The relationship between a wrist-worn automated device and a gold standard sphygmomanometer has been largely established, but what about using one to track individuals or populations over time? Does anyone have any practical experience or literature to share?
Dosn't the producer of the device provide any documentation?
From what I understand arm monitors are more accurate than wrist monitors because the brachial artery is larger and easier to read than the radial artery. But if wrist monitors are more convenient for your population then they should be used but they should be calibrated with an arm device or a manual sphygomamometer regularily. One should also choose from a list of validated monitoring devices see table in link below.
http://www.dableducational.org/sphygmomanometers/devices_1_clinical.html#ClinTable
Thank you, Martin and Liseli.
We have used Omron manufactured wrist-worn devices, which I see receives a "recommended" in the very handy table you sent through Liseli. While the device information from the manufacturer does provide some confidence limits, we also want to do our own investigations. This includes soliciting info from other users, clinicians, researchers, etc., plus we now have two waves of data collection (n=40,000+) using the wrist-worn devices - however, before we analyze, want to know whether anyone has experience with these over time. We are attempting to assess population risk rather than individual clinical diagnosis.
We have done some cross-sectional comparisons between a gold standard as well as automated arm worn devices - so we have some idea of how well the wrist-worn devices work at one point in time.
I am wondering whether anyone has experience using the wrist-worn devices over time in individuals or populations.
We used the wrist worn devices just to track the trend of the blood pressure at home
the standard measure is still at the office with the sphygmomanometer.
I use a wrist worn device in my consult and home-asistance bacause is operating, convenient, fast and practical. Very important: a validated device, of course....
In practice in the pharmacy I use the automated arm worn device, individual patients have anecdotal reports of their home readings with the wrist worn device but unfortunately I do not have any population data to be shared. I will keep my eyes and ears open and network with my colleagues, if I hear of anything that may be of use I will be sure to forward it on.
I think we must use all kind instrument we have. Ideally we must use arm device, but an wrist device take mensurements in a "high speed consult" like we generaly have in primary national helth care centers (5 minutes per patient in a normal shedule.
Dear Paul,
Thanks for your very interesting question. I have a strong interest in the potential role of cuffless blood pressure measurement devices. I believe they could have an important clinical role for management and monitoring of blood pressure in certain situations, even if the accuracy is not as high as BSH, ANSI/AAMI and ESH Guidelines. I have drafted a review paper and will be happy to share with you in confidence.
In fact I have designed a RCT to test the reliability and validity of wearable devices. The proposal is under consideration for funding in Australia. We contacted the IEEE professionals and experts in the fields. Till now no devise has passed the IEEE recommendations at any grade for BP standards, although a few manufacturers reported or claimed that their method/device can pass the Grad A of IEEE 1708 so far with current technology. Some said they can achieve grad C or D but remaining to be seen through a professional evaluation body...
Best regards,
Shariful
Blood pressure is not a stable indicator of health and the most accurate measurement gives only an assessment at the moment of that measurement - much more important (especially in the context of many studies, such as the populational ones) would be to have a long time series. The problem is that the time series should be analyzed and such an analysis could be non trivial. Still this has a potential to get indices relevant to individual health (like fitbit for the pulse rate).
The clinical utility of blood pressure readings in 'healthy ambulant' people is based on measures which are both static and ambulatory taken at set intervals to find out average proportion of excursions beyond a certain range. Is there much to be gained by beat to beat blood pressure readings in community dwelling people? I think not. In hospital settings when physiology is more unstable close monitoring of blood pressure so that it does not fall into dangerous levels is currently, and has been for a long time, the norm
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