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Celler BG, Argha A. Measuring blood pressure from Korotkoff sounds as the brachial cuff inflates on average provides higher values than when the cuff deflates. Physiol Meas 2024; 45:055027. [PMID: 38565129 DOI: 10.1088/1361-6579/ad39a2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 04/02/2024] [Indexed: 04/04/2024]
Abstract
Objectives. In this study, we test the hypothesis that if, as demonstrated in a previous study, brachial arteries exhibit hysteresis as the occluding cuff is deflated and fail to open until cuff pressure (CP) is well below true intra-arterial blood pressure (IAPB), estimating systolic (SBP) and diastolic blood pressure (DBP) from the presence of Korotkoff sounds (KS) as CP increases may eliminate these errors and give more accurate estimates of SBP and DBP relative to IABP readings.Approach. In 62 subjects of varying ages (45.1 ± 19.8, range 20.6-75.8 years), including 44 men (45.3 ± 19.4, range 20.6-75.8 years) and 18 women (44.4 ± 21.4, range 20.9-75.3 years), we sequentially recorded SBP and DBP both during cuff inflation and cuff deflation using KS.Results. There was a significant (p< 0.0001) increase in SBP from 122.8 ± 13.2 to 127.6 ± 13.0 mmHg and a significant (p= 0.0001) increase in DBP from 70.0 ± 9.0 to 77.5 ± 9.7 mmHg. Of the 62 subjects, 51 showed a positive increase in SBP (0-14 mmHg) and 11 subjects showed a reduction (-0.3 to -7 mmHg). The average differences for SBP and DBP estimates derived as the cuff inflates and those derived as the cuff deflates were 4.8 ± 4.6 mmHg and 2.5 ± 4.6 mmHg, not dissimilar to the differences reported between IABP and non-invasive blood pressure measurements. Although we could not develop multiparameter linear or non-linear models to explain this phenomenon we have clearly demonstrated through ANOVA tests that both body mass index (BMI) and pulse wave velocity are implicated, supporting the hypothesis that the phenomenon is associated with age, higher BMI and stiffer arteries.Significance. The implications of this study are that brachial sphygmomanometry carried out during cuff inflation could be more accurate than measurements carried out as the cuff deflates. Further research is required to validate these results with IAPB measurements.
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Affiliation(s)
- Branko G Celler
- Biomedical Systems Research Laboratory in the School of Electrical Engineering and Telecommunications, The University of New South Wales, Sydney, NSW 2052, Australia
| | - Ahmadreza Argha
- Graduate School of Biomedical Engineering, The University of New South Wales, Sydney, NSW 2052, Australia
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Celler BG, Argha A. Measuring blood pressure from Korotkoff sounds as the brachial cuff inflates on average provides higher values than when the cuff deflates. Physiol Meas 2022; 43. [PMID: 34530413 DOI: 10.1088/1361-6579/ac278f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 09/16/2021] [Indexed: 11/12/2022]
Abstract
Objective. In this study, we test the hypothesis that if, as demonstrated in a previous study, brachial arteries exhibit hysteresis as the occluding cuff is deflated and fail to open until cuff pressure (CP) is well below true intra-arterial blood pressure (IABP). Approach Estimating systolic (SBP) and diastolic blood pressure (DBP) from the presence of Korotkoff sounds as CPincreasesmay eliminate these errors and give more accurate estimates of SBP relative to IABP readings.Main Results.In 63 subjects of varying age 45.4 ± 19.9 years (range 21-76 years), including 44 men (45.2 ± 19.5, range 21-76 years) and 19 women (45.6 ± 21.4, range 21-75 years), there was a significant (p< 0.0001) increase in SBP from 124.4 ± 15.7 to 129.2 ± 16.3 mmHg and a significant (p< 0.0001) increase in DBP from 70.2 ± 10.7 to 73.6 ± 11.5 mmHg. Of the 63 subjects, 59 showed a positive increase in SBP (1-19 mmHg) and 5 subjects showed a reduction (-5 to -1 mmHg). The average differences for SBP estimates derived as the cuff inflates and estimates derived as the cuff deflates were 4.9 ± 4.7 mmHg, not dissimilar to the differences observed between IABP and NIBP measurements. Although we could not develop multiparameter linear or nonlinear models to explain this phenomenon we have clearly demonstrated through analysis of variance test that both body mass index (BMI) and pulse wave velocity are implicated, supporting the hypothesis that the phenomenon is associated with age, higher BMI and stiffer arteries.Significance. The implications of this study are potentially profound requiring the implementation of a new paradigm for NIBP measurement and a revision of the international standards for their calibration.
