{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:02:54Z","timestamp":1760058174002,"version":"build-2065373602"},"reference-count":44,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T00:00:00Z","timestamp":1741910400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"FCT\/MECI","award":["UID\/50008"],"award-info":[{"award-number":["UID\/50008"]}]},{"name":"EU funds","award":["UID\/50008"],"award-info":[{"award-number":["UID\/50008"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Applied Sciences"],"abstract":"<jats:p>Arterial hypertension is one of the most important public health problems, especially in developed countries. The quality and calibration of blood pressure (BP) equipment used for non-invasive blood pressure (NIBP) measurement are essential to obtain accurate data that support correct medical diagnostics. This paper includes the hardware and software description of a flexible, low-cost and algorithm-independent calibrator prototype that can be used for the static and dynamic calibration of automated blood pressure measuring devices (ABPMDs). In the context of this paper, the meaning of calibrator flexibility is mainly related to its ability to adapt or change easily in response to different situations in terms of the calibration of ABPMDs that can use a variety of calibration settings without the need to use specific oscillometric curves from different ABPMD manufacturers. The hardware part of the calibrator includes mainly an electro-pneumatic regulator, used to generate dynamic pressure signals with arbitrary waveforms, amplitudes and frequencies, a pressure sensor, remotely connected through a pneumatic tube to the blood pressure (BP) cuff, a blood pressure release valve and analog conditioning circuits, plus the A\/D converter. The software part of the calibrator, mainly developed in LabVIEW 20, enables the simulation of oscillometric pressure pulses with different envelope profiles and the implementation of the main algorithms that are typically used to evaluate systolic, diastolic and mean arterial pressure values. Simulation and experimental results that were obtained validate the theoretical expectations and show a very acceptable level of accuracy and performance of the presented NIBP calibrator prototype. The prototype calibration results were also validated using a certified NIBP calibrator that is frequently used in clinical environments.<\/jats:p>","DOI":"10.3390\/app15063198","type":"journal-article","created":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T13:07:51Z","timestamp":1741957671000},"page":"3198","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Flexible, Low-Cost and Algorithm-Independent Calibrator for Automated Blood Pressure Measuring Devices"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0183-132X","authenticated-orcid":false,"given":"Jos\u00e9 Miguel Costa Dias","family":"Pereira","sequence":"first","affiliation":[{"name":"Escola Superior de Tecnologia, Instituto Polit\u00e9cnico de Set\u00fabal, 2910-761 Set\u00fabal, Portugal"},{"name":"Instituto de Telecomunica\u00e7\u00f5es, ISCTE\u2014Instituto Universit\u00e1rio de Lisboa, 1649-026 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4978-7364","authenticated-orcid":false,"given":"Gon\u00e7alo","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Instituto de Telecomunica\u00e7\u00f5es, ISCTE\u2014Instituto Universit\u00e1rio de Lisboa, 1649-026 Lisboa, Portugal"}]},{"given":"Octavian","family":"Postolache","sequence":"additional","affiliation":[{"name":"Department of Information Science and Technology, ISCTE\u2014Instituto Universit\u00e1rio de Lisboa, Av. das For\u00e7as Armadas, 1649-026 Lisbon, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1093\/eurheartj\/ehz859","article-title":"Cardiovascular Disease Statistics 2019. European Society of Cardiology","volume":"41","author":"Timmis","year":"2020","journal-title":"Eur. Heart J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1161\/HYPERTENSIONAHA.120.15026","article-title":"International Society of Hypertension Global Hypertension Practice Guidelines","volume":"75","author":"Unger","year":"2020","journal-title":"Hypertension"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1161\/HYPERTENSIONAHA.120.16625","article-title":"The 2020 \u201cWHO Technical Specifications for Automated Non-Invasive Blood Pressure Measuring Devices With Cuff\u201d","volume":"77","author":"John","year":"2021","journal-title":"Hypertension"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"101298","DOI":"10.1016\/j.eml.2021.101298","article-title":"The effect of arterial stiffness on cuff-based blood pressure measurement","volume":"48","author":"Ma","year":"2021","journal-title":"Extrem. Mech. Lett."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e35","DOI":"10.1161\/HYP.0000000000000087","article-title":"Measurement of Blood Pressure in Humans: A Scientific Statement From the American Heart Association","volume":"73","author":"Muntner","year":"2019","journal-title":"Hypertension"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1111\/jch.13296","article-title":"Blood pressure measurement in special populations and circumstances","volume":"20","author":"Stergiou","year":"2018","journal-title":"J. Clin. Hypertens."