Cited by 250Non-Invasive Vital Sign MonitoringCardiovascular Health and Disease PreventionHeart Rate Variability and Autonomic Control

The DOI matches its Crossref record; 302 of the 302 references it cites were found in a registry or an index; none of the 172 sources its claims cite is checked for support yet.

Wearable Photoplethysmography for Cardiovascular Monitoring

Open access
Charlton, Peter H., Kyriacou, Panicos A., Mant, Jonathan, Marozas, Vaidotas, Chowienczyk, Phil, Alastruey, Jordi·2022·Proceedings of the IEEE

Abstract

Smart wearables provide an opportunity to monitor health in daily life and are emerging as potential tools for detecting cardiovascular disease (CVD). Wearables such as fitness bands and smartwatches routinely monitor the photoplethysmogram signal, an optical measure of the arterial pulse wave that is strongly influenced by the heart and blood vessels. In this survey, we summarize the fundamentals of wearable photoplethysmography and its analysis, identify its potential clinical applications, and outline pressing directions for future research in order to realize its full potential for tackling CVD.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

Wearable photoplethysmography (PPG) is widely used for heart-rate monitoring and is being developed for broader cardiovascular monitoring, including blood pressure, respiratory rate, oxygen saturation, atrial fibrillation, and vascular risk. This narrative review summarizes PPG fundamentals, signal processing, clinical applications, and research directions, concluding that accuracy, validation, and clinical integration remain key challenges.

Key findings

  • Wearable PPG can already estimate HR, but accuracy falls during exercise: summary MAE 2.15 bpm at rest vs 7.70 bpm during treadmill exercise and 10.64 bpm during cycling.
  • In a community smartwatch study, possible AF notifications from 1-min PPG recordings had a PPV of 0.84; sensitivity and specificity were not assessed.
  • Computational modeling of PPG in healthy subjects aged 25–75 found stiffness index increased with age and d/a decreased with age; both indices were predominantly influenced by arterial properties (large artery diameter, PWV, peripheral vascular resistance), with SI also strongly influenced by stroke volume and d/a by HR.
  • The review identifies AF detection as perhaps nearest to clinical use, while BP, RR, SpO2, arterial stiffness, sleep, stress, sepsis, HF, and preeclampsia applications need further validation.

Methods

  • Narrative review summarizing key literature on wearable PPG fundamentals, signal processing, physiological parameter estimation, clinical applications, future research, and resources; includes tables of further reading, PPG datasets, and wearable devices.
  • No systematic search, meta-analysis, or formal risk-of-bias assessment is described.
  • A computational model simulated PPG for healthy subjects aged 25–75 under varied cardiovascular conditions using the PWDB; SI and d/a were extracted and assessed via relative sensitivity to cardiovascular properties.

Limitations

  • The paper states it is a narrative review; it notes that mechanisms underlying PPG pulse wave shape are not fully understood, it is not clear which pulse-wave detection approaches perform best, and many clinical applications require further validation.
  • The paper notes that most wearable BP devices are not validated, and SpO2 measurements from conventional pulse oximeters have been found less accurate and less reliable in black patients than white patients.
  • Evident from the text: the modeling findings use synthetic/simulated data from healthy adults aged 25–75, not daily-life wearable recordings, and the review does not provide a systematic synthesis of evidence quality.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1109/jproc.2022.3149785

Cites

302 of 302 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

0 of 172 cited sources checked · 0 supported · 0 flagged

Show all 85 claims

  • It may state two separate claims as one. 62
  • Probably not a substantial claim. 44
92 of 92
  • The paper relies on this without support.

    A diagnosis of atrial fibrillation requires ECG verification.

    “Currently, a diagnosis of AF requires ECG verification, so the potential role of PPG-based devices is limited to initial assessment.”
  • The paper relies on this without support.

    Subsequent anticoagulant treatment for atrial fibrillation has the side effect of increased bleeding risk.