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Affiliation(s)
- Branko G Celler
- Biomedical Systems Research Laboratory in the School of Electrical Engineering and Telecommunications, the University of New South Wales, Sydney, NSW 2052, Australia
| | - Ahmadreza Argha
- Graduate School of Biomedical Engineering, the University of New South Wales, Sydney, NSW 2052, Australia
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Sawatari Y, Wang J, Anzai D. Blood pressure estimation system using human body communication-based electrocardiograph and photoplethysmography. Healthc Technol Lett 2020; 7:98-102. [PMID: 32983546 PMCID: PMC7494369 DOI: 10.1049/htl.2019.0105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 04/01/2020] [Accepted: 04/16/2020] [Indexed: 12/02/2022] Open
Abstract
In order to realise low-load cuffless and continuous blood pressure measurement in daily life, the authors developed a blood pressure estimation system combining human body communication-based wearable electrocardiograph and reflectance photoplethysmography. The principle is based on a relationship between the pulse arrive time and the systolic blood pressure. The pulse arrive time is the time period between the R-wave in electrocardiograph and peak of pulse wave. The greatest feature is the use of a human body communication-based electrocardiograph which can provide automatic synchronisation in time between the measured electrocardiograph and pulse wave signals to obtain the pulse arrive time so that no additional synchronisation circuit is required. Using this system, the authors measured the pulse arrive time from the electrocardiograph and pulse wave signals in real time, estimated the systolic blood pressure and compared the result with that measured by a cuff sphygmomanometer. The authors found that the root mean square error of the estimated blood pressure and the actual value measured using the cuff sphygmomanometer was 4.5 mmHg or less, and the correlation coefficient was >0.6 with a P value much <0.05. These results show the validity of the developed system for cuffless and continuous blood pressure estimation.
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Affiliation(s)
| | - Jianqing Wang
- Nagoya Institute of Technology, Nagoya 466-8555, Japan
| | - Daisuke Anzai
- Nagoya Institute of Technology, Nagoya 466-8555, Japan
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Li Y, Li Y, Li F, Liu D, Zhang Y, Cui X, Cui W. No effect of sleeved arms on the accuracy of blood pressure measurement. Intern Med J 2020; 51:2087-2094. [PMID: 32975880 DOI: 10.1111/imj.15071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/10/2020] [Accepted: 09/16/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND It is recommended that blood pressure should be measured on a bare upper arm with an appropriately sized cuff. However, in practice, it is more convenient to measure blood pressure on sleeved arms. AIMS We aim to examine the effect of sleeved arms on the accuracy of blood pressure measurement. METHODS Patients aged 18 years or older were enrolled. Participants underwent three blood pressure measurements in each of the following sleeve conditions in random order (bare arm; arm covered with a single-layer cotton shirt sleeve,1 mm; arm covered with two layers sleeve containing a cotton shirt and a polar fabric sweater, 3 mm; arm covered with two layers sleeve containing a cotton shirt and a thick cardigan, 4 mm). RESULTS Of the 300 participants, 155 (52%) were men. The mean age was 62.9 (10.7) years, and 226 (75%) had hypertension. There were no significant differences in either systolic blood pressure or diastolic blood pressure among the four kinds of sleeve conditions in all the participants (P > 0.5), and the mean blood pressure differences between measurements made on the sleeved arms and bare arm were within 1.0 mmHg. Blood pressure of sleeved arms was positively correlated with that of the bare arm (P < 0.001; r > 0.95), and showed good consistency. CONCLUSIONS In the present study, we concluded that there was no significant effect of sleeved arms on the accuracy of blood pressure measurement by using an electronic oscillometric sphygmomanometer equipped with a conventional cuff.
