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J Clin Epidemiol. 2003 Aug;56(8):768-74.

National Health and Nutrition Examination Survey 1999-2000: effect of observer training and protocol standardization on reducing blood pressure measurement error.

Author information

1
Division of Health Examination Statistics, National Center for Health Statistics, NHANES Program, 3311 Toledo Road, Room 4319, Centers for Disease Control and Prevention, Hyattsville, MD 20782, USA. yxo1@cdc.gov

Abstract

OBJECTIVE:

We describe the National Health and Nutrition Examination Survey (NHANES) blood pressure (BP) observer training and protocol standardization and evaluate the quality of BP measurement.

METHODS:

The participants were persons aged 8 years and older who had their BP measured (n=7467) during NHANES 1999-2000. Cuff width/arm circumference ratio (CW/AC), end digit preference, and observer agreement were examined.

RESULTS:

In stepwise principal components multiple regression analysis, CW/AC accounted for less than 2% of variability R(2) in all readings. The frequencies for all end digits were close to 20% ("0" end digit=21% systolic and 23% diastolic). No overall observer effect was present for mean systolic BP readings. A significant observer effect (P<.0001) was detected for mean diastolic BP readings of <90 mm Hg. For readings of > or =90 mm Hg, there was no significant observer effect (P=.157).

CONCLUSION:

We conclude that NHANES BP measurements do not demonstrate the variability that is commonly caused by observer and technical error.

PMID:
12954469
[Indexed for MEDLINE]

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