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Chrysant SG. Relatability of Blood Pressure Monitoring With Wearable Cuffless Devices. Am J Cardiol 2022; 169:145-147. [PMID: 35045932 DOI: 10.1016/j.amjcard.2021.12.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/17/2021] [Accepted: 12/21/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Steven G Chrysant
- Department of Cardiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
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Diagnostic accuracy of mercurial versus digital blood pressure measurement devices: a systematic review and meta-analysis. Sci Rep 2022; 12:3363. [PMID: 35233077 PMCID: PMC8888622 DOI: 10.1038/s41598-022-07315-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 02/02/2022] [Indexed: 11/08/2022] Open
Abstract
This study aims to systematically review the diagnostic accuracy of a digital blood pressure measurement device compared to the gold standard mercury sphygmomanometer in published studies. Searches were conducted in PubMed, Cochrane, EBSCO, EMBASE and Google Scholar host databases using the specific search strategy and filters from 1st January 2000 to 3rd April 2021. We included studies reporting data on the sensitivity or specificity of blood pressure measured by digital devices and mercury sphygmomanometer used as the reference standard. Studies conducted among children, special populations, and specific disease groups were excluded. We considered published manuscripts in the English language only. The risk of bias and applicability concerns were assessed based on the author's judgment using the QUADAS2 manual measurement evaluation tool. Based on the screening, four studies were included in the final analysis. Sensitivity, specificity, diagnostic odds ratio (DOR), and 95% confidence interval were estimated. The digital blood pressure monitoring has a moderate level of accuracy and the device can correctly distinguish hypertension with a pooled estimate sensitivity of 65.7% and specificity of 95.9%. After removing one study, which had very low sensitivity and very high specificity, the pooled sensitivity estimate was 79%, and the specificity was 91%. The meta-analysis of DOR suggests that the digital blood pressure monitor had moderate accuracy with a mercury sphygmomanometer. This will provide the clinician and patients with accurate information on blood pressure with which diagnostic and treatment decisions could be made.
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Corman BHP, Rajupet S, Ye F, Schoenfeld ER. The Role of Unobtrusive Home-Based Continuous Sensing in the Management of Post-Acute Sequelae of SARS CoV-2. J Med Internet Res 2021; 24:e32713. [PMID: 34932496 PMCID: PMC8989385 DOI: 10.2196/32713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 11/15/2021] [Accepted: 11/30/2021] [Indexed: 11/13/2022] Open
Abstract
UNSTRUCTURED Amid the COVID-19 pandemic, it has been reported that greater than 35% of patients with confirmed or suspected COVID-19 develop post-acute sequelae of SARS CoV-2 (PASC). PASC is still a disease for which preliminary medical data is being collected-mostly measurements collected during hospital or clinical visits-and pathophysiological understanding is yet in its infancy. The disease is notable for its prevalence and its variable symptom presentation and as such, management plans could be more holistically made if health care providers had access to unobtrusive home-based wearable and contactless continuous physiologic and physical sensor data. Such between-hospital or between-clinic data can quantitatively elucidate a majority of the temporal evolution of PASC symptoms. While not universally of comparable accuracy to gold-standard medical devices, home-deployed sensors offer great insights into the development and progression of PASC. Suitable sensors include those providing vital signs and activity measurements that correlate directly or by proxy to documented PASC symptoms. Such continuous, home-based data can give care providers contextualized information from which symptom exacerbation or relieving factors may be classified. Such data can also improve the collective academic understanding of PASC by providing temporally and activity-associated symptom cataloging. In this viewpoint, we make a case for the utilization of home-based continuous sensing that can serve as a foundation from which medical professionals and engineers may develop and pursue long-term mitigation strategies for PASC.
