title: Improved Measurement of Blood Pressure by Extraction of Characteristic Features from the Cuff Oscillometric Waveform.
abstract: We present a novel approach to improve the estimation of systolic (SBP) and diastolic blood pressure (DBP) from oscillometric waveform data using variable characteristic ratios between SBP and DBP with mean arterial pressure (MAP). This was verified in 25 healthy subjects, aged 28 ± 5 years. The multiple linear regression (MLR) and support vector regression (SVR) models were used to examine the relationship between the SBP and the DBP ratio with ten features extracted from the oscillometric waveform envelope (OWE). An automatic algorithm based on relative changes in the cuff pressure and neighbouring oscillometric pulses was proposed to remove outlier points caused by movement artifacts. Substantial reduction in the mean and standard deviation of the blood pressure estimation errors were obtained upon artifact removal. Using the sequential forward floating selection (SFFS) approach, we were able to achieve a significant reduction in the mean and standard deviation of differences between the estimated SBP values and the reference scoring (MLR: mean ± SD = -0.3 ± 5.8 mmHg; SVR and -0.6 ± 5.4 mmHg) with only two features, i.e., Ratio2 and Area3, as compared to the conventional maximum amplitude algorithm (MAA) method (mean ± SD = -1.6 ± 8.6 mmHg). Comparing the performance of both MLR and SVR models, our results showed that the MLR model was able to achieve comparable performance to that of the SVR model despite its simplicity.
authors.affiliation: Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia. veronicalimpooikhoon@gmail.com.
authors.forename: Pooi Khoon
authors.initials: PK
authors.lastname: Lim
authors.affiliation: Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia. siewcng@um.edu.my.
authors.forename: Siew-Cheok
authors.initials: SC
authors.lastname: Ng
authors.affiliation: Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia. wissam@um.edu.my.
authors.forename: Wissam A
authors.initials: WA
authors.lastname: Jassim
authors.affiliation: Graduate School of Biomedical Engineering, UNSW Australia, Sydney, NSW 2052, Australia. s.redmond@unsw.edu.au.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Redmond
authors.affiliation: Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia. zilany@um.edu.my.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Zilany
authors.affiliation: Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW 2109, Australia. alberto.avolio@mq.edu.au.
authors.forename: Alberto
authors.initials: A
authors.lastname: Avolio
authors.affiliation: Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia. einly_lim@um.edu.my.
authors.forename: Einly
authors.initials: E
authors.lastname: Lim
authors.affiliation: Department of Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia. mptan@ummc.edu.my.
authors.forename: Maw Pin
authors.initials: MP
authors.lastname: Tan
authors.affiliation: Graduate School of Biomedical Engineering, UNSW Australia, Sydney, NSW 2052, Australia. N.Lovell@unsw.edu.au.
authors.forename: Nigel H
authors.initials: NH
authors.lastname: Lovell
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D009991:Oscillometry / Q000379:methods*; D012815:Signal Processing, Computer-Assisted; D060388:Support Vector Machine; D055815:Young Adult
keywords: multiple linear regression; oscillometric blood pressure estimation; support vector regression