Design, development and clinical validation of a wrist-based optical heart rate monitor
Abstract
Development in the field of sensor technology, hardware miniaturization, ubiquitous computing and connected solutions paved the way for the development of wearables for continuous physiological parameter monitoring. Continuous heart rate monitoring with clinical accuracy using reflectance photoplethysmogram signals from wrist is highly challenging and presents a potential area of research. In this work, we present a wearable device in a wrist watch form factor for heart rate monitoring. The device runs on a low power ARM cortex M4 microcontroller and integrates a BLE (Bluetooth Low energy) module for wireless connectivity. A heart rate computation algorithm using reflectance photoplethysmography and a 3 axes accelerometer for motion artifact removal is presented in the paper. Heart rate computed by the wrist worn device was validated against heart rate measured using Masimo Radical-7 on 256 subjects. The validation study was conducted in a hospital setting for a duration of 1 month, after obtaining the ethics committee approval and informed consent from the subjects. Details of the experimental setup, clinical validation protocol and observations and inferences made from the study are presented.
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Preejith et al.'s device had an error of 1.04 BPM for 'fair' skinned individuals and 10.90 BPM for 'dark' skinned participants, a greater than 10 times increase in absolute error.
“There was an error of 1.04 beats per minute (BPM) for “fair” skinned individuals and an error of 10.90 BPM for “dark” skinned participants, citing the lack of usability of their device for dark skinned individuals.”
From Sources of inaccuracy in photoplethysmography for continuous cardiovascular monitoring (2021) · cites this paper as [40]
Preejith et al. found a significant direct correlation between SNR of heart rate and skin tone using a 535 nm LED, indicating that a darker skin tone yields higher error in the measurement.
“Preejith et al. confirmed that skin tone matters when using green light only. The analysis of their PPG biosensor (single source 535 nm LED) showed a significant direct correlation SNR of the heart rate with skin tone, indicating that a darker skin tone yields higher error in the measurement [40].”
From Sources of inaccuracy in photoplethysmography for continuous cardiovascular monitoring (2021) · cites this paper as [40]
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“In another validation study, the measured heart rate showed a minor deviation compared with the actual heart rate in participants with a dark skin tone [30].”
- Authors
- Preejith, S. P., Alex, A., Joseph, J., & Sivaprakasam, M.
- Affiliations
- Indian Institute of Technology Madras (IN)
- Venue
- 2016 IEEE International Symposium on Medical Measurements and Applications (MeMeA)
- Publisher
- IEEE
- Published
- 2016-05
- Pages
- 1-6
- OpenAlex
- W2511765933
- Cited by
- 41
- References
- 13
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 3 · 2023: 8 · 2022: 11 · 2021: 3 · 2020: 3 · 2019: 3 · 2018: 1 · 2017: 4
- FWCI
- 5.34
- Type
- conference paper
- Language
- en
- Open access
- closed
- Locations
- IEEE International Symposium on Medical Measurements and Applications (MeMeA) (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
- wearable sensors, motion artifact removal, accelerometer, Bluetooth Low Energy, ARM Cortex-M4, clinical validation, continuous physiological monitoring, low-power embedded systems
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