Ostchega Yechiam, Prineas Ronald J, Paulose-Ram Ryne, Grim Carlene M, Willard Grace, Collins Doreen
Division of Health Examination Statistics, National Center for Health Statistics, NHANES Program, 3311 Toledo Road, Room 4319, Centers for Disease Control and Prevention, Hyattsville, MD 20782, USA.
J Clin Epidemiol. 2003 Aug;56(8):768-74. doi: 10.1016/s0895-4356(03)00085-4.
We describe the National Health and Nutrition Examination Survey (NHANES) blood pressure (BP) observer training and protocol standardization and evaluate the quality of BP measurement.
The participants were persons aged 8 years and older who had their BP measured (n=7467) during NHANES 1999-2000. Cuff width/arm circumference ratio (CW/AC), end digit preference, and observer agreement were examined.
In stepwise principal components multiple regression analysis, CW/AC accounted for less than 2% of variability R(2) in all readings. The frequencies for all end digits were close to 20% ("0" end digit=21% systolic and 23% diastolic). No overall observer effect was present for mean systolic BP readings. A significant observer effect (P<.0001) was detected for mean diastolic BP readings of <90 mm Hg. For readings of > or =90 mm Hg, there was no significant observer effect (P=.157).
We conclude that NHANES BP measurements do not demonstrate the variability that is commonly caused by observer and technical error.
我们描述了美国国家健康与营养检查调查（NHANES）血压（BP）观察者培训及方案标准化情况，并评估了血压测量的质量。
参与者为1999 - 2000年NHANES期间接受血压测量的8岁及以上人群（n = 7467）。检查了袖带宽度/臂围比（CW/AC）、末位数字偏好以及观察者一致性。
在逐步主成分多元回归分析中，CW/AC在所有读数中对变异系数R²的贡献率小于2%。所有末位数字的频率接近20%（“0”末位数字 = 收缩压21%，舒张压23%）。平均收缩压读数不存在总体观察者效应。对于舒张压读数<90 mmHg，检测到显著的观察者效应（P <.0001）。对于读数≥90 mmHg，不存在显著的观察者效应（P = 0.157）。
我们得出结论，NHANES血压测量未显示出通常由观察者和技术误差引起的变异性。
