STRIDE BP REVIEW OF PUBLISHED EVIDENCE ON ACCURATE BLOOD PRESSURE MEASURING DEVICES

Abstract

Objective: STRIDE BP has systematically reviewed PubMed publications reporting validation data of BP measuring devices using an established protocol. Lists of accurate devices for clinical use are available on the STRIDE BP website (www.stridebp.org) and are circulated to hypertension societies. This report presents the results of the STRIDE BP review. Design and method: The STRIDE BP Advisory Board reviewed 446 validation studies of 287 BP measuring devices reported in 294 PubMed publications up to Nov. 2019. Using an online review system each study is evaluated independently by 2 reviewers experienced in validation studies using a structured checklist which is specific for each protocol and a final internal review is developed. This is reviewed by 2 members of the STRIDE BP Advisory Board and a final decision is taken to approve or reject the study. Results: 220 devices were approved (77%) and 115 (52%) were ‘Preferred’ according to predefined criteria (specific device features depending on its use; recent validation study). The numbers of approved office, home and ambulatory BP monitors for general population, children and pregnancy/preeclampsia are shown in the Table. Of 446 validations 390 (87%) were published as device ‘Pass’ and 56 (13%) ‘Fail’. Of 390 validations published as ‘Pass’, 95 (24%) were rejected in the STRIDE BP review process. The latter studies were rejected because of major protocol violation (single observer 22%, inadequate sample size 13%, BP measurement protocol violation 36%, inappropriate data analysis 31%, validation criteria not reported 32%). Conclusions: Using a standardised review process STRIDE BP provides independent evaluation of the accuracy of BP measuring devices that are available in various countries. The STRIDE BP review process by international experts, which examines validation studies using a structured and detailed process, is more critical than the classic review process of PubMed journals, which often miss important methodological issues in the validation studies. By widely circulating this information, STRIDE BP encourages health care professionals and the public to use only accurate devices for the evaluation of BP.