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Affiliation(s)
- Ya Li
- Department of Cardiology, The Second Hospital of Hebei Medical University and Institute of Cardiocerebrovascular Disease of Hebei Province, Shijiazhuang, China.,Department of Cardiology, Affiliated Hospital of Hebei University of Engineering, Handan, China
| | - Yi Li
- Department of Cardiology, The Second Hospital of Hebei Medical University and Institute of Cardiocerebrovascular Disease of Hebei Province, Shijiazhuang, China
| | - Fang Li
- Department of Cardiology, The Second Hospital of Hebei Medical University and Institute of Cardiocerebrovascular Disease of Hebei Province, Shijiazhuang, China
| | - Demin Liu
- Department of Cardiology, The Second Hospital of Hebei Medical University and Institute of Cardiocerebrovascular Disease of Hebei Province, Shijiazhuang, China
| | - Yanan Zhang
- Department of Cardiology, The Second Hospital of Hebei Medical University and Institute of Cardiocerebrovascular Disease of Hebei Province, Shijiazhuang, China
| | - Xiaoran Cui
- Department of Cardiology, The Second Hospital of Hebei Medical University and Institute of Cardiocerebrovascular Disease of Hebei Province, Shijiazhuang, China
| | - Wei Cui
- Department of Cardiology, The Second Hospital of Hebei Medical University and Institute of Cardiocerebrovascular Disease of Hebei Province, Shijiazhuang, China
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Lee S, Dajani HR, Rajan S, Lee G, Groza VZ. Uncertainty in Blood Pressure Measurement Estimated Using Ensemble-Based Recursive Methodology. SENSORS (BASEL, SWITZERLAND) 2020; 20:E2108. [PMID: 32276502 PMCID: PMC7180780 DOI: 10.3390/s20072108] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/21/2020] [Accepted: 03/27/2020] [Indexed: 11/25/2022]
Abstract
Automated oscillometric blood pressure monitors are commonly used to measure blood pressure for many patients at home, office, and medical centers, and they have been actively studied recently. These devices usually provide a single blood pressure point and they are not able to indicate the uncertainty of the measured quantity. We propose a new technique using an ensemble-based recursive methodology to measure uncertainty for oscillometric blood pressure measurements. There are three stages we consider: the first stage is pre-learning to initialize good parameters using the bagging technique. In the second stage, we fine-tune the parameters using the ensemble-based recursive methodology that is used to accurately estimate blood pressure and then measure the uncertainty for the systolic blood pressure and diastolic blood pressure in the third stage.
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Affiliation(s)
- Soojeong Lee
- Department of Computer Engineering, Sejong University, 209 Neungdong-ro, Gwangjin-gu, Seoul 05006, Korea
| | - Hilmi R Dajani
- School of Electrical Engineering and Computer Science, University of Ottawa, Ottawa, ON K1N6N5, Canada; (H.R.D.); (V.Z.G.)
| | - Sreeraman Rajan
- Department of Systems and Computer Engineering, Carleton University, Ottawa, ON K1S5B6, Canada;
| | - Gangseong Lee
- Ingenium College, Kwangwoon University, 20 Kwangwoon-ro, Nowon-gu, Seoul 01897, Korea;
| | - Voicu Z Groza
- School of Electrical Engineering and Computer Science, University of Ottawa, Ottawa, ON K1N6N5, Canada; (H.R.D.); (V.Z.G.)
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Ensemble Methodology for Confidence Interval in Oscillometric Blood Pressure Measurements. J Med Syst 2020; 44:91. [PMID: 32185510 DOI: 10.1007/s10916-020-01551-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 02/18/2020] [Indexed: 10/24/2022]
Abstract
Oscillometry blood pressure measurements are commonly used to measure blood pressure for many patients at hospitals, home, and office and they are actively studied recently. These devices generally offer a single blood pressure point and they are not able to indicate the confidence interval of the measured quantity. Therefore, we introduce a novel technique using ensemble-based adaptive methodology to measure confidence interval for oscillometry blood pressure measurements. The ensemble-based adaptive methodology that is used to accurately estimate blood pressure and then measure the confidence interval for the systolic blood pressure and diastolic blood pressure.
