Accuracy of a smartphone application for blood pressure estimation in Bangladesh, South Africa, and Tanzania

Festo, Charles; Vannevel, Valerie; Ali, Hasmot; Tamrat, Tigest; Mollel, Getrud Joseph; Hlongwane, Tsakane; Fahmida, Kaniz A.; Alland, Kelsey; Barreix, María; Mehrtash, Hedieh; Silva, Ronaldo; Thwin, Soe Soe; Mehl, Garrett; Labrique, Alain; Masanja, Honorati; Tunçalp, Özge

doi:10.1038/s41746-023-00804-z

Cited by 5 publications

(4 citation statements)

References 21 publications

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“…A more recent study included obstetric women in Africa and Asia. The results demonstrated that BP measurements also fell within the ISO81060-2:2018 standards [43]. It should be noted that the studies described above did not report error grid analysis, with the exception of the study carried out during the induction of general anesthesia (the study contained a small amount of recorded BP in zone C, which indicated moderate risk for the patient).…”

Section: Discussionmentioning

confidence: 72%

“…Currently, there are only seven studies that have compared BP measurements collected with the OptiBP™ versus a non-invasive or invasive reference method. Three studies were carried out in Lausanne, Switzerland, by the inventors of the BP application [26,28,31], three other studies by our team in Belgium [27,29,30] and the last study was conducted as a tri-center study in South Africa, Tanzania, and Bangladesh [43]. These studies are summarized in Table 2.…”

Section: Discussionmentioning

confidence: 99%

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Smartphone-Based versus Non-Invasive Automatic Oscillometric Brachial Cuff Blood Pressure Measurements: A Prospective Method Comparison Volunteer Study

Delmotte,

Desebbe,

Alexander

et al. 2023

JPM

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Introduction: Mobile health diagnostics have demonstrated effectiveness in detecting and managing chronic diseases. This method comparison study aims to assess the accuracy and precision of the previously evaluated OptiBP™ technology over a four-week study period. This device uses optical signals recorded by placing a patient’s fingertip on a smartphone’s camera to estimate blood pressure (BP). Methods: In adult participants without cardiac arrhythmias and minimal interarm blood pressure difference (systolic arterial pressure (SAP) < 15 mmHg or diastolic arterial pressure (DAP) < 10 mmHg), three pairs of 30 s BP measurements with the OptiBP™ (test method) were simultaneously compared using three pairs of measurements with the non-invasive oscillometric brachial cuff (reference method) on the opposite arm over a period of four consecutive weeks at a rate of two measurements per week (one in the morning and one in the afternoon). The agreement of BP values between the two technologies was analyzed using Bland–Altman and error grid analyses. The performance of the smartphone application was investigated using the International Organization for Standardization (ISO) definitions, which require the bias ± standard deviation (SD) between two technologies to be lower than 5 ± 8 mmHg. Results: Among the 65 eligible volunteers, 53 participants had adequate OptiBP™ BP values. In 12 patients, no OptiBP™ BP could be measured due to inadequate signals. Only nine participants had known chronic arterial hypertension and 76% of those patients were treated. The mean bias ± SD between both technologies was −1.4 mmHg ± 10.1 mmHg for systolic arterial pressure (SAP), 0.2 mmHg ± 6.5 mmHg for diastolic arterial pressure (DAP) and −0.5 mmHg ± 6.9 mmHg for mean arterial pressure (MAP). Error grid analyses indicated that 100% of the pairs of BP measurements were located in zones A (no risk) and B (low risk). Conclusions: In a cohort of volunteers, we observed an acceptable agreement between BP values obtained with the OptiBPTM and those obtained with the reference method over a four-week period. The OptiBPTM fulfills the ISO standards for MAP and DAP (but not SAP). The error grid analyses showed that 100% measurements were located in risk zones A and B. Despite the need for some technological improvements, this application may become an important tool to measure BP in the future.

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Smartphone-Based versus Non-Invasive Automatic Oscillometric Brachial Cuff Blood Pressure Measurements: A Prospective Method Comparison Volunteer Study

Delmotte,

Desebbe,

Alexander

et al. 2023

JPM

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“…51 52 Findings from this multi-site study demonstrated accuracy against International Organisation for Standardisation (ISO) benchmarks, including among pregnant populations, except in Bangladesh for systolic BP ISO criterion 2. 52 53 A similar validation study was also conducted in Indonesia among pregnant populations in West Lombok and East Lombok in West Nusa Tenggara Province. 54…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 96%

Exploring perceptions and operational considerations for use of a smartphone application to self-monitor blood pressure in pregnancy in Lombok, Indonesia: protocol for a qualitative study

