Video-based heart rate monitoring across a range of skin pigmentations during an acute hypoxic challenge
Open accessAbstract
The robust monitoring of heart rate from the video-photoplethysmogram (video-PPG) during challenging conditions requires new analysis techniques. The work reported here extends current research in this area by applying a motion tolerant algorithm to extract high quality video-PPGs from a cohort of subjects undergoing marked heart rate changes during a hypoxic challenge, and exhibiting a full range of skin pigmentation types. High uptimes in reported video-based heart rate (HR vid ) were targeted, while retaining high accuracy in the results. Ten healthy volunteers were studied during a double desaturation hypoxic challenge. Video-PPGs were generated from the acquired video image stream and processed to generate heart rate. HR vid was compared to the pulse rate posted by a reference pulse oximeter device (HR p ). Agreement between video-based heart rate and that provided by the pulse oximeter was as follows: Bias = − 0.21 bpm, RMSD = 2.15 bpm, least squares fit gradient = 1.00 (Pearson R = 0.99, p < 0.0001), with a 98.78% reporting uptime. The difference between the HR vid and HR p exceeded 5 and 10 bpm, for 3.59 and 0.35% of the reporting time respectively, and at no point did these differences exceed 25 bpm. Excellent agreement was found between the HR vid and HR p in a study covering the whole range of skin pigmentation types (Fitzpatrick scales I–VI), using standard room lighting and with moderate subject motion. Although promising, further work should include a larger cohort with multiple subjects per Fitzpatrick class combined with a more rigorous motion and lighting protocol.
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Numerous other studies that stratify results against Fitzpatrick classification identify the same trend: errors in determining heart rate from wearable PPG devices that use primarily green light are increased in individuals with dark skin tones due to high absorption caused by increased amounts of epidermal melanin.
“In addition to these examples, numerous other studies that stratify results against Fitzpatrick classification identify the same trend; errors in determining heartrate from wearable PPG devices that use primarily green light as their source is increased in individuals with dark skin tones due to the high absorption caused by increased amounts of epidermal melanin [42,43,44,45].”
From Sources of inaccuracy in photoplethysmography for continuous cardiovascular monitoring (2021) · cites this paper as [45]
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References 29 · Cited by 24
- Authors
- Addison, P. S., Jacquel, D., Foo, D. M. H., & Borg, U. R.
- Affiliations
- Medtronic (United Kingdom) (GB)
- Medtronic (United States) (US)
- Corresponding author
- Addison, Paul S.
- Venue
- Journal of Clinical Monitoring and Computing
- Published
- 2017-11-09
- Volume
- 32
- Issue
- 5
- Pages
- 871-880
- ISSN
- 1387-1307 (ISSN-L)
- 1573-2614
- PMC
- PMC6132623
- OpenAlex
- W2767575893
- Cited by
- 24
- References
- 29
- Citations by year
- 2026: 3 · 2025: 1 · 2023: 1 · 2022: 7 · 2021: 4 · 2020: 4 · 2019: 2 · 2018: 2
- FWCI
- 0.98
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Journal of Clinical Monitoring and Computing (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › ECG Monitoring and Analysis
- Keywords
- heart rate monitoring, skin pigmentation, Fitzpatrick skin type, non-contact vital sign monitoring
- MeSH terms
- Hemodynamic Monitoring, Adult, Algorithms, Hypoxia, Female, Heart Rate, Humans, Male, Oximetry, Signal Processing, Computer-Assisted, Skin Pigmentation, Video Recording, Least-Squares Analysis, Photoplethysmography, Young Adult, Healthy Volunteers
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