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Lee S, Lee G, Jeon G. Statistical Approaches Based on Deep Learning Regression for Verification of Normality of Blood Pressure Estimates. SENSORS (BASEL, SWITZERLAND) 2019; 19:E2137. [PMID: 31072052 PMCID: PMC6540460 DOI: 10.3390/s19092137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 05/01/2019] [Accepted: 05/04/2019] [Indexed: 11/17/2022]
Abstract
Oscillometric blood pressure (BP) monitors currently estimate a single point but do not identify variations in response to physiological characteristics. In this paper, to analyze BP's normality based on oscillometric measurements, we use statistical approaches including kurtosis, skewness, Kolmogorov-Smirnov, and correlation tests. Then, to mitigate uncertainties, we use a deep learning method to determine the confidence limits (CLs) of BP measurements based on their normality. The proposed deep learning regression model decreases the standard deviation of error (SDE) of the mean error and the mean absolute error and reduces the uncertainties of the CLs and SDEs of the proposed technique. We validate the normality of the distribution of the BP estimation which fits the standard normal distribution very well. We use a rank test in the deep learning technique to demonstrate the independence of the artificial systolic BP and diastolic BP estimations. We perform statistical tests to verify the normality of the BP measurements for individual subjects. The proposed methodology provides accurate BP estimations and reduces the uncertainties associated with the CLs and SDEs using the deep learning algorithm.
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Affiliation(s)
- Soojeong Lee
- Department of Computer Engineering, Sejong University, 209 Neungdong-ro, Gwangjin-gu, Seoul 05006, Korea.
| | - Gangseong Lee
- Ingenium College, Kwangwoon University, 20 Kwangwoon-ro, Nowon-gu, Seoul 01897, Korea.
| | - Gwanggil Jeon
- School of Electronic Engineering, Xidian Unversity, No. 2 South Taibai Road, Xi'an 710071, China.
- Department of Embedded Systems Engineering, Incheon National University, 119 Academy-ro, Yeonsu-gu, Incheon 22012, Korea.
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Lee S, Rajan S, Jeon G, Chang JH, Dajani HR, Groza VZ. Oscillometric blood pressure estimation by combining nonparametric bootstrap with Gaussian mixture model. Comput Biol Med 2017; 85:112-124. [DOI: 10.1016/j.compbiomed.2015.11.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 10/20/2015] [Accepted: 11/14/2015] [Indexed: 11/15/2022]
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Two-Step Pseudomaximum Amplitude-Based Confidence Interval Estimation for Oscillometric Blood Pressure Measurements. BIOMED RESEARCH INTERNATIONAL 2015; 2015:920206. [PMID: 26504847 PMCID: PMC4609396 DOI: 10.1155/2015/920206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 03/08/2015] [Indexed: 11/18/2022]
Abstract
Blood pressure (BP) is an important vital sign to determine the health of an individual. Although the estimation of average arterial blood pressure using oscillometric methods is possible, there are no established methods for obtaining confidence intervals (CIs) for systolic blood pressure (SBP) and diastolic blood pressure (DBP). In this paper, we propose a two-step pseudomaximum amplitude (TSPMA) as a novel approach to obtain improved CIs of SBP and DBP using a double bootstrap approach. The weighted median (WM) filter is employed to reduce impulsive and Gaussian noises in the step of preprocessing. Application of the proposed method provides tighter CIs and smaller standard deviation of CIs than the pseudomaximum amplitude-envelope and maximum amplitude algorithms with Student's t-method.
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Lim PK, Ng SC, Jassim WA, Redmond SJ, Zilany M, Avolio A, Lim E, Tan MP, Lovell NH. Improved Measurement of Blood Pressure by Extraction of Characteristic Features from the Cuff Oscillometric Waveform. SENSORS 2015; 15:14142-61. [PMID: 26087370 PMCID: PMC4507654 DOI: 10.3390/s150614142] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 03/23/2015] [Indexed: 11/16/2022]
Abstract
We present a novel approach to improve the estimation of systolic (SBP) and diastolic blood pressure (DBP) from oscillometric waveform data using variable characteristic ratios between SBP and DBP with mean arterial pressure (MAP). This was verified in 25 healthy subjects, aged 28 ± 5 years. The multiple linear regression (MLR) and support vector regression (SVR) models were used to examine the relationship between the SBP and the DBP ratio with ten features extracted from the oscillometric waveform envelope (OWE). An automatic algorithm based on relative changes in the cuff pressure and neighbouring oscillometric pulses was proposed to remove outlier points caused by movement artifacts. Substantial reduction in the mean and standard deviation of the blood pressure estimation errors were obtained upon artifact removal. Using the sequential forward floating selection (SFFS) approach, we were able to achieve a significant reduction in the mean and standard deviation of differences between the estimated SBP values and the reference scoring (MLR: mean ± SD = −0.3 ± 5.8 mmHg; SVR and −0.6 ± 5.4 mmHg) with only two features, i.e., Ratio2 and Area3, as compared to the conventional maximum amplitude algorithm (MAA) method (mean ± SD = −1.6 ± 8.6 mmHg). Comparing the performance of both MLR and SVR models, our results showed that the MLR model was able to achieve comparable performance to that of the SVR model despite its simplicity.
