The Accuracy of Blood Pressure Measurement by Two Cuff-Less Wearable and Portable Health Devices

Introduction: Wearable and portable devices that claim to measure blood pressure without the need of a cuff are becoming increasingly popular among consumers. Given that hypertension is the leading cause for cardiovascular mortality worldwide, a portable technology that allows consumers to easily measure their BP several times a day would be of great value. However, the convenience that portable health technology provides is useless, and even dangerous, if the measurements are inaccurate. Objective: Investigate the accuracy of two popular commercial cuff-less BP device, the Bodimetrics Performance Monitor and Everlast TR10 watch. Methods: A sample of 127 ambulatory patients (\u3e18y) were recruited from the Thomas Jefferson University Hospital Preadmission Testing Center. Following the 2013 ANSI/AAMI/ISO standard protocol for evaluating non-invasive automated sphygmomanometers, four reference and three investigational BP measurements were obtained after a five minute initial rest period. Reference measurements were taken with the validated Cardiocap 5 sphygmomanometer. Results: 85 subjects met inclusion criteria. The average absolute differences (SD) between the Everlast watch and reference were 22.7 (27.4) mmHg for SBP and 6.9 (6.2) mmHg for DBP. The average absolute difference (SD) between the BodiMetrics Performance Monitor and the reference was 5.3 (4.7) mmHg for systolic BP. Discussion: The Everlast fitness watch tested is not accurate enough to be used as BP measurement device. The Bodimetrics device was more accurate, likely due to calibration immediately prior to validation, but even with this advantage the BP device failed to meet accuracy guidelines. Widespread use of this technology likely results in the misclassification of patients’ BP status

The Accuracy of Blood Pressure Measurement by a Smartwatch and a Portable Health Device

Introduction: Hypertension is a leading cause of mortality. Proper blood pressure (BP) control can be achieved by lifestyle modification, pharmacotherapy, and frequent measurements. With the growing popularity of cuffless blood pressure monitors, it is important to independently validate their accuracy. Objective: We evaluated two cuffless blood pressure monitors, The Everlast TR10 fitness watch and the BodiMetrics Performance Monitor, for their accuracy and precision in BP measurements. Methods: Using a protocol derived from the ANSI/AAMI/ISO 2013 standard for evaluating automated sphygmomanometers, we measured the blood pressures of 85 patients recruited from the Thomas Jefferson University Hospital Preadmission Testing Center with two experimental devices and a validated automated sphygmomanometer cuff. We compared the mean absolute differences in measurements between the investigational and reference devices. Comparisons were analyzed with Spearman correlation and T-test, p\u3c0.05. Results: The BodiMetrics Performance Monitor SBP measurements correlated well with the reference SBP measurements (ρ = 0.88, P \u3c 0.01), whereas the Everlast TR10 fitness watch did not (SBP: ρ = -0.19, P \u3c 0.01; DBP: ρ = -0.01, P \u3c 0.01). The BodiMetrics performance monitor reported a hypertensive BP (≥140 mm Hg) for 80% of the hypertensive reference SBP measurements, whereas the Everlast watch measured no hypertensive BP values for any of the hypertensive reference SBP or DBP measurements. Discussion: The Everlast fitness watch and BodiMetrics Performance Monitor are not accurate enough to use for blood pressure monitoring. Use of these devices will likely result in misclassifying patients with hypertension as normotensive, which is a public health concern

Accuracy of Vital Signs Measurements by a Smartwatch and a Portable Health Device: Validation Study.

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 (\u3e18 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

Does Age-Related Macular Degeneration (AMD) Treatment Influence Patient Falls and Mobility? A Systematic Review.

PURPOSE: Age-related macular degeneration (AMD), a leading cause of irreversible blindness, increases fall risk through impaired central vision. Falls place an enormous economic burden on healthcare systems. We hypothesized that AMD treatments may reduce patients\u27 falls risk. This systematic review (ID #: 172623) synthesized the current understanding of wet and dry AMD treatments\u27 impact on patient falls and mobility, connecting these two public health issues. METHODS: On April 17, 2020, PubMed, Scopus, CINAHL, and the Cochrane Central Register of Controlled Trials were queried. Clinical trials and observational studies were included, while non-English and non-primary studies were excluded. Two authors screened, extracted data, and assessed bias using RoB-2 and ROBINS-I. A third author served as a tie breaker. RESULTS: This database search resulted in 3,525 studies, with an additional 112 identified through bibliography review. Ten articles met eligibility criteria. Most studies featured the outcome of interest as a secondary outcome (n = 4) and patient-reported adverse events (n = 5), rather than a primary focus (n = 2). Ten out of the 11 outcomes had a moderate to serious risk of bias. No two studies used the same instrument to measure falls or mobility. CONCLUSION: Despite the potential positive impact of AMD treatments on patient falls and mobility, quality data on this relationship are lacking. This work underscores the need to broaden ophthalmologic research outcomes beyond visual parameters to include patient-centred, functional measures. Incorporating standardized methods to track falls and screen for difficulty with walking and balance would enable evaluation of AMD treatments on functional outcomes, potentially helping guide management