IMPROVED ACCURACY IN MANUAL BLOOD PRESSURE MEASUREMENTS

EFFORTS TO REDUCE MEASUREMENT VARIATION AND OBSERVER ERROR IN BLOOD PRESSURE MEASUREMENTS HAVE MET WITH SOME SUCCESS INRESEARCH AND INSTITUTIONAL ENVIRONMENTS. HOWEVER, THESE EFFORTS, WHICH INCLUDE THE RANDOM-ZERO SPHYGMOMANOMETER, THEZERO MUDDLER, AND AUTOMATED SPHYGMOMANOMETERS, HAVE GENERALLY NOT BEEN SUITABLE IN PROFESSIONAL AND OFFICE-BASEDCLINICAL APPLICATIONS WHERE MOST BLOOD PRESSURE MEASUREMENTSARE STILL TAKEN. THE OBJECTIVE OF THIS PROPOSAL IS TO DETERMINE THE FEASIBILITY OF DEVELOPING AN IMPROVED SPHYGMOMANOMETER WHICHIS AFFORDABLE AND TECHNICALLY ACCEPTABLE TO THE MEDICAL PROFESSIONAL, AND WHICH CAN SIGNIFICANTLY REDUCE OBSERVER BIAS, MEASUREMENT VARIABILITY, AND SYSTEMATIC ERROR. THE PROPOSED DEVICE WOULD EMPLOY DIGITAL TECHNOLOGY TO ENHANCE HUMAN BLOOD PRESSURE JUDGEMENT (RATHER THAN REPLACE IT AS AUTOMATED ELECTRONIC DEVICES DO), AND TO ALLOW DECISION POINTS TO BE "LATCHED" OR MOMENTARILY FROZEN TO AVOID ERRORSASSOCIATED WITH READING A MOVING SCALE. THE PRINCIPAL AREAS OF INVESTIGATION WILL BE 1) THE DESIGN OF APPROPRIATE CIRCUITRY TO MEET REQUISITE SIZE, PERFORMANCE, AND COST CONSTRAINTS, 2) THE DEVELOPMENT OF A "LATCHING" FUNCTION TO FREEZE DECISION POINTS, 3) THE DEVELOPMENT OF BACK EXTRAPOLATION ALGORITHM (IF NECESSARY) TO ELIMINATE SYSTEMATIC ERROR, AND 4) EXTENSIVE TESTING OF PROTOTYPE UNITS IN REAL AND SIMULATED CLINICAL SITES.