Evidence map›Paper›PMID 34510915›Full record

ReviewHypertension (Dallas, Tex. : 1979)2021

Evaluation of the Accuracy of Cuffless Blood Pressure Measurement Devices: Challenges and Proposals.

Ramakrishna Mukkamala, Mohammad Yavarimanesh, Keerthana Natarajan, Jin-Oh Hahn, Konstantinos G Kyriakoulis, Alberto P Avolio, George S Stergiou

Abstract readReview
In one paragraph

Review in Hypertension (Dallas, Tex. : 1979), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 94 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
94citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

94 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Arterial blood pressure waveform reconstruction estimation from PPG using TCN-BiLSTM.American heart journal plus : cardiology research and practice · 2026
    Article
  6. Article
  7. Review
  8. Wearable Flexible Sensors for Cardiovascular Disease Monitoring.Advanced materials (Deerfield Beach, Fla.) · 2026
    Review
  9. Review
  10. Article
  11. Article
  12. Review
  13. Article
  14. Review
  15. Article
  16. Article
  17. Article
  18. Digital hypertension - what we need for the high-quality management of hypertension in the new era.Hypertension research : official journal of the Japanese Society of Hypertension · 2025
    Review
  19. Article
  20. Review

34 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Ramakrishna MukkamalaDepartments of Bioengineering, Anesthesiology and Perioperative Medicine, University of Pittsburgh, PA (R.M.).
Mohammad YavarimaneshDepartment of Electrical and Computer Engineering, Michigan State University, East Lansing (M.Y., K.N.).
Keerthana NatarajanDepartment of Electrical and Computer Engineering, Michigan State University, East Lansing (M.Y., K.N.).ORCID 0000-0002-9311-8192
Jin-Oh HahnDepartment of Mechanical Engineering, University of Maryland, College Park (J.-O.H.).
Konstantinos G KyriakoulisHypertension Center STRIDE-7, School of Medicine, Third Department of Medicine, Sotiria Hospital, National and Kapodistrian University of Athens, Greece (K.G.K., G.S.S.).ORCID 0000-0001-8986-2704
Alberto P AvolioMacquarie School of Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia (A.P.A.).
George S StergiouHypertension Center STRIDE-7, School of Medicine, Third Department of Medicine, Sotiria Hospital, National and Kapodistrian University of Athens, Greece (K.G.K., G.S.S.).ORCID 0000-0002-6132-0038

Funding

Unobtrusive and Affordable Blood Pressure Monitoring Via Pulse Transit TimeU01EB018818 · NIBIB · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI MUKKAMALA, RAMAKRISHNA · 2014 to 2018
$3.4M
A Smartphone-Based Device for Cuff-Less and Calibration-Free Blood Pressure MonitoringR01HL146470 · NHLBI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI MUKKAMALA, RAMAKRISHNA · 2019 to 2022
$1.1M
NHLBI NIH HHS R01 HL146470NIBIB NIH HHS U01 EB018818
6 · The paper itself

Abstract

Several novel cuffless wearable devices and smartphone applications claiming that they can measure blood pressure (BP) are appearing on the market. These technologies are very attractive and promising, with increasing interest among health care professionals for their potential use. Moreover, they are becoming popular among patients with hypertension and healthy people. However, at the present time, there are serious issues about BP measurement accuracy of cuffless devices and the 2021 European Society of Hypertension Guidelines on BP measurement do not recommend them for clinical use. Cuffless devices have special validation issues, which have been recently recognized. It is important to note that the 2018 Universal Standard for the validation of automated BP measurement devices developed by the American Association for the Advancement of Medical Instrumentation, the European Society of Hypertension, and the International Organization for Standardization is inappropriate for the validation of cuffless devices. Unfortunately, there is an increasing number of publications presenting data on the accuracy of novel cuffless BP measurement devices, with inadequate methodology and potentially misleading conclusions. The objective of this review is to facilitate understanding of the capabilities and limitations of emerging cuffless BP measurement devices. First, the potential and the types of these devices are described. Then, the unique challenges in evaluating the BP measurement accuracy of cuffless devices are explained. Studies from the literature and computer simulations are employed to illustrate these challenges. Finally, proposals are given on how to evaluate cuffless devices including presenting and interpreting relevant study results.

Indexed as

Blood PressureBlood Pressure DeterminationHumansHypertensionPulse Wave AnalysisReproducibility of ResultsSelf CareSensitivity and SpecificitySignal Processing, Computer-AssistedWearable Electronic Devicesaccuracyblood pressureblood pressure determinationcalibrationcufflessvalidation studywearable electronic devices

Identifiers

PMID34510915
PMCPMC8516718

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.