Assessment of the Uncertainty Associated With Two Consecutive Blood Pressure Measurements Using the Auscultatory Method

Accurate noninvasive blood pressure (BP) measurements are vital in preventing and treating many cardiovascular diseases. The gold standard for noninvasive procedures is the auscultatory method, which is based on detecting Korotkoff sounds while deflating an arm cuff. Using this method as a gold standard requires highly trained technicians and has an intrinsic uncertainty in its BP predictions. In this article, we analyze and characterize the origins of this uncertainty. This article defines an uncertainty model for two consecutive BP measurements. Our research group developed a computer-based simulation of auscultatory BP measurement uncertainty, and these results were compared to a human-subject experiment with a group of 20 diverse-conditioned individuals. Uncertainties were categorized and quantified. The total computer-simulated uncertainty ranged between -8.4 and 8.4 mmHg in systolic BP (SBP) and -8.4 and 8.3 mmHg in diastolic BP (DBP) at a 95% confidence interval (CI), while the limits in the human-based study ranged from -8.3 to 8.3 mmHg in SBP and -16.7 to 4.2 mmHg in DBP.

Automated summary

This article analyzes and characterizes the uncertainty in noninvasive blood pressure measurements and develops a computer-based simulation to simulate this uncertainty. The results show that the simulated uncertainty is consistent with the upper limits observed in a human-subject experiment.