Rapid estimation of the accuracy of automatic blood pressure measuring devices (READ)

Abstract

We propose a rapid method for the evaluation of automatic blood pressure measurement devices (READ) in response to the claim to simplify the validation of those devices. The READ is based on numerous blood pressure (BP) measurements at rest and during a standardised postural challenge in a small number of subjects who exhibit a wide range of BPs. Automatic (AU) and mercury sphygmomanometric (MS) brachial BP were measured simultaneously in a blinded manner. An average of 30 measurements per patient were done in 10-min while in a supine position, followed by 30 min in head-up tilt and again supine for 10 min. Two Collin-8800 automated oscillometric devices were tested with the aid of the READ in 15 adults. The consistency of the MS standard was demonstrated by duplicate MS measurements showing minimal inter-observer differences consistent with class A of the British Hypertension Society (BHS) grading system. AU-to-MS differences of 447 measurements were mean systolic ΔBP = 1.1 ± 11.4 mm Hg and mean diastolic ΔBP = −13.36 ± 8.9 mm Hg, classifying into category D of the BHS. Both tested instruments, each subject, each phase of the tilt test (supine I, tilt, supine II) and each mode of measurement (at 5-min intervals or continuously) equally qualified as ‘D’. We conclude that the READ permitted us to identify quickly and at low expense a grossly inaccurate automatic BP measuring device. Further studies will show whether the READ can be efficient as a pre-validation test, post-validation test, and for assessment of ambulatory BP measuring devices.