Key result
MLR calibration reduces cuffless monitor PWV measurement error by ~92% using a pulse wave simulator.
Why the study?
Cuffless blood pressure measurement devices require more reliable pulse wave simulation equipment and verification methods to test their accuracy using pulse wave velocity.
A novel hemodynamic pulse wave simulator with MLR calibration significantly improves the measurement accuracy of cuffless blood pressure monitors.
Bench calibration cuts PWV error in simulators; leaves open human validation before cuffless BP use.
OBJECTIVE: Devices for cuffless blood pressure (BP) measurement have become increasingly widespread in recent years. Non-invasive continuous BP monitor (BPM) devices can diagnose potential hypertensive patients at an early stage; however, these cuffless BPMs require more reliable pulse wave simulation equipment and verification methods. Therefore, we propose a device to simulate human pulse wave signals that can test the accuracy of cuffless BPM devices using pulse wave velocity (PWV). METHODS: We design and develop a simulator capable of simulating human pulse waves comprising an electromechanical system to simulate the circulatory system and an arm model-embedded arterial phantom. These parts form a pulse wave simulator with hemodynamic characteristics. We use a cuffless device for measuring local PWV as the device under test to measure the PWV of the pulse wave simulator. We then use a hemodynamic model to fit the cuffless BPM and pulse wave simulator results; this model can rapidly calibrate the cuffless BPM's hemodynamic measurement performance. RESULTS: We first used multiple linear regression (MLR) to generate a cuffless BPM calibration model and then investigated differences between the measured PWV with and without MLR model calibration. The mean absolute error of the studied cuffless BPM without the MLR model is 0.77 m/s, which improves to 0.06 m/s when using the model for calibration. The measurement error of the cuffless BPM at BPs of 100-180 mmHg is 1.7-5.99 mmHg before calibration, which decreases to 0.14-0.48 mmHg after calibration. CONCLUSION: This study proposes a design of a pulse wave simulator based on hemodynamic characteristics and provides a standard performance verification method for cuffless BPMs that requires only MLR modeling on the cuffless BPM and pulse wave simulator. The pulse wave simulator proposed in this study can be used to quantitively assess the performance of cuffless BPMs. The proposed pulse wave simulator is suitable for mass production for the verification of cuffless BPMs. As cuffless BPMs become increasingly widespread, this study can provide performance testing standards for cuffless devices.
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Guo et al. (2023) studied Device calibration for cuffless blood pressure monitors. Multiple linear regression (MLR) calibration model vs. Without MLR model calibration was evaluated on Mean absolute error of pulse wave velocity (m/s). A multiple linear regression calibration model with a pulse wave simulator reduced the mean absolute error of pulse wave velocity from 0.77 m/s to 0.06 m/s for cuffless blood pressure monitors.
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