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1593","DOI":"10.1161\/HYPERTENSIONAHA.120.14719","article-title":"Nonvalidated Home Blood Pressure Devices Dominate the Online Marketplace in Australia: Major Implications for Cardiovascular Risk Management: Hypertension","volume":"75","author":"Picone","year":"2020","journal-title":"Hypertension"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1038\/s41371-022-00693-x","article-title":"Automated oscillometric blood pressure measuring devices: How they work and what they measure","volume":"37","author":"Sharman","year":"2023","journal-title":"J. Hum. Hypertens."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Kumar, S., Yadav, S., and Kumar, A. (2022). Oscillometric Waveform Evaluation for Blood Pressure Devices. Biomed. Eng. Adv., 4.","DOI":"10.1016\/j.bea.2022.100046"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Celler, B.G., Argha, A., Le, P.N., and Ambikairajah, E. (2018). Novel methods of testing and calibration of oscillometric blood pressure monitors. PloS ONE, 13.","DOI":"10.1371\/journal.pone.0201123"},{"key":"ref_11","unstructured":"Rigel Medical GMC Instruments Group (2024, December 31). What Are \u2018O Curves\u2019 and How Do I Create Them?. Available online: https:\/\/www.rigelmedical.com\/gb\/support\/patient-simulation."},{"key":"ref_12","unstructured":"Fluke (2024, December 31). ProSim 8 Vital Signs Patient Simulator. Available online: https:\/\/www.flukebiomedical.com."},{"key":"ref_13","unstructured":"National Standards Authority of Ireland (NSAI) (2025, February 17). Developing an Infrastructure for Improved and Harmonised Metrological Checks of Blood-Pressure Measurements in Europe. National Metrology Laboratory (NML), Dublin. Available online: https:\/\/shop.standards.ie\/en-ie\/search\/standard\/?searchTerm=adOSSIG."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"100260","DOI":"10.1016\/j.measen.2021.100260","article-title":"Physiology-based patient simulator for blood pressure meter testing","volume":"18","author":"Schiebl","year":"2021","journal-title":"Meas. Sens."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Sedl\u00e1k, V., Pra\u017e\u00e1k, D., Tesa\u0159, J., Rosu, D., Ger\u0161ak, G., Ferreira, M., Nawotka, M., Bosnjakovic, A., Jugo, E., and Hetherington, P. (2022, January 17\u201319). Evaluation of Sphygmomanometers Using an Advanced Oscillometric Signal Generator. Proceedings of the Imeko TC11 & TC24 Joint Hybrid Conference, Dubrovnik, Croatia.","DOI":"10.21014\/tc11-2022.03"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2391","DOI":"10.1109\/TIM.2010.2050978","article-title":"Instruments and Methods for Calibration of Oscillometric Blood Pressure Measurement Devices","volume":"59","author":"Balestrieri","year":"2010","journal-title":"IEEE Trans. Instrum. Meas."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Ratnadewi, Ramdhani, M.F., Kurniasih, N., Putri, L.D., Parwito, Abdullah, D., Listyorini, T., Bakhtiar, M.I., Nanuru, R.F., and Rahim, R. (2018). Automatic Blood Pressure Detector Using Arduino to Measure Blood Pressure in Indonesian People Age 19\u201327 Years Old. Int. J. Eng. Technol., 7, 115\u2013118.","DOI":"10.14419\/ijet.v7i2.5.13964"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Chandrasekhar, A., Yavarimanesh, M., Hahn, J.-O., Sung, S.-H., Chen, C.-H., Cheng, H.-M., and Mukkamala, R. (2019). Formulas to Explain Popular Oscillometric Blood Pressure Estimation Algorithms. Front. Physiol., 10.","DOI":"10.3389\/fphys.2019.01415"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1109\/TBME.2022.3201433","article-title":"Mathematical Modeling of Oscillometric Blood Pressure Measurement: A Complete, Reduced Oscillogram Model","volume":"70","author":"Dhamotharan","year":"2023","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"ref_20","first-page":"28","article-title":"The Meaning of the point of maximum oscillations in cuff pressure in the indirect measurement of blood-pressure\u2014Part II","volume":"102","author":"Mauck","year":"1980","journal-title":"Trans. ASME"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1007\/BF02368225","article-title":"Theory of the oscillometric maximum and the systolic and diastolic detection ratios","volume":"22","author":"Drzewiecki","year":"1994","journal-title":"Ann. Biomed. Eng."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1007\/BF02367308","article-title":"Characterization of the oscillometric method for measuring indirect blood pressure","volume":"10","author":"Geddes","year":"1982","journal-title":"Ann. Biomed. Eng."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Bronzino, J.D. (2006). Medical Devices and Systems, Taylor & Francis.","DOI":"10.1201\/9781420003864"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1109\/RBME.2015.2434215","article-title":"Oscillometric blood pressure estimation: Past, present, and future","volume":"8","author":"Forouzanfar","year":"2015","journal-title":"IEEE Rev. Biomed. Eng."