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Hopkins Study Finds Popular Blood Pressure App Wildly Inaccurate (jamanetwork.com)

An anonymous reader writes to point out a software review of the kind you can't generally find in an app store. A group from Johns Hopkins checked the accuracy of the Instant Blood Pressure app, which has sold more than 148,000 copies, and purports to measure blood pressure with just an iPhone -- no cuff required -- and found it wanting, to put it mildly. In the researcher's study, published in JAMA Internal Medicine, the app missed elevated blood pressures four out of five times.

50 comments

  1. Measure blood pressure with just an iPhone? by Anonymous Coward · · Score: 1

    If there's no cuff or anything, how does it work? Magic?

    1. Re:Measure blood pressure with just an iPhone? by arielCo · · Score: 3, Informative

      The Instant Blood Pressure app (IBP; AuraLife) estimates blood pressure (BP) using a technique in which the top edge of the smartphone is placed on the left side of the chest while the individual places his or her right index finger over the smartphone’s camera.

      image
      I guess it's more accurate than rolling fair dice or plucking daisies.

      --
      This post contains no rudeness or derision of any kind. All arguments are friendly. Terms and exclusions may apply.
    2. Re:Measure blood pressure with just an iPhone? by rossdee · · Score: 1

      "how does it work? Magic?"

      It uses The Force.
      If its inaccuate its because you don't have enough Midiclorians in your blood...

    3. Re:Measure blood pressure with just an iPhone? by Anonymous Coward · · Score: 0

      What about people with

      https://en.wikipedia.org/wiki/Situs_inversus

    4. Re: Measure blood pressure with just an iPhone? by arielCo · · Score: 1
      --
      This post contains no rudeness or derision of any kind. All arguments are friendly. Terms and exclusions may apply.
    5. Re:Measure blood pressure with just an iPhone? by Zero__Kelvin · · Score: 1

      They will be happy to discover that their results are just as wildly inaccurate as the ones provided to the "normies" !

      --
      Guns don't kill people; Physics kills people! - John Lithgow as Dick Solomon on Third Rock From The Sun
    6. Re:Measure blood pressure with just an iPhone? by wonkey_monkey · · Score: 1

      That shows how to use it; doesn't explain how it (supposedly) works. One article claimed it could measure heart rate using the microphone, which doesn't sound right to me. I would assume that heart rate is actually measured by the camera, measuring the change in colour as blood pulses through whatever you've pressed it against - it's a simple and accurate way to measure heart rate.

      I've no idea what holding it against your chest is supposed to do.

      --
      systemd is Roko's Basilisk.
  2. Really! by Anonymous Coward · · Score: 1

    And this surprises anyone (other than those 148,000 customers, of course) because...

  3. This app works just as well as the iBomb detector by Anonymous Coward · · Score: 0

    It hasn't detected any bombs yet, and I still haven't been blown up. Proof that it works!

  4. Of course not by Anonymous Coward · · Score: 1

    No one should trust a digital health app. Unless it's been validated in a clinical study, you shouldn't trust anything that's put out to run a smartphone.

    Especially one like this. It uses the phone's accelerometer to measure your heart rate by putting it up against your chest and then measures the coloration of your fingertip by putting your finger over the camera lens. iPhone camera lenses and accelerometers were not designed for this use case, and this type of measurement has never been clinically studied or validated, and this is the common trend in nearly every single software health app out there.

    I'm sorry but phones weren't designed for this kind of use and the software isn't either. People making these apps are wishful thinking at best and dangerous at worst.

    1. Re:Of course not by Anonymous Coward · · Score: 1

      "No one should trust a digital health app. Unless it's been validated in a clinical study, you shouldn't trust anything that's put out to run a smartphone."

      So those penis enlargement Android apps don't really work? Asking for a friend.

    2. Re:Of course not by Anonymous Coward · · Score: 0

      "No one should trust a digital health app. Unless it's been validated in a clinical study, you shouldn't trust anything that's put out to run a smartphone."

      So those penis enlargement Android apps don't really work? Asking for a friend.

      Only if you're using Android Kit Kat. If you're using Lollipop or Ice cream sandwich, well let's just say that some users reported very adverse side effects.

    3. Re:Of course not by DutchUncle · · Score: 1

      "So those penis enlargement Android apps don't really work?" Just put the phone in your pocket and call yourself . . . a lot . . .