    “This is particularly important in the case of AF because subsequent anticoagulant treatment has the side effect of increased bleeding risk.”
  • The paper relies on this without support.

    A wide range of consumer devices is available with varying performance levels and no universal standards.

    “Second, a wide range of consumer devices is available with varying performance levels and no universal standards.”
  • The paper relies on this without support.

    At present, there is little evidence for the long-term health benefits of self-directed cardiovascular health monitoring.

    “At present, there is little evidence for the long-term health benefits of this approach.”
  • The paper relies on this without support.

    Even the best consumer devices may not perform sufficiently well to avoid excessive resource utilization.

    “First, even the best devices may not perform sufficiently well to avoid excessive resource utilization.”
5 of 5

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Citations

Cites

2 retracted

Flagged first, then by citations

Show all 296 references

Research works printed but not linked: 9

  1. 2019, Cisco Visual Networking Index (VNI) Global Mobile Data Traffic Forecast Update, 2017–2022 White Paper
  2. 2021, Gartner Forecasts Global Spending on Wearable Devices to Total $81.5 Billion in 2021
  3. 10.7717/peerj.6947/table-1 · DOI
  4. Charlton, 2017, Continuous Respiratory Rate Monitoring to Detect Clinical Deteriorations Using Wearable Sensors
  5. 2015, Atrial fibrillation prevalence estimates in England: Application of recent population estimates of AF in Sweden
  6. 2020, What Should I Know About the Fitbit Heart Study?
  7. Charlton, 2021, A Study of the Acceptability and Performance of Wearables for Atrial Fibrillation Screening in Older Adults
  8. Petersen, 2002, Coronary heart disease statistics: Heart failure supplement
  9. Healey, 2000, Wearable and Automotive Systems for the Recognition of Affect From Physiology

Cited by

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Items 101–200 of 250

Metadata

Authors
Charlton, P. H., Kyriacou, P. A., Mant, J., Marozas, V., Chowienczyk, P., & Alastruey, J.
Affiliations
  • University of London (GB)
  • University of Cambridge (GB)
  • Kaunas University of Technology (LT)
  • King's College London (GB)
Corresponding author
Charlton, Peter H.
Venue
Proceedings of the IEEE
Published
2022-03
Volume
110
Issue
3
Pages
355-381
ISSN
  • 0018-9219 (ISSN-L)
  • 1558-2256
OpenAlex
W4220840763
Cited by
250
References
296
Citations by year
2026: 108 · 2025: 62 · 2024: 37 · 2023: 33 · 2022: 10
FWCI
10.32
Type
journal article
Language
en
Open access
Locations
  • Proceedings of the IEEE (publishedVersion, cc-by-sa)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • City Research Online (City University London) (acceptedVersion)
  • Research Portal (King's College London) (submittedVersion, cc-by)
Funders
  • Wellcome Trust
  • National Institute for Health and Care Research (203148/Z/16/Z)
  • British Heart Foundation (WT203148/Z/16/Z, PG/15/104/31913, FS/20/20/34626, SP/14/8/31352)
  • University of Cambridge
  • King's College London (WT203148/Z/16/Z)
  • European Cooperation in Science and Technology (CA18216)
  • Lietuvos Mokslo Taryba (01.2.2-LMT-K-718, 01.2.2-LMT-K-718-01-0030)
  • Engineering and Physical Sciences Research Council ([WT203148/Z/16/Z], WT 203148/Z/16/, 203148/ Z/16/Z)
  • European Regional Development Fund (01.2.2-LMT-K-718, 01.2.2-LMT-K-718-01-0030)
  • Centre For Medical Engineering, King’s College London (203148/Z/16/Z, WT 203148/Z/16/Z)
Topics
  • Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
Keywords
cardiovascular monitoring, cardiovascular disease detection, smartwatches, fitness bands, arterial pulse wave, optical pulse measurement

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