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Affiliation(s)
- Pooi Khoon Lim
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia.
| | - Siew-Cheok Ng
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia.
| | - Wissam A Jassim
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia.
| | - Stephen J Redmond
- Graduate School of Biomedical Engineering, UNSW Australia, Sydney, NSW 2052, Australia.
| | - Mohammad Zilany
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia.
| | - Alberto Avolio
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW 2109, Australia.
| | - Einly Lim
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia.
| | - Maw Pin Tan
- Department of Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
| | - Nigel H Lovell
- Graduate School of Biomedical Engineering, UNSW Australia, Sydney, NSW 2052, Australia.
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Lee S, Rajan S, Park CH, Chang JH, Dajani HR, Groza VZ. Estimated confidence interval from single blood pressure measurement based on algorithmic fusion. Comput Biol Med 2015; 62:154-63. [PMID: 25935123 DOI: 10.1016/j.compbiomed.2015.04.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 04/06/2015] [Accepted: 04/09/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Current oscillometric blood pressure measurement devices generally provide only single-point estimates for systolic and diastolic blood pressures and rarely provide confidence ranges for these estimates. A novel methodology to obtain confidence intervals (CIs) for systolic blood pressure (SBP) and diastolic blood pressure (DBP) estimates from a single oscillometric blood pressure measurement is presented. METHODS The proposed methodology utilizes the multiple regression technique to fuse optimally a set of SBP and DBP estimates obtained through different algorithms. However, the set of SBP and DBP estimates is a small number to determine the CI of each individual subject. To address this issue, the weighted bootstrap approach based on the multiple regression technique was used to generate a pseudo sample set for the SBP and the DBP. In this paper, the multiple regression technique can estimate the best-fitting surface of an efficient function that relates the input sample set as an independent vector to the auscultatory nurse measurement as a dependent vector to estimate regression coefficients. Consequently, the coefficients are assigned to an eight-sample set obtained from the fusion of different algorithms as optimally weighted parameters. CIs are also estimated using the conventional methods on the set of fused SBP and DBP estimates for comparison purposes. RESULTS The proposed method was applied to an experimental dataset of 85 patients. The results indicated that the proposed approach provides better blood pressure estimates than the existing algorithms and, in addition, is able to provide CIs for a single measurement. CONCLUSIONS The CIs derived from the proposed scheme are much smaller than those calculated by conventional methods except for the pseudo maximum amplitude-envelope algorithm for both the SBP and the DBP, probably because of the decrease in the standard deviation through the increase in the pseudo measurements using the weighted bootstrap method for each subject. The proposed methodology is likely the only one currently available that can provide CIs for single-sample blood pressure measurements.
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Affiliation(s)
- Soojeong Lee
- School of Electronic Engineering, Hanyang University, 222 Wangsimni-ro, Seongdong, Seoul 133-791, South Korea
| | - Sreeraman Rajan
- School of Electrical Engineering and Computer Science, University of Ottawa, Ottawa, ON, Canada, K1N 6N5
| | - Chee-Hyun Park
- School of Electronic Engineering, Hanyang University, 222 Wangsimni-ro, Seongdong, Seoul 133-791, South Korea
| | - Joon-Hyuk Chang
- School of Electronic Engineering, Hanyang University, 222 Wangsimni-ro, Seongdong, Seoul 133-791, South Korea.
