Accuracy enhancement in reflective pulse oximetry by considering wavelength-dependent pathlengths

Objective. Noninvasive measurement of oxygen saturation (SpO (2)) using transmissive photoplethysmography (tPPG) is clinically accepted and widely employed. However, reflective photoplethysmography (rPPG)-currently present in smartwatches-has not become equally accepted, partially because the pathlengths of the red and infrared PPGs are patient-dependent. Thus, even the most popular 'Ratio of Modulation' (R) method requires patient-dependent calibration to reduce the errors in the measurement of SpO (2) using rPPGs. Approach. In this paper, a correction factor or 'pathlength ratio' beta is introduced in an existing calibration-free algorithm that compensates the patient-dependent pathlength variations, and improved accuracy is obtained in the measurement of SpO (2) using rPPGs. The proposed pathlength ratio beta is derived through the analytical model of a rPPG signal. Using the new expression and data obtained from a human hypoxia study wherein arterial oxygen saturation values acquired through Blood Gas Analysis were employed as a reference, beta is determined. Main results. The results of the analysis show that a specific combination of the beta and the measurements on the pulsating part of the natural logarithm of the red and infrared PPG signals yields a reduced root-mean-square error (RMSE). It is shown that the average RMSE in measuring SpO (2) values reduces to 1 %. Significance. The human hypoxia study data used for this work, obtained in a previous study, covers SpO (2) values in the range from 70 % to 100 %, and thus shows that the pathlength ratio beta proposed here works well in the range of clinical interest. This work demonstrates that the calibration-free method applicable for transmission type PPGs can be extended to determine SpO (2) using reflective PPGs with the incorporation of the correction factor beta. Our algorithm significantly reduces the number of parameters needed for the estimation, while keeping the RMSE below the clinically accepted 2 %.

Automated summary

The paper introduces a correction factor or 'pathlength ratio' beta to compensate for patient-dependent pathlength variations in reflective photoplethysmography (rPPG) for accurate measurement of oxygen saturation. Results show that the proposed method reduces the root-mean-square error (RMSE) to 1% in measuring SpO2 values, demonstrating its applicability in the clinical range of interest. The calibration-free algorithm significantly reduces the number of parameters needed for estimation while maintaining RMSE below 2%.