scholarly journals A Web-based, Smartphone-enabled Algorithm for Calculating Blood Pressure Remotely using Photoplethysmogram (PPG) Waveforms: Observational Study (Preprint)

2020 ◽  
Author(s):  
Paul Holyoke ◽  
Karthika Yogaratnam ◽  
Elizabeth Kalles
Keyword(s):  
Blood Pressure ◽  
Pulse Oximeter ◽  
Gold Standard ◽  
Consensus Statement ◽  
Blood Pressure Level ◽  
International Consensus ◽  
Novel Approach ◽  
Finger Pulse ◽  
Manual Blood Pressure ◽  
International Consensus Statement

BACKGROUND The current gold standard instrument for measuring blood pressure is a mercury-filled sphygmomanometer with a cuff and stethoscope. However, this is not convenient or feasible for remote monitoring and virtual care. HeartBeat Technologies Ltd. developed a novel approach to measuring blood pressure remotely after an initial blood pressure reading using the conventional measurement method. Using a finger pulse oximeter, a photoplethysmogram wave (PPG) is transmitted by Bluetooth to a smartphone or tablet. An application called MediBeat on the smartphone transmits the PPG to a server where a proprietary algorithm analyzes it to calculate the person’s current blood pressure level and sends the level back to the smartphone and the device of the individual’s healthcare provider. OBJECTIVE This study sought to determine whether the HeartBeat algorithm calculates blood pressure as accurately as required by the European Society of Hypertension International Protocol revision 2010 (ESH-IP2) for validation of blood pressure measuring devices. METHODS The ESH-IP2, modified to conform to a more recent international consensus statement, was followed. The ESH-IP2 establishes strict guidelines for the conduct and reporting of any validation of any device to measure blood pressure, including using the gold standard manual blood pressure instrument as a comparator and specific required accuracy levels for low, medium and high ranges of blood pressure readings. The consensus statement requires a greater number of study participants for each of the blood pressure ranges. The validation of the accuracy of the algorithm was conducted in conjunction with a Contec CMS50EW pulse oximeter and a Samsung Galaxy XCover 4 smartphone. RESULTS The differences between the HeartBeat-calculated and the manually-measured blood pressures did not meet the ESH-IP2 standards for accuracy for either systolic or diastolic blood pressure measurements. There was no discernible pattern in the inaccuracies in the HeartBeat-calculated measures. CONCLUSIONS The current version of the HeartBeat algorithm, implemented in combination with the MediBeat application, the specific pulse oximeter and the Android smartphones, is not accurate for use in the general population. CLINICALTRIAL This study was registered with ClinicalTrials.gov (ClinicalTrials.gov ID: NCT04082819).

scholarly journals Web-Based Smartphone Algorithm for Calculating Blood Pressure From Photoplethysmography Remotely in a General Adult Population: Validation Study

10.2196/19187 ◽  
2021 ◽  
Vol 23 (4) ◽  
pp. e19187
Author(s):  
Paul Holyoke ◽  
Karthika Yogaratnam ◽  
Elizabeth Kalles
Keyword(s):  
Blood Pressure ◽  
Pulse Oximeter ◽  
Consensus Statement ◽  
Adult Population ◽  
International Consensus ◽  
Novel Approach ◽  
General Adult Population ◽  
Finger Pulse ◽  
International Consensus Statement ◽  
Study Participants

