Ataman S L, Cooper R, Rotimi C, McGee D, Osotimehin B, Kadiri S, Kingue S, Muna W, Fraser H, Forrester T, Wilks R
Department of Preventive Medicine and Epidemiology, Loyola University Stritch School of Medicine, Maywood, Illinois 60153, USA.
J Clin Epidemiol. 1996 Aug;49(8):869-77. doi: 10.1016/0895-4356(96)00111-4.
In the context of a collaborative study on the epidemiology of hypertension in populations of West African origin procedures for standardization of the measurement of blood pressure were evaluated. Comparisons of mean levels of blood pressure, which in large part determine prevalence rates, are highly sensitive to differences in technique. While rotating a single field team may be the ideal approach to multisite studies, it is not practical in international collaborative research. Appropriate techniques to standardize multiple teams over a long period of time have not been well developed, however. In the present study 8981 individuals were examined in eight sites in six countries with the standard mercury sphygmomanometer. An evaluation of the effectiveness of central training, site visits, monitoring of digit preference, and the use of an electronic device for internal standardization is described. In all but one of the sites reliability was high and comparable to the observers at the Coordinating Center. Digit preference for the entire set of measurements was limited (frequency of terminal zero = 23.5% for systolic and 28.9% for diastolic readings) and could be shown to have virtually no effect on prevalence rates or correlation estimates. Mean differences among observers within a given site and between sites were small (+/- 0-5 mmHg). While logistically complex, these methods can provide the basis for standardization in international comparative blood pressure surveys.
在一项关于西非裔人群高血压流行病学的合作研究中，对血压测量标准化程序进行了评估。血压平均水平的比较在很大程度上决定了患病率，而这种比较对测量技术的差异高度敏感。虽然轮换单个现场团队可能是多地点研究的理想方法，但在国际合作研究中并不实际。然而，长期规范多个团队的适当技术尚未得到充分发展。在本研究中，使用标准汞柱血压计在六个国家的八个地点对8981名个体进行了检查。本文描述了对集中培训、现场访问、数字偏好监测以及使用电子设备进行内部标准化的有效性评估。除一个地点外，所有地点的可靠性都很高，与协调中心的观察者相当。整套测量中的数字偏好有限（收缩压读数的末位为零的频率 = 23.5%，舒张压读数为28.9%），并且可以证明对患病率或相关性估计几乎没有影响。给定地点内以及不同地点之间观察者的平均差异很小（±0 - 5 mmHg）。虽然在后勤方面很复杂，但这些方法可为国际比较血压调查的标准化提供基础。
