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Differences between observers in blood pressure measurement with an automatic oscillometric recorder
N G Bruce1, D G Cook, A G Shaper
1Department of Clinical Epidemiology and General Practice, Royal Free Hospital Medical School, London, UK.
Summary
Observer differences in blood pressure readings using the Dinamap device were minimal but statistically significant for systolic pressure in males and diastolic pressure in females. These variations, though small, highlight the need for careful calibration in large-scale studies.
Area of Science:
- Clinical Measurement
- Cardiovascular Health
- Epidemiological Research
Background:
- Accurate blood pressure measurement is crucial for epidemiological studies.
- Automated devices like the Dinamap aim to reduce observer variability.
- Understanding residual observer differences is important for data interpretation.
Purpose of the Study:
- To assess observer variability in blood pressure measurements using the Dinamap device.
- To determine if observer differences are statistically significant in a large cohort.
- To investigate how observer differences vary across different geographical locations.
Main Methods:
- Two observers recorded blood pressure on 2596 subjects (males and females, aged 25-59) across nine British towns.
- Data were adjusted for age, body mass index, and town.
- Statistical analysis was performed to identify significant observer differences.
Main Results:
- Significant observer differences were found for systolic pressure in males (3.07 mmHg) and females (2.08 mmHg).
- Differences for mean arterial and diastolic pressure were less than 1 mmHg and not significant.
- Observer variation magnitude differed significantly between towns, particularly for systolic and diastolic pressures in males.
Conclusions:
- The Dinamap device minimizes observer variation in field studies but does not eliminate it entirely.
- Systolic pressure in males and diastolic pressure in females showed statistically significant observer differences.
- Geographical location influences the magnitude of observer variation, necessitating localized quality control.