    4. Re:Of course not by nospam007 · · Score: 1

      "No one should trust a digital health app. Unless it's been validated in a clinical study, you shouldn't trust anything ..."

      You mean approved stuff like Lipobay and Vioxx?

    5. Re:Of course not by wonkey_monkey · · Score: 2

      It uses the phone's accelerometer to measure your heart rate by putting it up against your chest and then measures the coloration of your fingertip by putting your finger over the camera lens.

      Are you sure?

      The heart rate apps I've seen use the fingertip colour to measure the heart rate. It's pretty accurate.

      --
      systemd is Roko's Basilisk.
    6. Re:Of course not by StormReaver · · Score: 1

      Unless it's been validated in a clinical study....

      Clinical studies can't be trusted, either, as they have usually been co-opted by financial interests.

  5. a child bearing only the truth will lead them out, by Anonymous Coward · · Score: 0

    it says in all the manuals? if he/she/it manages to survive our poopslide into the nether? spooky?

  6. Not much better than dedicated hardware by geekmux · · Score: 0

    I remember when I wanted to take a more proactive approach to monitoring my BP, so I went out and bought one of those machines. Paid almost $100 for it, so wasn't exactly the cracker-jack model.

    Plugged it in and performed several tests on both arms. Measurements swung so wildly that I ended up returning the damn thing the next day. Utterly pointless.

    You want to measure your blood pressure accurately and consistently? Do it the old-fashioned way. Find a seasoned nurse with a good ear.

    1. Re:Not much better than dedicated hardware by Anonymous Coward · · Score: 1

      $100? I've been using a $50 Walgreen wrist bp monitor for 3 years now that's been reliable and accurate. I just went to the doctor last Tuesday and before I went I checked my bp with my monitor and it was 127/84. 45 minutes later at the doctors office the nurse checked it and my bp was 126/79. Unless you've got circulatory problems in your arms, the monitors are decently accurate. When buying one, take it to the doctor's office and compare with the nurse's readings.

    2. Re:Not much better than dedicated hardware by Anonymous Coward · · Score: 1

      I have taken my Omron to the doctor's office to compare to his measurement several times and it's been very close every time.

    3. Re:Not much better than dedicated hardware by Anonymous Coward · · Score: 0

      My blood pressure is typically a pretty good indication of how smokin' hot the nurse is.

    4. Re:Not much better than dedicated hardware by Anonymous Coward · · Score: 0

      Or make sure you actually know how to use one of those machines. You need to position the cuff very deliberately, make sure you are siting correctly, make sure the arm is at the proper level. There's more to it then it seems. I'm not say you specifically didn't use it correctly but in general people don't.

    5. Re:Not much better than dedicated hardware by cdrudge · · Score: 1

      When buying one, take it to the doctor's office and compare with the nurse's readings.

      What happens when your doctor's office doesn't use an old fashion cuff and instead use this one? Every time I go in I have to position my arm in a different way. Sometimes it's stretched out, sometimes it's across by chest, once it was straight up. It's not really a surprise that my blood pressure always seems to be different (both significantly lower or higher) than what a traditional reading normally is for me.

    6. Re:Not much better than dedicated hardware by Zero__Kelvin · · Score: 1

      " Find a seasoned nurse with a good ear."

      Suppose I have an unseasoned nurse. What seasoning would you recommend? Thyme and Oregano? Maybe a little Cilantro?

      --
      Guns don't kill people; Physics kills people! - John Lithgow as Dick Solomon on Third Rock From The Sun
    7. Re:Not much better than dedicated hardware by Zero__Kelvin · · Score: 1

      "My blood pressure is typically a pretty good indication of how smokin' hot the nurse is."

      Oh, who do you think you are kidding? If he is just average looking, but pays you any attention at all, that alone would get your blood pumping and you know it.

      --
      Guns don't kill people; Physics kills people! - John Lithgow as Dick Solomon on Third Rock From The Sun
    8. Re:Not much better than dedicated hardware by Zero__Kelvin · · Score: 1

      " You need to position the cuff very deliberately"

      All this time I have been waiting for the damn cuff to fall into the correct position of its own volition!

