2 research outputs found
Arterial stiffness as underlying mechanism of disagreement between an oscillometric blood pressure monitor and a sphygmomanometer
Oscillometric blood pressure devices tend to overestimate systolic blood
pressure and underestimate diastolic blood pressure compared with
sphygmomanometers. Recent studies indicate that discrepancies in
performance between these devices may differ between healthy and diabetic
subjects. Arterial stiffness in diabetics could be the underlying factor
explaining these differences. We studied differences between a Dinamap
oscillometric blood pressure monitor and a random-zero sphygmomanometer in
relation to arterial stiffness in 1808 healthy elderly subjects. The study
was conducted within the Rotterdam Study, a population-based cohort study
of subjects aged 55 years and older. Systolic and diastolic blood pressure
differences between a Dinamap and a random-zero sphygmomanometer were
related to arterial stiffness, as measured by carotid-femoral pulse wave
velocity. Increased arterial stiffness was associated with higher systolic
and diastolic blood pressure readings by the Dinamap compared with the
random-zero sphygmomanometer, independent of age, gender, and average mean
blood pressure level of both devices. The beta-coefficient (95% CI) was
0.25 (0.00 to 0.50) mm Hg/(m/s) for the systolic blood pressure difference
and 0.35 (0.20 to 0.50) mm Hg/(m/s) for the diastolic blood pressure
difference. The results indicate that a Dinamap oscillometric blood
pressure device, in comparison to a random-zero sphygmomanometer,
overestimates systolic and diastolic blood pressure readings in subjects
with stiff arteries
Development of an International Standard Set of Value-Based Outcome Measures for Patients With Chronic Kidney Disease
Value-based health care is increasingly promoted as a strategy for improving care quality by benchmarking outcomes that matter to patients relative to the cost of obtaining those outcomes. To support the shift toward value-based health care in chronic kidney disease (CKD), the International Consortium for Health Outcomes Measurement (ICHOM) assembled an international working group of health professionals and patient representatives to develop a standardized minimum set of patient-centered outcomes targeted for clinical use. The considered outcomes and patient-reported outcome measures were generated from systematic literature reviews. Feedback was sought from patients and health professionals. Patients with very high-risk CKD (stages G3a/A3 and G3b/A2-G5, including dialysis, kidney transplantation, and conservative care) were selected as the target population. Using an online modified Delphi process, outcomes important to all patients were selected, such as survival and hospitalization, and to treatment-specific subgroups, such as vascular access survival and kidney allograft survival. Patient-reported outcome measures were included to capture domains of health-related quality of life, which were rated as the most important outcomes by patients. Demographic and clinical variables were identified to be used as case-mix adjusters. Use of these consensus recommendations could enable institutions to monitor, compare, and improve the quality of their CKD care