| | - Hilmi R Dajani
- School of Electrical Engineering and Computer Science, University of Ottawa, Ottawa, ON, Canada, K1N 6N5
| | - Voicu Z Groza
- School of Electrical Engineering and Computer Science, University of Ottawa, Ottawa, ON, Canada, K1N 6N5
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Forouzanfar M, Dajani HR, Groza VZ, Bolic M, Rajan S, Batkin I. Oscillometric Blood Pressure Estimation: Past, Present, and Future. IEEE Rev Biomed Eng 2015; 8:44-63. [DOI: 10.1109/rbme.2015.2434215] [Citation(s) in RCA: 105] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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13
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Logistic ordinal regression for the calibration of oscillometric blood pressure monitors. Biomed Signal Process Control 2014. [DOI: 10.1016/j.bspc.2014.01.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Lee S, Jeon G, Lee G. On using maximum a posteriori probability based on a Bayesian model for oscillometric blood pressure estimation. SENSORS 2013; 13:13609-23. [PMID: 24152924 PMCID: PMC3859082 DOI: 10.3390/s131013609] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 09/02/2013] [Accepted: 09/24/2013] [Indexed: 11/16/2022]
Abstract
The maximum amplitude algorithm (MAA) is generally utilized in the estimation of the pressure values, and it uses heuristically obtained ratios of systolic and diastolic oscillometric amplitude to the mean arterial pressure (known as systolic and diastolic ratios) in order to estimate the systolic and diastolic pressures. This paper proposes a Bayesian model to estimate the systolic and diastolic ratios. These ratios are an improvement over the single fixed systolic and diastolic ratios used in the algorithms that are available in the literature. The proposed method shows lower mean difference (MD) with standard deviation (SD) compared to the MAA for both SBP and DBP consistently in all the five measurements.
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Affiliation(s)
- Soojeong Lee
- Department of Electronics and Computer Engineering, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul 133-791, Korea
- Authors to whom correspondence should be addressed; E-Mails: (S.L.); (G.J.); Tel./Fax: +82-22-291-0357 (S.L.); Tel.: +82-32-835-8946 (G.J.); Fax: +82-32-835-0782 (G.J.)
| | - Gwanggil Jeon
- Department of Embedded Systems Engineering, Incheon National University, 119 Academy-ro, Yeonsu-gu, Incheon 406-772, Korea
- Authors to whom correspondence should be addressed; E-Mails: (S.L.); (G.J.); Tel./Fax: +82-22-291-0357 (S.L.); Tel.: +82-32-835-8946 (G.J.); Fax: +82-32-835-0782 (G.J.)
| | - Gangseong Lee
- School of General Education, Kwangwoon University, 447-1 Wolgye-dong, Nowon-gu, Seoul 139-701, Korea; E-Mail:
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Babbs CF. Oscillometric measurement of systolic and diastolic blood pressures validated in a physiologic mathematical model. Biomed Eng Online 2012; 11:56. [PMID: 22913792 PMCID: PMC3541069 DOI: 10.1186/1475-925x-11-56] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Accepted: 08/03/2012] [Indexed: 11/10/2022] Open
Abstract
Background The oscillometric method of measuring blood pressure with an automated cuff yields valid estimates of mean pressure but questionable estimates of systolic and diastolic pressures. Existing algorithms are sensitive to differences in pulse pressure and artery stiffness. Some are closely guarded trade secrets. Accurate extraction of systolic and diastolic pressures from the envelope of cuff pressure oscillations remains an open problem in biomedical engineering. Methods A new analysis of relevant anatomy, physiology and physics reveals the mechanisms underlying the production of cuff pressure oscillations as well as a way to extract systolic and diastolic pressures from the envelope of oscillations in any individual subject. Stiffness characteristics of the compressed artery segment can be extracted from the envelope shape to create an individualized mathematical model. The model is tested with a matrix of possible systolic and diastolic pressure values, and the minimum least squares difference between observed and predicted envelope functions indicates the best fit choices of systolic and diastolic pressure within the test matrix. Results The model reproduces realistic cuff pressure oscillations. The regression procedure extracts systolic and diastolic pressures accurately in the face of varying pulse pressure and arterial stiffness. The root mean squared error in extracted systolic and diastolic pressures over a range of challenging test scenarios is 0.3 mmHg. Conclusions A new algorithm based on physics and physiology allows accurate extraction of systolic and diastolic pressures from cuff pressure oscillations in a way that can be validated, criticized, and updated in the public domain.
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Affiliation(s)
- Charles F Babbs
- Department of Basic Medical Sciences, Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN 47907-1246, USA.
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