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Affiliation(s)
- Benjamin Harris Peterson Corman
- Renaissance School of Medicine, Stony Brook University, Stony Brook, US.,Program in Public Health, Stony Brook University, Stony Brook, US
| | - Sritha Rajupet
- Department of Family, Population & Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, US.,Department of Biomedical Informatics, Renaissance School of Medicine, Stony Brook University, Stony Brook, US
| | - Fan Ye
- Department of Electrical and Computer Engineering, College of Engineering and Applied Science, Stony Brook University, Light Engineering Building, Room 217Department of Electrical and Computer Engineering, Stony Brook University, Stony Brook, US
| | - Elinor Randi Schoenfeld
- Department of Family, Population & Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, US
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van Wamelen DJ, Sringean J, Trivedi D, Carroll CB, Schrag AE, Odin P, Antonini A, Bloem BR, Bhidayasiri R, Chaudhuri KR. Digital health technology for non-motor symptoms in people with Parkinson's disease: Futile or future? Parkinsonism Relat Disord 2021; 89:186-194. [PMID: 34362670 DOI: 10.1016/j.parkreldis.2021.07.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/26/2021] [Accepted: 07/28/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION There is an ongoing digital revolution in the field of Parkinson's disease (PD) for the objective measurement of motor aspects, to be used in clinical trials and possibly support therapeutic choices. The focus of remote technologies is now also slowly shifting towards the broad but more "hidden" spectrum of non-motor symptoms (NMS). METHODS A narrative review of digital health technologies for measuring NMS in people with PD was conducted. These digital technologies were defined as assessment tools for NMS offered remotely in the form of a wearable, downloadable as a mobile app, or any other objective measurement of NMS in PD that did not require a hospital visit and could be performed remotely. Searches were performed using peer-reviewed literature indexed databases (MEDLINE, Embase, PsycINFO, Cochrane Database of Systematic Reviews, Cochrane CENTRAL Register of Controlled Trials), as well as Google and Google Scholar. RESULTS Eighteen studies deploying digital health technology in PD were identified, for example for the measurement of sleep disorders, cognitive dysfunction and orthostatic hypotension. In addition, we describe promising developments in other conditions that could be translated for use in PD. CONCLUSION Unlike motor symptoms, non-motor features of PD are difficult to measure directly using remote digital technologies. Nonetheless, it is currently possible to reliably measure several NMS and further digital technology developments are underway to offer further capture of often under-reported and under-recognised NMS.
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Affiliation(s)
- Daniel J van Wamelen
- King's College London, Department of Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom; Parkinson's Foundation Centre of Excellence at King's College Hospital, Denmark Hill, London, United Kingdom; Radboud University Medical Centre; Donders Institute for Brain, Cognition and Behaviour; Department of Neurology, Nijmegen, the Netherlands.
| | - Jirada Sringean
- Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Dhaval Trivedi
- King's College London, Department of Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom; Parkinson's Foundation Centre of Excellence at King's College Hospital, Denmark Hill, London, United Kingdom
| | - Camille B Carroll
- Faculty of Health, University of Plymouth, Plymouth, Devon, United Kingdom
| | - Anette E Schrag
- Department of Clinical and Movement Neurosciences, University College London, London, United Kingdom
| | - Per Odin
- Division of Neurology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Angelo Antonini
- Movement Disorders Unit, Department of Neuroscience, University of Padua, Padua, Italy
| | - Bastiaan R Bloem
- Radboud University Medical Centre; Donders Institute for Brain, Cognition and Behaviour; Department of Neurology, Nijmegen, the Netherlands
| | - Roongroj Bhidayasiri
- Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand; The Academy of Science, The Royal Society of Thailand, Bangkok, Thailand
| | - K Ray Chaudhuri
- King's College London, Department of Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom; Parkinson's Foundation Centre of Excellence at King's College Hospital, Denmark Hill, London, United Kingdom
