Best Approach for Modelling Pulse Wave Analysis (PWA)

Clinical
1

Hi everyone,

I’m currently working on modelling the 24-hour blood pressure measurement at the University Hospital Basel. In some cases, a Pulse Wave Analysis (PWA) is performed alongside the 24-hour BP measurement.

The Pulse/Heart beat archetype doesn’t currently include data elements to represent PWA measurements. In our case, the 24-hour average (mean) values for the following parameters are recorded:

  • Augmentation Index at Heart Rate 75 per Minute
  • Cardiac Output
  • Peripheral Resistance
  • Pulse Wave Velocity
  • Reflection Coefficient
  • Central Diastolic Blood Pressure
  • Central Systolic Blood Pressure

I discussed this with my colleagues, and we have identified different approaches to model the PWA:

  • Since the PWA is strongly related to the clinical concept of the pulse, it could be modelled in the Pulse archetype which would require a change request.

  • The Pulse Archetype could be extended with a cluster for the PWA data elements (more tactical than strategical modeling).

  • The PWA could be modelled as a new Observation archetype.

What do you think is the best approach here? I would be very grateful for your input.

2

I probably don’t know enough about PWA but I’d probably opt for the CLUSTER extension or even more so towards a new Observation.

I think to would be overloading the Pulse archetype to add this in there. It is already quite complex re Heart beat vs pulse etc.

3 Likes