Development of tools for a systematic review and meta- analysis aimed at determining evidence-based equivalences between standardized manual office blood pressure measurements and automated methods
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Background: Blood Pressure (BP) treatment thresholds and targets for automated devices are largely consensus informed. This thesis is part of a larger project, MeasureBP, which aims to establish evidence-based equivalences between automated BP measurement (BPM) methods and the standardized manual office method. The specific objectives of the thesis project are: 1) To develop lists of 'essential' and 'less essential' criteria for achieving standardized measurements of BP for manual and automated methods. 2) To develop a Quality Assessment tool of eligible studies measuring BP with manual and automated methods. 3) To develop a methodology questionnaire that will obtain information about a study's BPM methodology and to test it against information obtained from the individual manuscripts. 4) To assess evidence-based equivalences between ambulatory BPM and standardized manual office BPM via a subset of databases from the systematic review with 4a) individual patient level data and 4b) with manuscript level data.Methods: A modified Delphi method was applied to develop lists of essential and less essential Standardized Criteria. A Quality Assessment tool was created as a hybrid of existing validates assessment tools. Methodology Questionnaires were developed and in a subgroup of studies, the responses by the corresponding authors were compared against the information obtained from the respective manuscripts. Lastly, a subset of 5 databases that included measurements with ambulatory BPM and standardized manual office BPM was pooled together and a preliminary analysis was performed to assess equivalent values between the methods with individual patient level data and with manuscript level data. Results and conclusions: The lists of Standardized Criteria provided refined classification of the included studies BPM methodology in terms of 'essential' and the 'less essential' criteria. The quality assessment tool was tailored to the nature of the project and helped refine the overall assessment of the quality of the studies, while identifying specific elements that were not stated in the manuscripts. Applying the methodology questionnaires revealed that manuscripts may contain incomplete information to properly evaluate the level of standardization in the studies' BPM protocols. Finally, in the preliminary analysis, the equivalent ambulatory BPM values from a subset of studies were somehow similar with the thresholds for the diagnosis of hypertension recommended by the Canadian Hypertension Education Program. The final equivalent values will be determined when the analysis with the complete database of MeasureBP will be performed. Introduction: Les seuils et les cibles thérapeutiques de la pression artérielle (PA) pour les dispositifs automatisés sont largement basés sur les consensus. Cette thèse, qui fait partie d'un projet plus vaste, vise à établir des équivalences entre des techniques automatisées pour les mesures de la PA, et la méthode auscultatoire usuelle. Les objectifs spécifiques du projet de thèse sont: 1) De… Advisors/Committee Members: Styliani Stella Daskalopoulou (Internal/Supervisor).