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"National High Blood Pressure Education Program\/National Heart (2003). The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension, 289, 2560\u20132571.","DOI":"10.1001\/jama.289.19.2560"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"930","DOI":"10.1016\/j.jash.2014.08.014","article-title":"Oscillometric blood pressure: A review for clinicians","volume":"8","author":"Alpert","year":"2014","journal-title":"J. Am. Soc. Hypertens."},{"key":"ref_27","first-page":"64","article-title":"Novel Method for More Precise Determination of Oscillometric Pulse Amplitude Envelopes","volume":"8","author":"Fei","year":"2015","journal-title":"Comput. Inf. Sci."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Mafi, M., Rajan, S., Bolic, M., Groza, V.Z., and Dajani, H.R. (September, January 28). Blood pressure estimation using maximum slope of oscillometric pulses. Proceedings of the 2012 Annual International Conference of the IEEE Engineering in Medicine and Biology Society, San Diego, CA, USA.","DOI":"10.1109\/EMBC.2012.6346655"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Barrios-Fernandez, S., Sosa-S\u00e1nchez, E.M., Mu\u00f1oz-Bermejo, L., Morenas-Mart\u00edn, J., Apolo-Arenas, M.D., Adsuar, J.C., and Dom\u00ednguez-Mu\u00f1oz, F.J. (2022). Intrasession Reliability Analysis for Oscillometric Blood Pressure Method Using a Digital Blood Pressure Monitor in Peruvian Population. Healthcare, 10.","DOI":"10.3390\/healthcare10020209"},{"key":"ref_30","first-page":"16","article-title":"Comparison of auscultatory and oscillometric BP measurements in children with obesity and their effect on the diagnosis of arterial hypertension","volume":"88","year":"2018","journal-title":"Arch. Cardiol. Mex."},{"key":"ref_31","unstructured":"NXP Semiconductors (2024, December 31). Document Number: MP3V5050. Data Sheet: Technical Data Rev. 1.4. Available online: https:\/\/www.nxp.com\/docs\/en\/data-sheet\/MP3V5050.pdf."},{"key":"ref_32","unstructured":"Parker (2018). Miniature Electronic Pressure Regulators\u2014Precision Fluidcs, Parker."},{"key":"ref_33","unstructured":"Koge Micro Tech Co., Ltd. (2024, December 31). Selenoid Valve, KSV05 Series. Available online: https:\/\/www.koge.com\/."},{"key":"ref_34","unstructured":"ARDUINO (2024, December 31). Arduino UNO WIFI REV2. Available online: https:\/\/store.arduino.cc\/en-pt\/products."},{"key":"ref_35","unstructured":"Air Flow Developments Ltd (2024, December 31). FL 1.5 Manometer. Available online: https:\/\/www.bsria.com\/doc\/Bv6AdB\/."},{"key":"ref_36","unstructured":"Keithley (2024, December 31). Keithley 2000 Series: 6\u00bd-Digit Multimeter with Scanning. Available online: https:\/\/www.tek.com\/tektronix-and-keithley-digital-multimeter."},{"key":"ref_37","unstructured":"National Instruments (2024, December 31). MyDAQ Data Acquisition Board. Available online: https:\/\/www.ni.com\/pt."},{"key":"ref_38","unstructured":"General Electric Company (2024, December 31). Measurement and Control. Druck DPI611\u2014Portable Pressure Calibrator. Available online: https:\/\/www.neoinstruments.com."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1111\/jch.13902","article-title":"Effect of cuff positioning on the accuracy of blood pressure measurement with automated electronic blood pressure monitors","volume":"22","author":"Li","year":"2020","journal-title":"J. Clin. Hypertens."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1627","DOI":"10.1021\/ac60214a047","article-title":"Smoothing and differentiation of data by simplified least squares procedures","volume":"36","author":"Savitzky","year":"1964","journal-title":"Anal. Chem."},{"key":"ref_41","unstructured":"Paul Hartmann, A.G. (2024, December 31). Veroval DUO CONTROL. Available online: https:\/\/www.veroval.info\/en-ae\/technology."},{"key":"ref_42","unstructured":"DATREND Systems (2024, December 31). Vpad-BP NIBP Simulator. Available online: https:\/\/www.datrend.com\/product\/vpad-bp\/."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1097\/00004872-199007000-00004","article-title":"Protocol for the evaluation of automated and semi-automated blood pressure measuring devices with special reference to ambulatory systems","volume":"8","author":"Petrie","year":"1990","journal-title":"J. Hypertens."},{"key":"ref_44","unstructured":"GE Healthcare\u2014Product Specifications\u2014DINAMAP\u00ae PRO 300 (2024, December 31). Vital Signs Monitor, DINAMAP\u00ae PRO 300 Vital Signs Monitor. Available online: https:\/\/www.medlikim.com\/wp-content\/."}],"container-title":["Applied Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3417\/15\/6\/3198\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:54:03Z","timestamp":1760028843000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3417\/15\/6\/3198"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,14]]},"references-count":44,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["app15063198"],"URL":"https:\/\/doi.org\/10.3390\/app15063198","relation":{},"ISSN":["2076-3417"],"issn-type":[{"type":"electronic","value":"2076-3417"}],"subject":[],"published":{"date-parts":[[2025,3,14]]}}}