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van Helmond N, Plante TB. Cuff-less blood pressure measurement with pulse transit time: The importance of rigorous assessment. J Clin Hypertens (Greenwich) 2020; 23:71-72. [PMID: 33314569 PMCID: PMC8029688 DOI: 10.1111/jch.14133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Noud van Helmond
- Department of Anesthesiology, Cooper Medical School of Rowan University, Cooper University Health Care, Camden, NJ, USA
| | - Timothy B Plante
- Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, USA
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Kooman JP, Wieringa FP, Han M, Chaudhuri S, van der Sande FM, Usvyat LA, Kotanko P. Wearable health devices and personal area networks: can they improve outcomes in haemodialysis patients? Nephrol Dial Transplant 2020; 35:ii43-ii50. [PMID: 32162666 PMCID: PMC7066542 DOI: 10.1093/ndt/gfaa015] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Indexed: 12/15/2022] Open
Abstract
Digitization of healthcare will be a major innovation driver in the coming decade. Also, enabled by technological advancements and electronics miniaturization, wearable health device (WHD) applications are expected to grow exponentially. This, in turn, may make 4P medicine (predictive, precise, preventive and personalized) a more attainable goal within dialysis patient care. This article discusses different use cases where WHD could be of relevance for dialysis patient care, i.e. measurement of heart rate, arrhythmia detection, blood pressure, hyperkalaemia, fluid overload and physical activity. After adequate validation of the different WHD in this specific population, data obtained from WHD could form part of a body area network (BAN), which could serve different purposes such as feedback on actionable parameters like physical inactivity, fluid overload, danger signalling or event prediction. For a BAN to become clinical reality, not only must technical issues, cybersecurity and data privacy be addressed, but also adequate models based on artificial intelligence and mathematical analysis need to be developed for signal optimization, data representation, data reliability labelling and interpretation. Moreover, the potential of WHD and BAN can only be fulfilled if they are part of a transformative healthcare system with a shared responsibility between patients, healthcare providers and the payors, using a step-up approach that may include digital assistants and dedicated ‘digital clinics’. The coming decade will be critical in observing how these developments will impact and transform dialysis patient care and will undoubtedly ask for an increased ‘digital literacy’ for all those implicated in their care.
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Affiliation(s)
- Jeroen P Kooman
- Department of Internal Medicine, Division of Nephrology, University Hospital Maastricht, Maastricht, The Netherlands
| | - Fokko Pieter Wieringa
- Connected Health Solutions, imec, Eindhoven, The Netherlands.,Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Maggie Han
- Renal Research Institute, New York, NY, USA
| | - Sheetal Chaudhuri
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Global Medical Office, Fresenius Medical Care, Waltham, MA, USA
| | - Frank M van der Sande
- Department of Internal Medicine, Division of Nephrology, University Hospital Maastricht, Maastricht, The Netherlands
| | - Len A Usvyat
- Global Medical Office, Fresenius Medical Care, Waltham, MA, USA
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Mizuno A, Changolkar S, Patel MS. Wearable Devices to Monitor and Reduce the Risk of Cardiovascular Disease: Evidence and Opportunities. Annu Rev Med 2020; 72:459-471. [PMID: 32886543 DOI: 10.1146/annurev-med-050919-031534] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
There is a growing interest in using wearable devices to improve cardiovascular risk factors and care. This review evaluates how wearable devices are used for cardiovascular disease monitoring and risk reduction. Wearables have been evaluated for detecting arrhythmias (e.g., atrial fibrillation) as well as monitoring physical activity, sleep, and blood pressure. Thus far, most interventions for risk reduction have focused on increasing physical activity. Interventions have been more successful if the use of wearable devices is combined with an engagement strategy such as incorporating principles from behavioral economics to integrate social or financial incentives. As the technology continues to evolve, wearable devices could be an important part of remote-monitoring interventions but are more likely to be effective at improving cardiovascular care if integrated into programs that use an effective behavior change strategy.