Background Outside of a clinical setting, oscillometric devices make remote monitoring of blood pressure and virtual care more convenient and feasible. HeartBeat Technologies Ltd developed a novel approach to measuring blood pressure remotely after an initial blood pressure reading by a nurse using the conventional measurement method. Using a finger pulse oximeter, a photoplethysmogram wave is transmitted by Bluetooth to a smartphone or tablet. A smartphone app (MediBeat) transmits the photoplethysmogram to a server for analysis by a proprietary algorithm—the person’s current blood pressure is sent back to the smartphone and to the individual’s health care provider. Objective This study sought to determine whether the HeartBeat algorithm calculates blood pressure as accurately as required by the European Society of Hypertension International Protocol revision 2010 (ESH-IP2) for validation of blood pressure measuring devices. Methods ESH-IP2 requirements, modified to conform to a more recent international consensus statement, were followed. The ESH-IP2 establishes strict guidelines for the conduct and reporting of any validation of any device to measure blood pressure, including using the standard manual blood pressure instrument as a comparator and specific required accuracy levels for low, medium, and high ranges of blood pressure readings. The consensus statement requires a greater number of study participants for each of the blood pressure ranges. The validation of the accuracy of the algorithm was conducted with a Contec CMS50EW pulse oximeter and a Samsung Galaxy XCover 4 smartphone. Results The differences between the HeartBeat-calculated and the manually measured blood pressures of 62 study participants did not meet the ESH-IP2 standards for accuracy for either systolic or diastolic blood pressure measurements. There was no discernible pattern in the inaccuracies of the HeartBeat-calculated measurements. Conclusions The October 4, 2019 version of the HeartBeat algorithm, implemented in combination with the MediBeat app, a pulse oximeter, and an Android smartphone, was not sufficiently accurate for use in a general adult population. Trial Registration ClinicalTrials.gov NCT04082819; http://clinicaltrials.gov/ct2/show/NCT04082819

scholarly journals P3 A closed loop audit on pre-operative anaemia in major elective orthopaedic surger

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Chan Hee Koh ◽  
Nicolai Gruner-Hegge ◽  
Dancho Ignatov ◽  
Aneesul Shakir ◽  
Chan Hee Koh
Keyword(s):  
Closed Loop ◽  
Perioperative Management ◽  
Consensus Statement ◽  
Preoperative Assessment ◽  
Action Plans ◽  
International Consensus ◽  
Change In Practice ◽  
International Consensus Statement ◽  
Preoperative Anaemia

Abstract Introduction The international consensus statement on perioperative management of anaemia advises that patients with haemoglobin (Hb) <130 be treated before undergoing elective operations. The advantages include reduced risk of acute kidney injuries, infections and transfusions, and quicker recovery. Methods Data was collected prospectively from 127 consecutive patients undergoing elective arthroplasties at Hinchingbrooke hospital. Baseline compliance with the consensus statement was first assessed in May 2018, and the results presented at a clinical governance meeting. Departmental action plans included early identification of anaemia and treatment to Hb 130, delaying operations where necessary. We then reassessed compliance in May 2019. Results There was a statistically significant change in practice (p = 0.036). The proportion of patients undergoing arthroplasties despite Hb < 130 reduced from 38% to 21%. Those operated with Hb < 120 decreased from 14% to 0%. The proportion of preoperative anaemias that were appropriately investigated during preoperative assessment increased from 11% to 80% (p < 0.001). The increase in attempted treatment of preoperative anaemia prior to surgery however was not significant (7% vs 20%; p = 0.279). Discussion Implementation of departmental action plans resulted in substantial improvements to clinical practice. For those that underwent arthroplasties despite mild preoperative anaemia, it may have been felt that delays in improvement to quality of life for treatment may be unacceptable, or the causes (e.g. chronic disease) difficult to treat. Further action plans should involve even earlier identification of anaemia, involving primary care at the point of referral.

SCENIC international consensus statement on surveillance and management of dysplasia in inflammatory bowel disease

2015 ◽  
Vol 81 (3) ◽  
pp. 489-501.e26 ◽  
Author(s):  
Loren Laine ◽  
Tonya Kaltenbach ◽  
Alan Barkun ◽  
Kenneth R. McQuaid ◽  
Venkataraman Subramanian ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Consensus Statement ◽  
International Consensus ◽  
Inflammatory Bowel ◽  
International Consensus Statement

International Consensus Statement on Major Depressive Disorder

2010 ◽  
Vol 71 (suppl E1) ◽  
Author(s):  
David J. Nutt ◽  
Jonathan R. T. Davidson ◽  
Alan J. Gelenberg ◽  
Teruhiko Higuchi ◽  
Shigenobu Kanba ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Consensus Statement ◽  
Major Depressive ◽  
International Consensus ◽  
International Consensus Statement
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