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Heart rate assessment using NeoTapAdvancedSupport: a simulation study
  1. Marco Binotti1,2,
  2. Francesco Cavallin3,
  3. Pier Luigi Ingrassia2,
  4. Nicolas J Pejovic4,5,6,
  5. Alice Monzani7,
  6. Giulia Genoni7,
  7. Daniele Trevisanuto8
  1. 1 Neonatal and Pediatric Intensive Care Unit, Maggiore della Carità Hospital, Novara, Italy
  2. 2 Centro Interdipartimentale di Didattica Innovativa e di Simulazione in Medicina e Professioni Sanitarie, SIMNOVA, University of Piemonte Orientale, Novara, Italy
  3. 3 Independent Statistician, Solagna, Italy
  4. 4 Global Health, Health Systems and Policy, Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
  5. 5 Sachs' Children and Youth Hospital, Stockholm, Sweden
  6. 6 Centre for International Health, University of Bergen, Bergen, Norway
  7. 7 Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
  8. 8 Department of Woman’s and Child’s Health, Padua University, Padova, Italy
  1. Correspondence to Dr Giulia Genoni, Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara 28100, Italy; genonigiulia{at}


Background NeoTapAdvancedSupport (NeoTapAS) is a mobile application, based on a screen tapping method that calculates the heart rate (HR). We aimed to evaluate the accuracy of NeoTapAS in reliably determining HR from auscultation in a high-fidelity simulated newborn resuscitation scenario.

Methods Paediatric residents assessed HR by auscultation plus NeoTapAS in an asphyxiated term infant scenario and orally communicated the estimated HR. An external observer simultaneously documented the actual HR set in the manikin and the communicated HR.

Results One hundred and sixty HR measurements were recorded. The agreement between communicated and set HR was good (Cohen’s kappa 0.80, 95% CI 0.72 to 0.87; Bangdiwala’s weighted agreement strength statistic 0.93). Bland-Altman plot showed a mean difference between communicated and set HR values of 1 beats per minute (bpm) (95% agreement limits −9 to 11 bpm).

Conclusion NeoTapAS showed a good accuracy in estimating HR and it could be an important resource in settings with limited availability of ECG monitor.

  • neonatology
  • resuscitation
  • mobile health
  • heart rate
  • accuracy

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All the data of the current study are published in the manuscript. Raw data will be made available on request.