Meta-analyses of Bland–Altman-style cardiac output validation studies: good, but do they provide answers to all our questions?

<span class="paragraphSection">No one would deny the need for safe, reliable, and non-invasive cardiac output (CO) monitoring in anaesthesia and acute medicine. Measuring CO, or better still stroke volume (SV), adds a further dimension to haemodynamic monitoring as it completes the circulatory equation BP=CO×PR, where BP is blood pressure, PR is peripheral resistance, CO=SV×HR, and HR is heart rate. Clinical use of the pulmonary artery thermodilution catheter has been in decline since the 1990s,<a href="#aew442-B1" class="reflinks"><sup>1</sup></a> and newer, less invasive technologies have been developed that still need clinical evaluation.<a href="#aew442-B2" class="reflinks"><sup>2</sup></a> Since its first description in 1986, the Bland–Altman method of determining accuracy and precision against a reference method, such as thermodilution, has become the gold standard in validation statistics.<a href="#aew442-B3" class="reflinks"><sup>3</sup></a> In this month’s edition of the Journal, one finds a ‘state-of-the-art’ systematic review and meta-analysis by Joosten and colleagues<a href="#aew442-B4" class="reflinks"><sup>4</sup></a> that focuses on totally non-invasive and continuous CO monitoring technology and analyses published data extracted from Bland–Altman-style CO validation studies. It is one of a number of recent reviews published by this group that uses...
Source: British Journal of Anaesthesia - Category: Anesthesiology Source Type: research