Wu Hongjun, Wang Bingjian, Zhu Xinpu, Chu Guang, Zhang Zhi
Department of Cardiology, Yixing No. 2 People's Hospital Department of Cardiology, Huai'an First People's Hospital, Nanjing Medical University, Jiangsu Province Department of Neurology, Branch of Shanghai General Hospital Department of Cardiology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
Medicine (Baltimore). 2016 Aug;95(32):e4538. doi: 10.1097/MD.0000000000004538.
The widely used oscillometric automated blood pressure (BP) monitor was continuously questioned on its accuracy. A novel BP kit named Accutension which adopted Korotkoff auscultation method was then devised. Accutension worked with a miniature microphone, a pressure sensor, and a smartphone. The BP values were automatically displayed on the smartphone screen through the installed App. Data recorded in the phone could be played back and reconfirmed after measurement. They could also be uploaded and saved to the iCloud. The accuracy and consistency of this novel electronic auscultatory sphygmomanometer was preliminarily verified here. Thirty-two subjects were included and 82 qualified readings were obtained. The mean differences ± SD for systolic and diastolic BP readings between Accutension and mercury sphygmomanometer were 0.87 ± 2.86 and -0.94 ± 2.93 mm Hg. Agreements between Accutension and mercury sphygmomanometer were highly significant for systolic (ICC = 0.993, 95% confidence interval (CI): 0.989-0.995) and diastolic (ICC = 0.987, 95% CI: 0.979-0.991). In conclusion, Accutension worked accurately based on our pilot study data. The difference was acceptable. ICC and Bland-Altman plot charts showed good agreements with manual measurements. Systolic readings of Accutension were slightly higher than those of manual measurement, while diastolic readings were slightly lower. One possible reason was that Accutension captured the first and the last korotkoff sound more sensitively than human ear during manual measurement and avoided sound missing, so that it might be more accurate than traditional mercury sphygmomanometer. By documenting and analyzing of variant tendency of BP values, Accutension helps management of hypertension and therefore contributes to the mobile heath service.
广泛使用的示波法自动血压监测仪的准确性一直受到质疑。随后，一种名为Accutension的新型血压测量套件应运而生，它采用了柯氏音听诊法。Accutension与一个微型麦克风、一个压力传感器和一部智能手机配合使用。血压值通过安装的应用程序自动显示在智能手机屏幕上。手机记录的数据在测量后可以回放并再次确认。它们还可以上传并保存到iCloud。在此初步验证了这种新型电子听诊血压计的准确性和一致性。研究纳入了32名受试者，共获得82次合格读数。Accutension与汞柱式血压计收缩压和舒张压读数的平均差值±标准差分别为0.87±2.86和-0.94±2.93 mmHg。Accutension与汞柱式血压计在收缩压（组内相关系数ICC = 0.993，95%置信区间CI：0.989 - 0.995）和舒张压（ICC = 0.987，95% CI：0.979 - 0.991）方面的一致性非常显著。总之，根据我们的初步研究数据，Accutension工作准确。差异是可以接受的。ICC和布兰德-奥特曼图显示与手动测量有良好的一致性。Accutension的收缩压读数略高于手动测量值，而舒张压读数略低。一个可能的原因是，Accutension在手动测量过程中比人耳更灵敏地捕捉到了柯氏音的第一声和最后一声，避免了声音遗漏，因此可能比传统的汞柱式血压计更准确。通过记录和分析血压值的变化趋势，Accutension有助于高血压的管理，从而为移动健康服务做出贡献。
