Accuracy and reliability of a wireless vital signs monitor for hospitalized patients in a low-resource setting

OBJECTIVE: The purpose of this study was to evaluate the accuracy and reliability of neoGuard in comparison to a conventional bedside monitor on patients in a low-resource clinical setting. DESIGN: This was a single-arm methods comparison study involving the use of a wearable vital signs monitor (neoGuard(TM)) versus a conventional bedside monitor (Edan iM8). SETTING: The study was conducted at Jinja Regional Referral Hospital, a tertiary care hospital situated in Eastern Uganda. PARTICIPANTS: Thirty patients (10 male, 20 female) were enrolled from the adult recovery ward at JRRH. Participants were eligible for the study if they were at least 18 years of age, had 2 sets of normal vital sign measurements obtained 1 h apart, and were able and willing to provide informed consent. MAIN OUTCOME AND MEASURES: The primary outcome measures were (i) bias (mean deviation) and (ii) limits of agreement [95% CI]. Bland-Altman plots were generated to illustrate the level of agreement between the neoGuard(TM) technology and the Edan iM8 monitor. RESULTS: Bland-Altman analysis was performed for 24 participants; datasets from six participants were excluded due to missing or invalid measurements. Findings showed a moderate level of agreement for measurement of SpO(2), PR, and RR, with >80% of subject means falling within the predefined acceptability limits. However, there was also notable variation in accuracy between subjects, with large standard deviations observed for measurement of all four parameters. While the level of agreement for measurement of temperature was low, this is partly explained by limitations in the comparison method.