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Evidence regarding whether smartphones can accurately measure pulse oximetry is mixed, with some sources indicating successful applications of integrated biosensors while other technical evaluations and limitations suggest significant challenges.
The measurement of blood pressure (BP) is critical to the treatment and management of many medical conditions. High blood pressure is associated with many chronic disease conditions, and is a major source of mortality and morbidity around the world. For outpatient care as well as general health monitoring, there is great interest in being able to accurately and frequently measure BP outside of a clinical setting, using mobile or wearable devices. One possible solution is photoplethysmography (PPG), which is most commonly used in pulse oximetry in clinical settings for measuring oxygen saturation. PPG technology is becoming more readily available, inexpensive, convenient, and easily integrated into portable devices. Recent advances include the development of smartphones and wearable devices that collect pulse oximeter signals. In this article, we review (i) the state-of-the-art and the literature related to PPG signals collected by pulse oximeters, (ii) various theoretical approaches that have been adopted in PPG BP measurement studies, and (iii) the potential of PPG measurement devices as a wearable application. Past studies on changes in PPG signals and BP are highlighted, and the correlation between PPG signals and BP are discussed. We also review the combined use of features extracted from PPG and other physiological signals in estimating BP. Although the technology is not yet mature, it is anticipated that in the near future, accurate, continuous BP measurements may be available from mobile and wearable devices given their vast potential.
Smartphone-based colorimetry has been widely applied in clinical analysis, although significant challenges remain in its practical implementation, including the need to consider biases introduced by the ambient imaging environment, which limit its potential within a clinical decision pathway. In addition, most commercial devices demonstrate variability introduced by manufacturer-to-manufacturer differences. Here, we undertake a systematic characterization of the potential imaging interferences that lead to this limited performance in conventional smartphones and, in doing so, provide a comprehensive new understanding of smartphone color imaging. Through derivation of a strongly correlated parameter for sample quantification, we enable real-time imaging, which for the first time, takes the first steps to turning the mobile phone camera into an analytical instrument - irrespective of model, software, and the operating systems used. We demonstrate clinical applicability through the imaging of patients' skin, enabling rapid and convenient diagnosis of cyanosis and measurement of local oxygen concentration to a level that unlocks clinical decision-making for monitoring cardiovascular disease and anemia. Importantly, we show that our solution also accounts for the differences in individuals' skin tones as measured across the Fitzpatrick scale, overcoming potential clinically significant errors in current optical oximetry.
ical pulse oximetry, respiratory viral pandemics, smartphone sensor with app
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Millions of smartphones contain photoplethysmography (PPG) biosensors with applications (apps) that accurately measure heart rate (HR) and blood oxygen saturation (Sp o 2 ). 1 , 2 High-grade PPG biosensors (Maxim Integrated) are currently integrated into Android smartphones worldwide, totaling more than 300 million smartphones. 3 The PPG sensor measures the distension of arteries and arterioles in the subcutaneous tissue, due to blood flow with each cardiac cycle. As blood flows through the vessels, the pulse pressure is detected by illuminating the skin with the light from two light-emitting diodes. The amount of light transmitted, absorbed, or reflected to a photodiode is measured. A signal-processing app containing an algorithm then detects and interprets the PPG signal to determine Sp o
2 and HR values. Finally, additional software within the app then accesses and displays individual biosensor readings on the smartphone screen.
Direct use of this technology for remote clinical pulse oximetry is highly relevant to the expanding integration of digital technologies into clinical care models. The usefulness of smartphones with embedded sensors and apps for intermittent clinical pulse oximetry is broad, potentially supporting the effective management of a wide range of chronic cardiopulmonary disease, including congestive heart failure, COPD, or acute disorders such as pneumonia, and postoperative recovery. 4 , 5 , 6 Smartphone sensors with apps for clinical pulse oximetry would allow patients to gather and track their own data to inform outpatient clinic or telemedicine visits, and increase communication with health-care providers, which may lead to earlier outpatient interventions that potentially reduce both morbidity and hospitalization risks. Smartphone sensors with apps for clinical pulse oximetry may be of considerable importance in low- and middle-
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