Uma avaliação do rastreômetro, um novo equipamento para triagem populacional da pressão arterial elevada, em países em desenvolvimento

Abstract

objective: To test a simplified blood pressure device called Rastreometro that could be used by the Health Agents. Methods:The measurements made by the Rastreometro were compared with those by the auscultatory method, and were carried out in 268 patients, by two operators. The influence on the results of confounding variables such as age, gender, BMI, onfounding variables such as age, gender, BMI, arm length, upper arm circunference, skin colour and antihypertensive treatment were taken into consideration, as well as intra and interobserver variation. results:In the whole group, sensitivity was 95.1%, specificity 63.1%, positive preditive value 62.4% and negative preditiveIn the whole group, sensitivity was 95.1%, specificity 63.1%, positive preditive value 62.4% and negative preditive value 95.3%. Hypertensive treatment significantly affected specificity, 32.7% as compared to 77.8% for the non-treated group. Both operators improved their results over time.conclusion: This study suggests that the Rastreometro technique, as a screener for hypertension, has a good sensitivity. ConThis study suggests that the Rastreometro technique, as a screener for hypertension, has a good sensitivity. Concerning specificity, it is acceptable, provided the patient is not on regular antihypertensive treatment. In this latter situation, it can be improved by a proper standardization of the method to read the systolic pressure by needle oscillations . Furthermore, the use of this technique requires well trained operators.

Avaliação da acurácia do rastreômetro: um novo equipamento para rastreamento de hipertensão arterial

“…However, this situation can be explained in part by the fact of having been used a cuff smaller than indicated in the Rastreometer in 80.7% of the sample, which increased its sensitivity to some extent due to an overestimation of the arterial pressure 14 reading and did not influence the specificity. This finding confirms the finding of Forsvall 9 , which also has not identified differences in accuracy of the Rastreometer when using cuffs inadequate to arm circumference, however, in that study we used identical cuffs in the Rastreometer and a reference standard. Post-test probability -(%) 6,1 (2,5 -13,3) It is worth noting that the evaluation of the influence of arm circumference in the Rastreometer accuracy is impossible to achieve if using cuffs inadequate for arm circumference in the reference standard instrument, as the result obtained in this unit would not be consistent with the reality, but compatible with the Rastreometer measures.…”

“…In the second study 9 the Rastreometer was tested on a sample of 268 patients, by two medical students, with results of 95.1% for sensitivity and 63.1% for specificity.…”

“…In the study of Forsvall 9 it was used reference standard with an accuracy of 5 mmHg. In our study, the accuracy in measurements of blood pressure was 1 mmHg.…”

“…So far, however, does there is no instrument available that makes it feasible for mass screening of the population. Studies 8,9 have shown that a new instrument, the Rastreometer could be a possibility for population screening for hypertension in primary care, since it was designed to…”

“…This means that more than 240,000 ACS 10 across the country could apply this test quickly, with low costs and minimal risks, to detect suspected hypertension individuals. However, the Rastreometer has only been tested by professionals and medical students in controlled environments 8,9 .…”