Key result
Sampling and processing methods significantly alter noninvasive arterial pressure accuracy by up to ~9 mmHg.
Why the study?
The effect of different methods for data sampling and data processing on comparative statistical analyses in continuous arterial blood pressure monitoring studies remains unknown.
Observational (n=49)
No
Mean Difference: 9 (95% CI -12.9–30.9)
May alter conclusions from AP monitoring comparisons; leaves open optimal standardization for method studies.
BACKGROUND: The effect of different methods for data sampling and data processing on the results of comparative statistical analyses in method comparison studies of continuous arterial blood pressure (AP) monitoring systems remains unknown. OBJECTIVE: We sought to investigate the effect of different methods for data sampling and data processing on the results of statistical analyses in method comparison studies of continuous AP monitoring systems. DESIGN: Prospective observational study. SETTING: University Medical Center Hamburg-Eppendorf, Hamburg, Germany, from April to October 2019. PATIENTS: 49 patients scheduled for neurosurgery with AP measurement using a radial artery catheter. MAIN OUTCOME MEASURES: We assessed the agreement between continuous noninvasive finger cuff-derived (CNAP Monitor 500; CNSystems Medizintechnik, Graz, Austria) and invasive AP measurements in a prospective method comparison study in patients having neurosurgery using all beat-to-beat AP measurements (Methodall), 10-s averages (Methodavg), one 30-min period of 10-s averages (Method30), Method30 with additional offset subtraction (Method30off), and 10 30-s periods without (Methodiso) or with (Methodiso-zero) application of the zero zone. The agreement was analysed using Bland-Altman and error grid analysis. RESULTS: For mean AP, the mean of the differences (95% limits of agreement) was 9.0 (-12.9 to 30.9) mmHg for Methodall, 9.2 (-12.5 to 30.9) mmHg for Methodavg, 6.5 (-9.3 to 22.2) mmHg for Method30, 0.5 (-9.5 to 10.5) mmHg for Method30off, 4.9 (-6.0 to 15.7) mmHg for Methodiso, and 3.4 (-5.9 to 12.7) mmHg for Methodiso-zero. Similar trends were found for systolic and diastolic AP. Results of error grid analysis were also influenced by using different methods for data sampling and data processing. CONCLUSION: Data sampling and data processing substantially impact the results of comparative statistics in method comparison studies of continuous AP monitoring systems. Depending on the method used for data sampling and data processing, the performance of an AP test method may be considered clinically acceptable or unacceptable.
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Flick et al. (2021) conducted an observational in Neurosurgery (n=49). Continuous noninvasive finger cuff-derived arterial blood pressure measurement vs. Invasive arterial blood pressure measurement was evaluated on Agreement between continuous noninvasive and invasive arterial blood pressure measurements for mean AP (MD 9.0 mmHg, 95% CI -12.9 to 30.9). Data sampling and processing methods substantially impacted agreement between noninvasive and invasive arterial blood pressure measurements (mean differences ranged from 0.5 to 9.2 mmHg).