Validation of the Instant Blood Pressure Smartphone App

Plante, Timothy B; Urrea, Bruno; MacFarlane, Zane; Blumenthal, Roger S.; Miller, Edgar R.; Appel, Lawrence J.; Martin, Seth S.

doi:10.1001/jamainternmed.2016.0157

Cited by 141 publications

(102 citation statements)

References 3 publications

(3 reference statements)

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“…However, cuffless measurements differed as much as -19.3 to 18.2 mm Hg from simultaneous oscillometric readings and the proportion of people with systolic blood pressure differences between the two methods exceeding 5 mm Hg was 45.9% and 65.7% in the supine and standing position, respectively [34]. For a smartphone-based application, the proportion of systolic readings deviating more than 5 mm Hg was 76.0% [35]. None of these devices would have passed current validation criteria for blood-pressure measuring devices [36].…”

Section: Discussionmentioning

confidence: 99%

Evidence-based proposal for the number of ambulatory readings required for assessing blood pressure level in research settings: an analysis of the IDACO database

et al. 2018

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, we randomly selected a certain number of readings (from 30 to 1 awake and 10 to 1 asleep readings) at a time over 1000 bootstraps at each step. We evaluated: (i) concordance of the ABP level; (ii) consistency of the cross-classification based on office blood pressure and ABP; and (iii) accuracy in predicting cardiovascular complications. For each criterion, we fitted a regression line joining data points relating outcome to the number of readings covering the ranges of 30-20/10-7 for awake/ asleep readings. Results: Reducing readings widened the SD of the systolic/diastolic differences between full (reference) and selected recordings from 1.7/1.2 (30 readings) to 14.3/10.3 mm Hg (single reading) during wakefulness, and from 1.9/1.4 to 10.3/7.7 mm Hg during sleep; lowered the j statistic from 0.94 to 0.63, and decreased the hazard ratio associated with 10/5 mm Hg increments in systolic/diastolic ABP from 1.21/1.14 to 1.06/1.04 during wakefulness and from 1.26/1.17 to 1.14/1.08 during sleep. The first data points falling off these regression lines during wakefulness/sleep corresponded to 8/3 and 8/4 readings for criteria (i) and (iii) and to 5 awake readings for criterion (ii). Conclusions: 24-h ambulatory recordings with !8/!4 awake/asleep readings yielded ABP levels similar to recordings including the guideline-recommended !20/!7 readings. These criteria save valuable data in a research setting, but are not applicable to clinical practice.

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Section: Discussionmentioning

confidence: 99%

Evidence-based proposal for the number of ambulatory readings required for assessing blood pressure level in research settings: an analysis of the IDACO database

et al. 2018

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“…Also, more emphasis is needed on the validation of health sensors (32), other digital health devices and smartphone applications (33) to provide quality, reliable information to users. Comparing their accuracy to well-documented technologies is a good starting point, but double-blind studies involving large patient cohorts are also needed.…”

Section: The Challenging Questions Digital Health Raisesmentioning

confidence: 99%

Digital health is a cultural transformation of traditional healthcare

Meskó¹,

Drobni²,

Bényei³

et al. 2017

mHealth

463

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Under the term "digital health", advanced medical technologies, disruptive innovations and digital communication have gradually become inseparable from providing best practice healthcare. While the cost of treating chronic conditions is increasing and doctor shortages are imminent worldwide, the needed transformation in the structure of healthcare and medicine fails to catch up with the rapid progress of the medical technology industry. This transition is slowed down by strict regulations; the reluctance of stakeholders in healthcare to change; and ignoring the importance of cultural changes and the human factor in an increasingly technological world. With access and adoption of technology getting higher, the risk of patients primarily turning to an accessible, but unregulated technological solution for their health problem is likely to increase. In this paper, we discuss how the old paradigm of the paternalistic model of medicine is transforming into an equal level partnership between patients and professionals and how it is aided and augmented by disruptive technologies. We attempt to define what digital health means and how it affects the status quo of care and also the study design in implementing technological innovations into the practice of medicine.

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“…24 For example, a recent study high lighted inaccuracies in assessments of blood pressure by an application sold to nearly 150 000 users, by providing falsely reassuring blood pressure levels with hypertensive readings. 25 Although such cases warrant concern, considerable effort and resources are being invested in integrating diagnostics into smartphones for a wide array of conditions (e.g., Apple's ResearchKit). 26 The current report highlights that a smartphone application can outperform the current standard of care and pro vide incremental diagnostic yield in clinical practice.…”

Section: Discussionmentioning

confidence: 99%