IDEAS home Printed from https://ideas.repec.org/a/sae/medema/v8y1988i3p182-190.html
   My bibliography  Save this article

Bayesian Analysis of Diastolic Blood Pressure Measurement

Author

Listed:
  • Clyde B. Schechter
  • Rhodes S. Adler

Abstract

A mathematical model is presented for measurements that include substantial fluctuation and error. Under the assumptions that the fluctuation-error variance is the same for all subjects, and that the distributions of fluctuation-error variance within subjects and "true" values of the measurements in the population are normal, Bayes' theorem produces a simple estimate of the "true" value of a measurement, and a standard error, conditional on a single observation. The model is easily extended to several observations. Methods for estimating the parameters of the model from a data set are presented, and applied to diastolic blood pressures of patients in the authors' primary care clinic. The test-retest reliability of a single blood pressure measurement for this population is 0.41. Because continuous measurements are often dichotomized into "normal" and "abnormal" ranges by a threshold criterion, the authors present formulas for the positive predictive value when a decision rule based on a given number of observations is used in a population with respect to a threshold criterion for the "true" values. For example, classifying their patients as hypertensive on the basis of the average of two readings exceeding 90 mm Hg diastolic pressure would have a positive predictive value of 52% for the "gold standard" of average diastolic pressure exceeding 90 mm Hg. Formulas to calculate the frequency with which patients will be classified "abnormal" by one decision rule but will be classified "normal" by later application of another rule are provided and used to "predict" the frequency with which this crossover phenomenon should have occurred in the enrollment phase of the Hypertension Detection and Follow-up Pro grams. 5,6 The authors' calculation of 36.3% agrees closely with the observed 34.7% crossover rate, enhancing confidence in the validity of their model and generalizability of their parameter estimates. Key words: Bayes' theorem; hypertension; screening tests. (Med Decis Making 8:182-190, 1988)

Suggested Citation

  • Clyde B. Schechter & Rhodes S. Adler, 1988. "Bayesian Analysis of Diastolic Blood Pressure Measurement," Medical Decision Making, , vol. 8(3), pages 182-190, August.
    • Handle: RePEc:sae:medema:v:8:y:1988:i:3:p:182-190
    DOI: 10.1177/0272989X8800800306
    as

    Download full text from publisher

    File URL: https://journals.sagepub.com/doi/10.1177/0272989X8800800306
    Download Restriction: no
    File URL: https://libkey.io/10.1177/0272989X8800800306?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:sae:medema:v:8:y:1988:i:3:p:182-190. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: SAGE Publications (email available below). General contact details of provider: .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.