Tamrat,

Setiyawati,

Barreix

et al. 2023

BMJ Open

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IntroductionHypertensive disorders of pregnancy (HDP) are a leading cause of maternal deaths globally and require close monitoring of blood pressure (BP) to mitigate potential adverse effects. Despite the recognised need for research on self-monitoring of blood pressure (SMBP) among pregnant populations, there are very few studies focused on low and middle income contexts, which carry the greatest burden of HDPs. The study aims to understand the perceptions, barriers, and operational considerations for using a smartphone software application to perform SMBP by pregnant women in Lombok, Indonesia.Methods and analysisThis study includes a combination of focus group discussions, in-depth interviews and workshop observations. Pregnant women will also be provided with a research version of the smartphone BP application to use in their home and subsequently provide feedback on their experiences. The study will include pregnant women with current or past HDP, their partners and the healthcare workers involved in the provision of antenatal care services within the catchment area of six primary healthcare centres. Data obtained from the interviews and observations will undergo thematic analyses using a combination of both inductive and deductive approaches.Ethics and disseminationThe study was approved by the World Health Organization (WHO) and Human Reproduction Programme (HRP) Research Project Review Panel and WHO Ethical Review Committee (A65932) as well as the Health Research Ethics Committee, Faculty of Medicine, Universitas Mataram in Indonesia (004/UN18/F7/ETIK/2023).Findings will be disseminated through research publications and communicated to the Lombok district health offices. The analyses from this study will also inform the design of a subsequent impact evaluation.

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“…Furthermore, shortfalls in human resources and the need for targeted health interventions, such as in the areas of maternal health care and management of STIs, serve as key issues that have the potential to be addressed through the predictive capabilities offered by AI [ 14 ]. In addition, the use of AI to power “software as a medical device” [ 15 ] presents an opportunity to leapfrog access to diagnostic devices, such as ultrasounds [ 16 ] and blood pressure equipment [ 17 ]. This has also been seen with the emergence of contraceptive and fertility software applications [ 18 , 19 ], which are increasingly securing regulatory approvals from national authorities [ 20 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

Exploring the Use and Implications of AI in Sexual and Reproductive Health and Rights: Protocol for a Scoping Review

Tamrat,

Zhao,

Schalet

et al. 2024

JMIR Res Protoc

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Background Artificial intelligence (AI) has emerged as a transformative force across the health sector and has garnered significant attention within sexual and reproductive health and rights (SRHR) due to polarizing views on its opportunities to advance care and the heightened risks and implications it brings to people’s well-being and bodily autonomy. As the fields of AI and SRHR evolve, clarity is needed to bridge our understanding of how AI is being used within this historically politicized health area and raise visibility on the critical issues that can facilitate its responsible and meaningful use. Objective This paper presents the protocol for a scoping review to synthesize empirical studies that focus on the intersection of AI and SRHR. The review aims to identify the characteristics of AI systems and tools applied within SRHR, regarding health domains, intended purpose, target users, AI data life cycle, and evidence on benefits and harms. Methods The scoping review follows the standard methodology developed by Arksey and O’Malley. We will search the following electronic databases: MEDLINE (PubMed), Scopus, Web of Science, and CINAHL. Inclusion criteria comprise the use of AI systems and tools in sexual and reproductive health and clear methodology describing either quantitative or qualitative approaches, including program descriptions. Studies will be excluded if they focus entirely on digital interventions that do not explicitly use AI systems and tools, are about robotics or nonhuman subjects, or are commentaries. We will not exclude articles based on geographic location, language, or publication date. The study will present the uses of AI across sexual and reproductive health domains, the intended purpose of the AI system and tools, and maturity within the AI life cycle. Outcome measures will be reported on the effect, accuracy, acceptability, resource use, and feasibility of studies that have deployed and evaluated AI systems and tools. Ethical and legal considerations, as well as findings from qualitative studies, will be synthesized through a narrative thematic analysis. We will use the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) format for the publication of the findings. Results The database searches resulted in 12,793 records when the searches were conducted in October 2023. Screening is underway, and the analysis is expected to be completed by July 2024. Conclusions The findings will provide key insights on usage patterns and evidence on the use of AI in SRHR, as well as convey key ethical, safety, and legal considerations. The outcomes of this scoping review are contributing to a technical brief developed by the World Health Organization and will guide future research and practice in this highly charged area of work. Trial Registration OSF Registries osf.io/ma4d9; https://osf.io/ma4d9 International Registered Report Identifier (IRRID) PRR1-10.2196/53888

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Accuracy of a smartphone application for blood pressure estimation in Bangladesh, South Africa, and Tanzania

Cited by 5 publications

References 21 publications

Smartphone-Based versus Non-Invasive Automatic Oscillometric Brachial Cuff Blood Pressure Measurements: A Prospective Method Comparison Volunteer Study

Smartphone-Based versus Non-Invasive Automatic Oscillometric Brachial Cuff Blood Pressure Measurements: A Prospective Method Comparison Volunteer Study

Exploring perceptions and operational considerations for use of a smartphone application to self-monitor blood pressure in pregnancy in Lombok, Indonesia: protocol for a qualitative study

Exploring the Use and Implications of AI in Sexual and Reproductive Health and Rights: Protocol for a Scoping Review

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