      --
      Guns don't kill people; Physics kills people! - John Lithgow as Dick Solomon on Third Rock From The Sun
    9. Re:Not much better than dedicated hardware by godel_56 · · Score: 2

      I remember when I wanted to take a more proactive approach to monitoring my BP, so I went out and bought one of those machines. Paid almost $100 for it, so wasn't exactly the cracker-jack model.

      Plugged it in and performed several tests on both arms. Measurements swung so wildly that I ended up returning the damn thing the next day. Utterly pointless.

      You want to measure your blood pressure accurately and consistently? Do it the old-fashioned way. Find a seasoned nurse with a good ear.

      I have an older Omron and the readings it gives seem to be both consistent and broadly in line with the readings at my doctor's office. Sometimes getting different readings on different arms can be a sign of something wrong.

    10. Re:Not much better than dedicated hardware by Anonymous Coward · · Score: 0

      The automatic ones have gotten MUCH better. But there still is not a better overall "method" than the Sphygmomanometer, which is the inflatable cuff. It's a complete pain in the ass to use properly; and the subject has to pretty much be at-rest, sitting, arm out horizontally. This will probably never be possible with a cell phone. It's a very medically important metric, so believe me, many very smart people have devoted a great deal of time and effort towards trying to figure out a better way to do this, for nearly a century.

    11. Re:Not much better than dedicated hardware by Obfuscant · · Score: 2

      Every time I go in I have to position my arm in a different way. Sometimes it's stretched out, sometimes it's across by chest, once it was straight up. It's not really a surprise that my blood pressure always seems to be different

      This is not the fault of the device, it is a problem in training and experience. If your health care professionals are as incompetent at the use of a standard blood pressure cuff as they are with the wrist cuff from Amazon, you'll get "significantly higher or lower" readings using the "traditional method", too.

      "Measuring device at heart level" is the rule. Which medical professional do you go to that thinks that your wrist held straight up above your head is "at heart level"?

    12. Re:Not much better than dedicated hardware by Anonymous Coward · · Score: 0

      Find a seasoned nurse with a good ear.

      ..... that's kind of hot....

    13. Re:Not much better than dedicated hardware by Anonymous Coward · · Score: 0

      Alcohol. Lots of alcohol.

    14. Re:Not much better than dedicated hardware by geekmux · · Score: 1

      Or make sure you actually know how to use one of those machines. You need to position the cuff very deliberately, make sure you are siting correctly, make sure the arm is at the proper level. There's more to it then it seems. I'm not say you specifically didn't use it correctly but in general people don't.

      I'm not sure I've ever heard a more polite way of accusing me that I didn't RTFM, but thank you.

      Oh, and by the way, yes, I did RTFM.

  7. could be more than one? by Anonymous Coward · · Score: 0

    stands to reason? https://www.youtube.com/watch?v=FjuY0iabhV8 .. https://www.youtube.com/watch?v=sghunMfTnPg ... almost home all life matters

  8. umm by Anonymous Coward · · Score: 0

    ok, how does it pretend to work?
    All we got was the write-up of the study. It guesses it from your personal info? That sounds like fraud, not cheap.

    One line tho..." data from 16 individuals were discarded because of unavailable cuff sizes (n=1), standard device errors (n=2), and excessive variation in sequential standard BP measurements,"

    I can't imagine who they got that JOHN HOPKINS UNIVERSITY couldn't find a BP cuff to fit !

    Of course, doctors are moving toward FINGER BP units now for convenience which aren't much better. Bad enough they accepted the wrist units which are pretty iffy on their own. Don't forget the 2% of regular units that failed. BP is overrated.

    FYI: Measure your BP the same way with the same unit and seek out trends. Unless you are REALLY good with a manual unit and stethoscope, they are not that consistent.

    ((35+ years of repairing BP units))

  9. BP is difficult enough to measure as it is by Anonymous Coward · · Score: 2, Insightful

    Even if you measure your BP with the standard cuff, it's difficult to measure. Patient beware. Your BP can be thrown off by a number of factors such as recent caffeine intake, urinating, not urinating (because you're anticipating the need for a sample), nerves known as "white coat hypertension", and probably some other things I don't know because I'm not a doctor.

    If you have a high reading, I advise you to freak out like you're GOING TO DIE RIGHT NOW. Just kidding of course; but that's exactly the kind of dynamic that could get you placed on medication when you don't really need it.

