4.6 Article

Hypothesis Scoring for Confidence-Aware Blood Pressure Estimation With Particle Filters

Journal

IEEE JOURNAL OF BIOMEDICAL AND HEALTH INFORMATICS
Volume 27, Issue 9, Pages 4273-4284

Publisher

IEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC
DOI: 10.1109/JBHI.2023.3289192

Keywords

Blood pressure; blood pressure variability; particle filtering; confidence-aware; ensemble modeling

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This study proposes a Confidence-Aware Particle Filter (CAPF) framework for analyzing estimated changes in blood pressure to provide multiple true state hypotheses. The framework assigns likelihood scores to each hypothesis and uses a particle filter formulation to provide stable trend estimation of blood pressure measurements. Experimental results show that CAPF outperforms ten baseline approaches in estimating blood pressure trends and achieves performance classification of Grade A according to AAMI and BHS standards.
We propose our Confidence-Aware Particle Filter (CAPF) framework that analyzes a series of estimated changes in blood pressure (BP) to provide several true state hypotheses for a given instance. Particularly, our novel confidence-awareness mechanism assigns likelihood scores to each hypothesis in an effort to discard potentially erroneous measurements - based on the agreement amongst a series of estimated changes and the physiological plausibility when considering DBP/SBP pairs. The particle filter formulation (or sequential Monte Carlo method) can jointly consider the hypotheses and their probabilities over time to provide a stable trend of estimated BP measurements. In this study, we evaluate BP trend estimation from an emerging bio-impedance (Bio-Z) prototype wearable modality although it is applicable to all types of physiological modalities. Each subject in the evaluation cohort underwent a hand-gripper exercise, a cold pressor test, and a recovery state to increase the variation to the captured BP ranges. Experiments show that CAPF yields superior continuous pulse pressure (PP), diastolic blood pressure (DBP), and systolic blood pressure (SBP) estimation performance compared to ten baseline approaches. Furthermore, CAPF performs on track to comply with AAMI and BHS standards for achieving a performance classification of Grade A, with mean error accuracies of -0.16 +/- 3.75 mmHg for PP (r = 0.81), 0.42 +/- 4.39 mmHg for DBP (r = 0.92), and -0.09 +/- 6.51 mmHg for SBP (r = 0.92) from more than test 3500 data points.

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