Accuracy of Patient-Collected Vital Signs.

Area of Science:

• Emergency Medicine
• Digital Health
• Clinical Informatics

Background:

• Telehealth is crucial for managing acute respiratory infections (ARIs), aiming to reduce emergency department overcrowding and nosocomial transmission.
• Current telehealth algorithms often rely on patient-provided vital signs, but their accuracy using home devices is unverified.

Purpose of the Study:

• To assess the accuracy of vital signs collected by patients at home compared to gold-standard measurements.
• To evaluate the reliability of patient-collected vital signs for informing telehealth management of ARIs.

Main Methods:

• A cross-sectional study involving 300 patients at an emergency and urgent care center.
• Patients used low-cost home devices to collect vital signs (heart rate, respiratory rate, temperature, oxygen saturation).
• A research coordinator collected parallel vital signs using standard hospital equipment as the gold standard.

Main Results:

• Patient-collected vital signs demonstrated high specificity for abnormal values.
• Sensitivity was poor for manually estimated heart rate (25%) and respiratory rate (60%).
• Pulse oximetry for heart rate and oxygen saturation, and oral temperature, showed higher sensitivity.

Conclusions:

• Patient-measured vital signs are not uniformly accurate, with manual techniques being less reliable than automated devices.
• Telehealth algorithms using inaccurate patient vital signs may lead to incorrect triage and management recommendations.
• The findings underscore the limitations of current remote patient monitoring in telehealth for ARIs.