    Likewise, don't ignore consistently high readings. Keyword--consistent. Obviously, don't listen to me. Listen to a lot of other people, especially doctors; but what I'm telling you is pretty much in line with consensus to the best of my knowledge.

    Bonus: that pinkish hibiscus tea? It's a natural diuretic. If you drink it and get tested, it could mask symptoms. Alternatively, it could act in tandem with your medication and bring your BP lower than you want it, causing you to get dizzy or even pass out.

    Anyway, IMHO it's not necessarily bad to have home testing; but you have to understand what it is you're measuring, how hard it is to measure, and what the measurements mean. I'd say the device might be useful if you can get consistent results, and then at some point you start getting a change for no good reason. Then, see a doctor; but you should probably be getting regular checkups anyway...

  10. Re:well under GOP healthcare black lists will be by Anonymous Coward · · Score: 0

    Found the liberal asshat. Sorry (not sorry) if that wasn't PC enough for you.

  11. Re:well under GOP healthcare black lists will be by Anonymous Coward · · Score: 0

    What a Democrat tool you are. That healthcare blacklist crap is just as much BS as the Obamacare death panels. You're like a liberal Sarah Palin.

  12. hype and fake all the way by sittingnut · · Score: 1

    so a badly coded app estimated blood pressure by superficial analysis of inaccurate measurements based on pseudo science.
    and blood pressure in everyday conditions( as opposed to condition of a patient in controlled situation (eg hooked up in a bed) with certain other symptoms), even when measured correctly, tells us almost nothing by itself.

    what a fake world!

    1. Re:hype and fake all the way by wonkey_monkey · · Score: 1

      so a badly coded app estimated blood pressure by superficial analysis of inaccurate measurements based on pseudo science.

      Oh, now, that's not fair. It could be an excellently coded app using superficial analysis of inaccurate measurements.

      --
      systemd is Roko's Basilisk.
  13. XKCD by ShanghaiBill · · Score: 2

    Is as accurate as TornadoGuard?

  14. Well, color me surprised! by kheldan · · Score: 1

    Wow, who could have possibly predicted that an app for your phone, using no extra sensory hardware whatsoever, could possibly be wildly inaccurate! After all it must have been written with the Best Intentions of the programmer, who fills his life with unicorns and puppies and fluffy kittens, sugar, spice, and everything nice, what could have possibly have gone wrong??? Obviously the silly testers and end-users must not be using it correctly. Seriously, those people who had heart attacks and strokes and died? Must be their fault!

    --
    Are YOU using the TOOL, or is the TOOL using YOU? Think about it!
  15. Class II Medical Device by captaindomon · · Score: 2

    A blood pressure monitor is a class II medical device, according to the FDA: http://www.fda.gov/MedicalDevi... Seems like the app creators could be in some pretty hot water if their device doesn't work and they didn't get certification from the FDA to distribute it...

    --
    Just because I can hook a shark from a boat, I do no offer to wrestle it in the water.
    1. Re:Class II Medical Device by wonkey_monkey · · Score: 1

      For entertainment purposes only!

      --
      systemd is Roko's Basilisk.
  16. I'm a little surprised by mhkohne · · Score: 1

    That they haven't had a visit from the FDA. Even with all their weasel-words, I don't see how they can get out of being considered a medical device by the FDA.

    Considering the amount of crap my company goes through to comply with the relevant regs, I get really annoyed by people flaunting them and getting away with it.

    --
    A thousand pounds of wood moving at 300 feet per minute. Don't get in the way.
  17. 120/80 ! by Ihlosi · · Score: 1
    120/80. Okay, add some randomness to make it more believable.

    Just like blood oxygen saturation. It's 99% +/- 1% for 99% of all users.

  18. Arterial pressure propagation speed. by Ihlosi · · Score: 1
    I've no idea what holding it against your chest is supposed to do.

    The thinge probably measures the time it takes for the arterial pressure spike from a heartbeat to propagate to the tip of your finger, and then uses some wild guessing to translate that into a blood pressure value. The technique kind of works, but only for measuring changes in blood pressure. You have to start with a regular (oscillometric or RR) blood pressure measurement and then track changes using the arterial pressure propagation delay.

    1. Re:Arterial pressure propagation speed. by wonkey_monkey · · Score: 1

      I did wonder if that might be it, but as you say it seems unlikely to work at all well.

      --
      systemd is Roko's Basilisk.