Key result
Fusing three blood pressure estimation models using a covariance intersection algorithm improved blood pressure and prediction interval estimates by up to 24% compared to individual model precision.
Why the study?
Clinical adoption of cuffless blood pressure monitoring is hindered by the lack of unified error standards and methods for estimating measurement uncertainty.
Absolute Event Rate: 5.74% vs 6.91%
May refine noninvasive BP monitoring; leaves open prospective clinical validation before practice adoption.
A substantial barrier to the clinical adoption of cuffless blood pressure (BP) monitoring techniques is the lack of unified error standards and methods of estimating measurement uncertainty. This study proposes a fusion approach to improve accuracy and estimate prediction interval (PI) as a proxy for uncertainty for cuffless blood BP monitoring. BP was estimated during activities of daily living using three model architectures: nonlinear autoregressive models with exogenous inputs, feedforward neural network models, and pulse arrival time models. Multiple one-class support vector machine (OCSVM) models were trained to cluster data in terms of the percentage of outliers. New BP estimates were then assigned to a cluster using the OCSVMs hyperplanes, and the PIs were estimated using the BP error standard deviation associated with different clusters. The OCSVM was used to estimate the PI for the three BP models. The three BP estimations from the models were fused using the covariance intersection fusion algorithm, which improved BP and PI estimates in comparison with individual model precision by up to 24%. The employed model fusion shows promise in estimating BP and PI for potential clinical uses. The PI indicates that about 71%, 64%, and 29% of the data collected from sitting, standing, and walking can result in high-quality BP estimates. Our PI estimator offers an effective uncertainty metric to quantify the quality of BP estimates and can minimize the risk of false diagnosis.
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Landry et al. (2022) studied Healthy (cuffless blood pressure monitoring) (n=5). Fusion approach (Covariance intersection of NARX, ANNSys, and PATLog models) vs. Individual BP estimation models was evaluated on Mean absolute error (MAE) for systolic blood pressure estimation. Fusing three blood pressure estimation models using a covariance intersection algorithm improved blood pressure and prediction interval estimates by up to 24% compared to individual model precision.
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