Validating cuffless continuous blood pressure monitoring devices

Hu, Jiun-Ruey; Martin, Gabrielle; Iyengar, Sanjna; Kovell, Lara C.; Plante, Timothy B; Helmond, Noud van; Dart, Richard A.; Brady, Tammy M.; Turkson‐Ocran, Ruth‐Alma; Juraschek, Stephen P

doi:10.1016/j.cvdhj.2023.01.001

Cited by 18 publications

(8 citation statements)

References 45 publications

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“…However, the methods for clinical validation of these new measurement approaches are different to the ISO requirements for currently used BP measurement devices and methodologically more difficult. [24][25][26] They need to be clinically validated to ensure they provide accurate and precise measurement of BP. Currently, no cuffless BP measurement device is recommended for use in clinical practice.…”

Section: Implementation Of Bp Cpg Recommendationsmentioning

confidence: 99%

Editors’ Commentary on the 2023 ESH Management of Arterial Hypertension Guidelines

et al. 2023

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Clinical practice guidelines are ideally suited to the provision of advice on the prevention, diagnosis, evaluation, and management of high blood pressure (BP). The recently published European Society of Hypertension (ESH) 2023 ESH Guidelines for the management of arterial hypertension is the latest in a long series of high BP clinical practice guidelines. It closely resembles the 2018 European Society of Cardiology/ESH guidelines, with incremental rather than major changes. Although the ESH guidelines are primarily written for European clinicians and public health workers, there is a high degree of concordance between its recommendations and those in the other major BP guidelines. Despite the large number of national and international BP guidelines around the world, general population surveys demonstrate that BP guidelines are not being well implemented in any part of the world. The level of BP, which is the basis for diagnosis and management, continues to be poorly measured in routine clinical practice and control of hypertension remains sub-optimal, even to a conservative blood pressure target such as a systolic/diastolic BP <140/90 mm Hg. BP guidelines need to focus much more on implementation of recommendations for accurate diagnosis and strategies for improved control in those being treated for hypertension. An evolving body of implementation science can assist in meeting this goal. Given the enormous health, social, and financial burden of high BP better diagnosis and management should be an imperative for clinicians, government, and others responsible for the provision of healthcare services. Hopefully, the 2023 ESH will help enable this.

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Section: Implementation Of Bp Cpg Recommendationsmentioning

confidence: 99%

Editors’ Commentary on the 2023 ESH Management of Arterial Hypertension Guidelines

et al. 2023

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“…during low perfusion, 7 and as all the cuff-based methods, is also dependent on the correct choice of cuff size. 8 Pulse Arrival Time (PAT) is a feature commonly used as a proxy for BP estimations. PAT is the time elapsed between electrical activation of the ventricles and the arrival of the pressure wave at a distal location.…”

Section: Introductionmentioning

confidence: 99%

“…PAT is the time elapsed between electrical activation of the ventricles and the arrival of the pressure wave at a distal location. 8 The electrical activation of the ventricles moment can be monitored through the ECG, the R-peak, and the pressure wave has been commonly detected using Photoplethysmography (PPG). However, the relationship between PAT and BP depends on the Pre-Ejection Period (PEP), which is an unknown added interval corresponding to the time between the electrical activation and the actual blood ejection from the heart.…”

Section: Introductionmentioning

confidence: 99%

“…PWA based on PPG features requires a particularly high quality signal; however, this method also resulted in limited accuracy. 8,10 Speckle Plethysmography (SPG), is an emerging method [11][12][13][14][15][16][17][18] based on the use of coherent light, as opposite to PPG, which does not require coherence to work. SPG is related to Laser Contrast Analysis (LASCA) and Laser Speckle Imaging (LSI), however SPG produces a single waveform as output, not an image.…”

Section: Introductionmentioning

confidence: 99%

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Towards continuous blood pressure monitoring using speckle plethysmography

Lorato,

Herranz Olazábal,

Kling

et al. 2024

Biophotonics in Exercise Science, Sports Medicine, Health Monitoring Technologies, and Wearables V

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Speckle Plethysmography (SPG) is recently gaining interest as an addition to Photoplethysmography (PPG), due to higher Signal-to-Noise Ratio and the reduced sensitivity to both ambient light changes and variation in skin melanin content. SPG can be obtained by analyzing the spatial changes in the speckle pattern generated by a coherent light source over time. Continuous Blood Pressure (BP) monitoring is a particularly relevant topic in the biomedical domain as elevated BP is a major risk factor for cardiovascular diseases. Noninvasive methodologies are being researched as an alternative to cuff-based methods, which are considered uncomfortable and cumbersome. Typical approaches are Pulse Arrival Time (PAT), using Electrocardiogram (ECG) signals and PPG, or Pulse Waveform Analysis (PWA), by analyzing PPG's morphological features. These approaches, however, still lack accuracy and require personalized BP models. SPG could offer better performance for this type of application. Therefore, in this work, ten subjects were monitored using a contact SPG system synchronized with simultaneous reference recordings of ECG, PPG, and BP signals. PAT and PWA features were calculated from SPG and ECG. The same features were calculated from PPG, which were used for benchmarking purposes. Linear regression analysis was performed between the extracted features and the reference BP. In addition, the inter-subject variability in the feature BP-slope and the correlation coefficients were analyzed. The results show a high correlation between the SPG features and BP. Furthermore, the SPG features resulted in a reduced inter-subject variability compared to the PPG-derived features, possibly indicating that SPG could be used for a generalized BP model.

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“…Although online blood pressure monitoring offers many advantages, there are also potential challenges and problems associated with this approach, such as new measurement technologies [8], device validation and calibration [9], [10] high energy consumption, availability of fewer resources and security issues [11], transaction time, throughput, different design priorities such as latency, mobility, cost and size, QoS requirements based on traffic type, data quality, quality of device and network metrics [12], the medical data routing protocols. To improve the QoS of health data transmission, the authors in [13] developed and tested a multi-hop enhanced cluster routing protocol (MRCRP).…”

mentioning

confidence: 99%

Delay of Transmitted Data in the Remote Patient Monitoring System through AMQP and CoAP

Tsvetanov,

Pandurski

2024

Int. J. Onl. Eng.

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Remote Patient Monitoring (RPM) is a healthcare solution that uses technology to monitor patients outside conventional healthcare settings. It is especially useful for people with chronic conditions or needing regular monitoring. One of the main reasons for the increase in the number of deaths each year is the increase in cardiovascular diseases, including hypertension. Online blood pressure monitoring offers many advantages but also potential challenges. This work reviews the key communication technologies and research challenges in the real-time transmission of measured blood pressure data. Delay in these systems is not tolerated as it involves human lives. To conduct the experimental studies, a prototype of an experimental intelligent system was created to study the delay and processor load of the RPI4 gateway. The measured blood pressure data is sent to the Things Board cloud using the AMQP and CoAP protocols. The experimental results are particularly useful for RPM system designers. The results of this research facilitate an informed decision on the choice of protocol that transmits the data from the gateway to the cloud in the process of designing remote patient monitoring systems.

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Validating cuffless continuous blood pressure monitoring devices

Cited by 18 publications

References 45 publications

Editors’ Commentary on the 2023 ESH Management of Arterial Hypertension Guidelines

Editors’ Commentary on the 2023 ESH Management of Arterial Hypertension Guidelines

Towards continuous blood pressure monitoring using speckle plethysmography

Delay of Transmitted Data in the Remote Patient Monitoring System through AMQP and CoAP

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