Artifact management methodologies for arterial blood pressure signals: A systematic scoping review of human and animal literature

Arterial blood pressure (ABP) is a broadly measured vital signal used to monitor cardiovascular health through raw signal and derived metrics. Artifacts are a pervasive issue, resulting in a declined utility of the signal. The aim of this review was to examine the existing literature pertinent to artifact management strategies in ABP signals. A search of five databases was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The search question examined existing algorithms for artifact management in ABP signals. The initial search yielded 15,564 articles (update included 1967 additional). The review included 73 articles. Categories included: (1) artifact management in low-frequency signals, (2) artifact management in full-waveform signals, (3) identification of valid or fiducial points. There were several algorithms that achieved strong effectiveness results. However, there was poor algorithm generalizability and inter-comparability due to insufficient population size, diversity in recording methodologies, and external validation. This made it difficult to quantitatively elucidate a leading method. Real-time utility was also not mentioned, critical for clinical use. This work provides novel insights into the literature regarding artifact management in ABP, identifying shortcomings and ways in which a more generalizable solution can be identified.