2 mmHg for 24-hour, daytime, and nighttime periods respectively, compared to ABPM values of 129.7±11.7/84.4±11.2, 131.9±11.6/86.3±11.1, and 124.5±13.6/80.0±12.2 mmHg. Mean differences in SBP/DBP between the two devices were 1.74±6.69/-3.24±6.51 mmHg, 0.75±7.44/-4.41±7.42 mmHg, and 4.15±6.15/-0.67±5.23 mmHg for 24-hour, daytime, and nighttime periods respectively. Strong correlations were also observed between the devices, with r=0.725 and r=0.750 for transitions in SBP and DBP from daytime to nighttime, respectively (both p<0.001).ConclusionsThe CART-I Plus device, with its unique ring-type design, shows promising accuracy in BP estimation and offers a potential avenue for continuous BP monitoring in clinical practice.Trial registrationClinicalTrials.gov Identifier: NCT06084065.
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Project description:A substantial barrier to the clinical adoption of cuffless blood pressure (BP) monitoring techniques is the lack of unified error standards and methods of estimating measurement uncertainty. This study proposes a fusion approach to improve accuracy and estimate prediction interval (PI) as a proxy for uncertainty for cuffless blood BP monitoring. BP was estimated during activities of daily living using three model architectures: nonlinear autoregressive models with exogenous inputs, feedforward neural network models, and pulse arrival time models. Multiple one-class support vector machine (OCSVM) models were trained to cluster data in terms of the percentage of outliers. New BP estimates were then assigned to a cluster using the OCSVMs hyperplanes, and the PIs were estimated using the BP error standard deviation associated with different clusters. The OCSVM was used to estimate the PI for the three BP models. The three BP estimations from the models were fused using the covariance intersection fusion algorithm, which improved BP and PI estimates in comparison with individual model precision by up to 24%. The employed model fusion shows promise in estimating BP and PI for potential clinical uses. The PI indicates that about 71%, 64%, and 29% of the data collected from sitting, standing, and walking can result in high-quality BP estimates. Our PI estimator offers an effective uncertainty metric to quantify the quality of BP estimates and can minimize the risk of false diagnosis.
| S-EPMC9106676 | biostudies-literature
Project description:This study proposes a low-cost, high-sensitivity sensor of beat-to-beat local pulse wave velocity (PWV), to be used in a cuffless blood pressure monitor (BPM).ObjectiveWe design an adaptive algorithm to detect the feature of the pulse wave, making it possible for two sensors to measure the local PWV in the radial artery at a short distance. Unlike the cuffless BPM that needs to use a regression model for calibration.MethodWe encapsulate the piezoelectric sensor material in a cavity and design an analog front-end circuit. This study used color ultrasound imaging equipment to measure radial arterial parameters, including the diameter and wall thickness, to aid the estimation of blood pressure (BP) using the Moens-Korteweg (MK) equation of hemodynamics.ResultsWe compared the blood pressure estimated by the MK equation with the reference BP measured using an aneroid sphygmomanometer in a test group of 32 people, resulting in a mean difference of systolic BP of -0.63 mmHg, and a standard deviation of ±5.14 mmHg, a mean difference of mean arterial pressure (MAP) of 0.97 mmHg, with a standard deviation of ±3.54 mmHg, and a mean difference of diastolic BP of -1.14 mmHg, with a standard deviation of ±4.08 mmHg. This study has verified its compliance with ISO 81060-2.ConclusionsA new type of wearable continuous calibration-free BPM can replace the situation that requires the use of traditional ambulatory BPM and reduce patient discomfort.Clinical impactIn this study can provide long-term continuous blood pressure monitoring in the hospital.
| S-EPMC10756135 | biostudies-literature