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Research Letter |

Validation of the Instant Blood Pressure Smartphone App

Timothy B. Plante, MD1; Bruno Urrea, MD2; Zane T. MacFarlane3; Roger S. Blumenthal, MD2; Edgar R. Miller III, MD, PhD1,4; Lawrence J. Appel, MD, MPH1,4; Seth S. Martin, MD, MHS2
[+] Author Affiliations
1Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
2Ciccarone Center for the Prevention of Heart Disease, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
3Department of Chemistry, Pomona College, Claremont, California
4Welch Center for Prevention, Epidemiology, Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland
JAMA Intern Med. 2016;176(5):700-702. doi:10.1001/jamainternmed.2016.0157.
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The accuracy and precision of the Instant Blood Pressure app are evaluated amid concerns that individuals may use these apps to assess their blood pressure and titrate therapy.

Mobile health (mHealth) technologies include unregulated consumer smartphone apps.1 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. Between its release on June 5, 2014, and removal on July 30, 2015 (421 days), the IBP app spent 156 days as one of the top 50 best-selling iPhone apps; at least 950 copies of this $4.99 app were sold on each of those days.2 Validation of this popular app or any of the similar iPhone apps still available (eg, Blood Pressure Pocket, Quick Blood Pressure Measure and Monitor), have not been performed. Using a protocol based on national guidelines,3 we investigated the accuracy and precision of IBP.

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Standard Blood Pressure (BP) vs Instant Blood Pressure (IBP) App Measurements

A, Scatterplot of the IBP app and standard BP measurements with line of identity in black. The gray lines represent the cutoff points for hypertension. Spearman rank-order correlation coefficient is a nonparametric test for strength of association for non–normally distributed continuous variables with ρ of −1 or +1 indicating perfect correlation and 0.4 to 0.6 representing moderate correlation. IBP measurements were not normally distributed by the Shapiro-Wilk test. B, Bland-Altman plot for IBP and the standard BP measurement. The short dashed line represents the means (SDs) of the absolute value of the difference (IBP minus standard), which were −1.2 (16.2) and 7.1 (10.8) mm Hg. The long dashed lines represent ±2 SDs for this range (32.4 and 21.6, respectively).

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