In silico data-based comparison of the accuracy and error source of various methods for noninvasively estimating central aortic blood pressure

IF 4.9 2区 医学 Q1 COMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS Computer methods and programs in biomedicine Pub Date : 2024-09-30 DOI:10.1016/j.cmpb.2024.108450
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Abstract

Background and objectives

The higher clinical significance of central aortic blood pressure (CABP) compared to peripheral blood pressures has been extensively demonstrated. Accordingly, many methods for noninvasively estimating CABP have been proposed. However, there still lacks a systematic comparison of existing methods, especially in terms of how they differ in the ability to tolerate individual differences or measurement errors. The present study was designed to address this gap.

Methods

A large-scale ‘virtual subject’ dataset (n = 600) was created using a computational model of the cardiovascular system, and applied to examine several classical CABP estimation methods, including the direct method, generalized transfer function (GTF) method, n-point moving average (NPMA) method, second systolic pressure of periphery (SBP2) method, physical model-based wave analysis (MBWA) method, and suprasystolic cuff-based waveform reconstruction (SCWR) method. The errors of CABP estimation were analyzed and compared among methods with respect to the magnitude/distribution, correlations with physiological/hemodynamic factors, and sensitivities to noninvasive measurement errors.

Results

The errors of CABP estimation exhibited evident inter-method differences in terms of the mean and standard deviation (SD). Relatively, the estimation errors of the methods adopting pre-trained algorithms (i.e., the GTF and SCWR methods) were overall smaller and less sensitive to variations in physiological/hemodynamic conditions and random errors in noninvasive measurement of brachial arterial blood pressure (used for calibrating peripheral pulse wave). The performances of all the methods worsened following the introduction of random errors to peripheral pulse wave (used for deriving CABP), as characterized by the enlarged SD and/or increased mean of the estimation errors. Notably, the GTF and SCWR methods did not exhibit a better capability of tolerating pulse wave errors in comparison with other methods.

Conclusions

Classical noninvasive methods for estimating CABP were found to differ considerably in both the accuracy and error source, which provided theoretical evidence for understanding the specific advantages and disadvantages of each method. Knowledge about the method-specific error source and sensitivities of errors to different physiological/hemodynamic factors may contribute as theoretical references for interpreting clinical observations and exploring factors underlying large estimation errors, or provide guidance for optimizing existing methods or developing new methods.
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对各种无创估测中心主动脉血压方法的准确性和误差源进行基于硅数据的比较。
背景和目的:与外周血压相比,中心主动脉血压(CABP)具有更高的临床意义,这一点已得到广泛证实。因此,人们提出了许多无创估测 CABP 的方法。然而,目前仍缺乏对现有方法的系统性比较,尤其是在对个体差异或测量误差的耐受能力方面。本研究旨在填补这一空白:方法:使用心血管系统计算模型创建了一个大规模 "虚拟受试者 "数据集(n = 600),并应用该数据集检验了几种经典的 CABP 估算方法,包括直接法、广义传递函数(GTF)法、n 点移动平均(NPMA)法、外周第二收缩压(SBP2)法、基于物理模型的波形分析(MBWA)法和基于袖带的收缩上心动图波形重建(SCWR)法。分析并比较了各种方法的 CABP 估算误差的大小/分布、与生理/血流动力学因素的相关性以及对无创测量误差的敏感性:从平均值和标准差(SD)来看,不同方法的 CABP 估测误差存在明显差异。相对而言,采用预训练算法的方法(即 GTF 和 SCWR 方法)的估计误差总体较小,对生理/血流动力学条件的变化和肱动脉血压(用于校准外周脉搏波)无创测量随机误差的敏感性较低。在外周脉搏波(用于推导 CABP)中引入随机误差后,所有方法的性能都有所下降,表现为估计误差的标度扩大和/或平均值增加。值得注意的是,与其他方法相比,GTF 和 SCWR 方法对脉搏波误差的耐受能力并不强:结论:研究发现,估测 CABP 的经典无创方法在准确性和误差源方面都存在很大差异,这为了解每种方法的具体优缺点提供了理论依据。有关特定方法的误差源和误差对不同生理/血流动力学因素的敏感性的知识可作为解释临床观察结果和探索导致估计误差较大的因素的理论参考,或为优化现有方法或开发新方法提供指导。
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来源期刊
Computer methods and programs in biomedicine
Computer methods and programs in biomedicine 工程技术-工程:生物医学
CiteScore
12.30
自引率
6.60%
发文量
601
审稿时长
135 days
期刊介绍: To encourage the development of formal computing methods, and their application in biomedical research and medical practice, by illustration of fundamental principles in biomedical informatics research; to stimulate basic research into application software design; to report the state of research of biomedical information processing projects; to report new computer methodologies applied in biomedical areas; the eventual distribution of demonstrable software to avoid duplication of effort; to provide a forum for discussion and improvement of existing software; to optimize contact between national organizations and regional user groups by promoting an international exchange of information on formal methods, standards and software in biomedicine. Computer Methods and Programs in Biomedicine covers computing methodology and software systems derived from computing science for implementation in all aspects of biomedical research and medical practice. It is designed to serve: biochemists; biologists; geneticists; immunologists; neuroscientists; pharmacologists; toxicologists; clinicians; epidemiologists; psychiatrists; psychologists; cardiologists; chemists; (radio)physicists; computer scientists; programmers and systems analysts; biomedical, clinical, electrical and other engineers; teachers of medical informatics and users of educational software.
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