Medical & Biological Engineering & Computing

, Volume 54, Issue 7, pp 1025–1035 | Cite as

A review of methods for the signal quality assessment to improve reliability of heart rate and blood pressures derived parameters

  • Nicolò Gambarotta
  • Federico Aletti
  • Giuseppe Baselli
  • Manuela FerrarioEmail author
Review Article


The assessment of signal quality has been a research topic since the late 1970s, as it is mainly related to the problem of false alarms in bedside monitors in the intensive care unit (ICU), the incidence of which can be as high as 90 %, leading to alarm fatigue and a drop in the overall level of nurses and clinicians attention. The development of efficient algorithms for the quality control of long diagnostic electrocardiographic (ECG) recordings, both single- and multi-lead, and of the arterial blood pressure (ABP) signal is therefore essential for the enhancement of care quality. The ECG signal is often corrupted by noise, which can be within the frequency band of interest and can manifest similar morphologies as the ECG itself. Similarly to ECG, also the ABP signal is often corrupted by non-Gaussian, nonlinear and non-stationary noise and artifacts, especially in ICU recordings. Moreover, the reliability of several important parameters derived from ABP such as systolic blood pressure or pulse pressure is strongly affected by the quality of the ABP waveform. In this work, several up-to-date algorithms for the quality scoring of a single- or multi-lead ECG recording, based on time-domain approaches, frequency-domain approaches or a combination of the two will be reviewed, as well as methods for the quality assessment of ABP. Additionally, algorithms exploiting the relationship between ECG and pulsatile signals, such as ABP and photoplethysmographic recordings, for the reduction in the false alarm rate will be presented. Finally, some considerations will be drawn taking into account the large heterogeneity of clinical settings, applications and goals that the reviewed algorithms have to deal with.


False alarm detection Signal quality ECG Arterial blood pressure Heart rate 



This research was supported by the Shockomics Grant (FP7 EU Project No 602706).

Conflict of interest

The authors declare that there are no conflicts of interest.


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Copyright information

© International Federation for Medical and Biological Engineering 2016

Authors and Affiliations

  • Nicolò Gambarotta
    • 1
  • Federico Aletti
    • 1
  • Giuseppe Baselli
    • 1
  • Manuela Ferrario
    • 1
    Email author
  1. 1.Department of Electronics, Information and BioengeneeringPolitecnico di MilanoMilanItaly

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