Accuracy relationship of blood pressure devices between the AAMI SP 10 standard and the British Hypertension Society protocols.

This article analyzes and compares the accuracy requirements for the AAMI SP10 standard and the British Hypertension Society (BHS) protocol for evaluation of blood pressure devices. It generates a theoretical mapping relationship between the AAMI accuracy criteria and the BHS grading system, using these requirements. It locates within that relationship the analyses of blood pressure devices in the literature that have used both of these standards from 1990, when the original BHS protocol was published and the original AAMI SP10 standard was available, through the end of 1997. Comparison of 67 paired entries thus provides a framework for consideration of the concept of accuracy implicit in both systems against empirical testing of devices. Results of accuracy testing with each of the two systems should be consistent and convertible to the other system. The discrepancies between the theoretic combination of accuracy standards and empirical testing for each standard separately suggest a variety of difficulties in determining accuracy, such as statistical variability and test procedure variations. Using a chi-square test for matched samples, the discrepancies are found statistically significantly different (chi-square = 28.96, p < 0.001). Although there are fewer literature reports using the revised BHS protocol, the differences in the two systems suggest a potential need for an international agreement on accuracy determinations of blood pressure devices.