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Affiliation(s)
- Atsushi Mizuno
- Penn Medicine Nudge Unit, University of Pennsylvania; and the Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania 19104, USA; ,
| | | | - Mitesh S Patel
- Penn Medicine Nudge Unit, University of Pennsylvania; and the Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania 19104, USA; ,
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Bredie SJH, de Jong JM, van de Belt TH, van Goor H. Authors' Reply to: Comment on "Feasibility of a New Cuffless Device for Ambulatory Blood Pressure Measurement in Patients With Hypertension: Mixed Methods Study". J Med Internet Res 2020; 22:e16205. [PMID: 32319954 PMCID: PMC7203614 DOI: 10.2196/16205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 09/28/2019] [Indexed: 11/29/2022] Open
Affiliation(s)
- Sebastian J H Bredie
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | - Jelske M de Jong
- REshape Center for Innovation, Radboud University Medical Center, Nijmegen, Netherlands
| | - Tom H van de Belt
- REshape Center for Innovation, Radboud University Medical Center, Nijmegen, Netherlands
| | - Harry van Goor
- Department of Surgery, Radboud University Medical Center, Nijmegen, Netherlands
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Hahnen C, Freeman CG, Haldar N, Hamati JN, Bard DM, Murali V, Merli GJ, Joseph JI, van Helmond N. Accuracy of Vital Signs Measurements by a Smartwatch and a Portable Health Device: Validation Study. JMIR Mhealth Uhealth 2020; 8:e16811. [PMID: 32049066 PMCID: PMC7055753 DOI: 10.2196/16811] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 11/18/2019] [Accepted: 12/15/2019] [Indexed: 12/13/2022] Open
Abstract
Background New consumer health devices are being developed to easily monitor multiple physiological parameters on a regular basis. Many of these vital sign measurement devices have yet to be formally studied in a clinical setting but have already spread widely throughout the consumer market. Objective The aim of this study was to investigate the accuracy and precision of heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and oxygen saturation (SpO2) measurements of 2 novel all-in-one monitoring devices, the BodiMetrics Performance Monitor and the Everlast smartwatch. Methods We enrolled 127 patients (>18 years) from the Thomas Jefferson University Hospital Preadmission Testing Center. SBP and HR were measured by both investigational devices. In addition, the Everlast watch was utilized to measure DBP, and the BodiMetrics Performance Monitor was utilized to measure SpO2. After 5 min of quiet sitting, four hospital-grade standard and three investigational vital sign measurements were taken, with 60 seconds in between each measurement. The reference vital sign measurements were calculated by determining the average of the two standard measurements that bounded each investigational measurement. Using this method, we determined three comparison pairs for each investigational device in each subject. After excluding data from 42 individuals because of excessive variation in sequential standard measurements per prespecified dropping rules, data from 85 subjects were used for final analysis. Results Of 85 participants, 36 (42%) were women, and the mean age was 53 (SD 21) years. The accuracy guidelines were only met for the HR measurements in both devices. SBP measurements deviated 16.9 (SD 13.5) mm Hg and 5.3 (SD 4.7) mm Hg from the reference values for the Everlast and BodiMetrics devices, respectively. The mean absolute difference in DBP measurements for the Everlast smartwatch was 8.3 (SD 6.1) mm Hg. The mean absolute difference between BodiMetrics and reference SpO2 measurements was 3.02%. Conclusions Both devices we investigated met accuracy guidelines for HR measurements, but they failed to meet the predefined accuracy guidelines for other vital sign measurements. Continued sale of consumer physiological monitors without prior validation and approval procedures is a public health concern.
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Affiliation(s)
- Christina Hahnen
- College of Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | - Cecilia G Freeman
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States
| | - Nilanjan Haldar
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States
| | - Jacquelyn N Hamati
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States
| | - Dylan M Bard
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States
| | - Vignesh Murali
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States
| | - Geno J Merli
- Department of Surgery and Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States
| | - Jeffrey I Joseph
- Department of Anesthesiology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States
| | - Noud van Helmond
- Department of Anesthesiology, Cooper Medical School of Rowan University, Cooper University Health Care, Camden, NJ, United States
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