Comparison of Different Automated Office Blood Pressure Measurement Devices: Evidence of Nonequivalence and Clinical Implications

Rinfret, Félix; Cloutier, Lyne; Wistaff, Robert; Birnbaum, Leora; Cheong, Nathalie Ng; Laskine, Mikhael; Roederer, Ghislaine O.; Nguyen, P.; Bertrand, Michel; Rabasa‐Lhoret, Rémi; Dufour, Robert; Lamarre-Cliché, Maxime

doi:10.1016/j.cjca.2017.09.011

Cited by 24 publications

(16 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…No such bias was identified with any of the same 3 nurses using an automated device. This TDB was previously described in numerous other studies, 19,[21][22][23][24][25][26][27][28][29] most of which show that TDB is reduced but not completely eliminated by the introduction of automated devices in measuring BP. Myers and Campbell 11 found evidence of TDB of 14% of readings when using the BpTRU automated device, when the expected proportion of zero terminal digits is 10%.…”

Section: Discussionsupporting

confidence: 56%

Sources of Error in Office Blood Pressure Measurement

Morcos¹,

Carter

Castro

et al. 2019

J Am Board Fam Med

View full text Add to dashboard Cite

Purposes: To evaluate 2 commonly overlooked sources of error in measuring blood pressure (BP) in the office, improper patient positioning and frequency of terminal digit bias (TDB) using manual and automated (BP) devices. Methods: BPs recorded by 3 nurses using manual and automated devices were analyzed for TDB. In the next part of the study, 294 patients were recruited and tested with each patient's BP measured twice in the table position and compared with BP measured in the chair position. To eliminate concern for position sequence, a randomized controlled trial was initially conducted. Results: Significant TDB for the digit zero was identified in BPs measured by all nurses using a manual device. No such bias was identified for any nurse when measuring BP with an automated device. For the positional study, the randomized controlled study showed no significant sequencing effect therefore the sequence of table then chair BP measurements was adopted. Significant BP lowering was observed in 128 patients (42.7%) in the chair compared with the table position. Misclassification of prehypertension and hypertension would have occurred in 15.3% and 16% of patients, respectively, when BP was recorded in the table instead of the chair position. Conclusions: Significant TDB was identified for all nurses when using a manual but not an automated device. Patient positioning on the examination table resulted in elevations of systolic and diastolic BPs.

show abstract

Section: Discussionsupporting

confidence: 56%

Sources of Error in Office Blood Pressure Measurement

Morcos¹,

Carter

Castro

et al. 2019

J Am Board Fam Med

View full text Add to dashboard Cite

show abstract

“…Various factors could be responsible for this discrepancy, such as differences in the devices internal algorithm and differences in threshold values for small cuffs between BpTRU and Omron HEM 907 XL 55,56 , and lower mean BP values 31 . We acknowledge that, even if the results of the subgroup analysis confirmed previous reports, it is difficult to make robust conclusions due to the small number of included studies.…”

Section: Discussionmentioning

confidence: 99%

“…Only attrition bias was relevant in 7 studies due to missing data (BP readings missing, patients lost at follow-up). 16 studies compared AOBP with traditional OBP taken by physicians 4,8,10,12,19,[21][22][23][24]27,28,30,[32][33][34]37 ; 16 studies compared AOBP with awake ABPM 4,8,10,18,19,20,22,[24][25][26]29,[33][34][35]37,38 ; AOBP was compared with HBPM in 7 studies 10,12,24,27,28,30,38 and with non-physician OBP in 10 studies 4,8,15,[18][19][20]31,[36][37][38] .…”

Section: Characteristic Of the Included Studiesmentioning

confidence: 99%

Comparison of Automated Office Blood Pressure With Office and Out-Off-Office Measurement Techniques

et al. 2019

View full text Add to dashboard Cite

Automated office blood pressure (AOBP) has emerged as valuable tool to assess patient's blood pressure (BP) status, but the lack of strong evidences to establish a threshold value for hypertension diagnosis limits its use in clinical practice. We aimed at synthesizing the published literature through a meta-analysis of studies comparing AOBP with other BP measurement techniques and at analysing the differences between AOBP and physician's office BP, non-physician's office BP, daytime ambulatory BP monitoring (ABPM) and home BP monitoring (HBPM). We searched PubMed database for articles published up to April 2018; eligible studies compared AOBP with office and/or out-of-office measurement techniques and reported the BP differences or BP values obtained. Twenty-six studies, for a total of 7,116 patients were included in the analysis. AOBP values were lower than physician (systolic blood pressure, SBP-10.48 mmHg [95% CI-13.15 to-7.81] / diastolic blood pressure, DBP-4.44 mmHg [95% CI-6.07 to-2.80]) and non-physician office ones (SBP-6.89 mmHg [95% CI-8.75 to-5.04] / DBP-3.82 mmHg [95% CI-4.86 to-2.78]). No significant differences were detected between AOBP and daytime ABPM (SBP-1.85 mmHg [95% CI-4.50 to 0.79] / DBP 0.12 mmHg [95% CI-1.42 to 1.66]) and HBPM (SBP-2.65 mmHg [95% CI-8.42 to 3.12]) / DBP-1.67 mmHg [95% CI-4.20 to 0.87]). AOBP readings did not differ significantly from out-of-office blood pressure, still remaining an office technique; it may improve hypertension diagnosis by overcoming some of office BP limitations, including the white-coat effect.

show abstract

“…A review of studies examining the relationship between awake ABP and a normal office BP, recorded using several different techniques, including AOBP, has shown that mean office BP is invariably lower than awake ABP, regardless of how BP is recorded. Thus, the equivalence of attended and unattended AOBP in 3 of the studies in the present meta‐analysis in which subjects had a mean office systolic BP in research settings < 130 mm Hg is likely valid, in that having the patient alone would not be expected to lower mean BP by reducing WCE.…”

mentioning

confidence: 86%

A meta‐analysis that helps clarify the use of automated office blood pressure in clinical practice

Myers

2019

J of Clinical Hypertension

View full text Add to dashboard Cite

Comparison of Different Automated Office Blood Pressure Measurement Devices: Evidence of Nonequivalence and Clinical Implications

Cited by 24 publications

References 20 publications

Sources of Error in Office Blood Pressure Measurement

Sources of Error in Office Blood Pressure Measurement

Comparison of Automated Office Blood Pressure With Office and Out-Off-Office Measurement Techniques

A meta‐analysis that helps clarify the use of automated office blood pressure in clinical practice

Contact Info

Product

Resources

About