A Novel Clustering-Based Algorithm for Continuous and Non-invasive Cuff-Less Blood Pressure Estimation

Extensive research has been performed on continuous, non-invasive, cuffless blood pressure (BP) measurement using artificial intelligence algorithms. This approach involves extracting certain features from physiological signals like ECG, PPG, ICG, BCG, etc. as independent variables and extracting features from Arterial Blood Pressure (ABP) signals as dependent variables, and then using machine learning algorithms to develop a blood pressure estimation model based on these data. The greatest challenge of this field is the insufficient accuracy of estimation models. This paper proposes a novel blood pressure estimation method with a clustering step for accuracy improvement. The proposed method involves extracting Pulse Transit Time (PTT), PPG Intensity Ratio (PIR), and Heart Rate (HR) features from Electrocardiogram (ECG) and Photoplethysmogram (PPG) signals as the inputs of clustering and regression, extracting Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) features from ABP signals as dependent variables, and finally developing regression models by applying Gradient Boosting Regression (GBR), Random Forest Regression (RFR), and Multilayer Perceptron Regression (MLP) on each cluster. The method was implemented using the MIMICII dataset with the silhouette criterion used to determine the optimal number of clusters. The results showed that because of the inconsistency, high dispersion, and multi-trend behavior of the extracted features vectors, the accuracy can be significantly improved by running a clustering algorithm and then developing a regression model on each cluster, and finally weighted averaging of the results based on the error of each cluster. When implemented with 5 clusters and GBR, this approach yielded an MAE of 2.56 for SBP estimates and 2.23 for DBP estimates, which were significantly better than the best results without clustering (DBP: 6.27, SBP: 6.36)

The 2023 wearable photoplethysmography roadmap

Photoplethysmography is a key sensing technology which is used in wearable devices such as smartwatches and fitness trackers. Currently, photoplethysmography sensors are used to monitor physiological parameters including heart rate and heart rhythm, and to track activities like sleep and exercise. Yet, wearable photoplethysmography has potential to provide much more information on health and wellbeing, which could inform clinical decision making. This Roadmap outlines directions for research and development to realise the full potential of wearable photoplethysmography. Experts discuss key topics within the areas of sensor design, signal processing, clinical applications, and research directions. Their perspectives provide valuable guidance to researchers developing wearable photoplethysmography technology

Advances in non-invasive blood pressure measurement techniques

Hypertension, or elevated blood pressure (BP), is a marker for many cardiovascular diseases and can lead to life threatening conditions such as heart failure, coronary artery disease and stroke. Several techniques have recently been proposed and investigated for non-invasive BP monitoring. The increasing desire for telemonitoring solutions that allow patients to manage their own conditions from home has accelerated the development of new BP monitoring techniques. In this review, we present the recent progress in non-invasive blood pressure monitoring solutions emphasizing clinical validation and trade-offs between available techniques. We introduce the current BP measurement techniques with their underlying operating principles. New promising proof-of-concept studies are presented and recent modeling and machine learning approaches for improved BP estimation are summarized. This aids discussions on how new BP monitors should evaluated in order to bring forth new home monitoring solutions in wearable form factor. Finally, we discuss on unresolved challenges in making convenient, reliable and validated BP monitoring solutions.</p

Blood pressure estimation with complexity features from electrocardiogram and photoplethysmogram signals

A novel method for the continual, cuff-less estimation of the systolic blood pressure (SBP) and diastolic blood pressure (DBP) values based on signal complexity analysis of the photoplethysmogram (PPG) and the electrocardiogram (ECG) is reported. The proposed framework estimates the blood pressure (BP) values obtained from signals generated from 14 volunteers subjected to a series of exercise routines. Herein, the physiological signals were first pre-processed, followed by the extraction of complexity features from both the PPG and ECG. Subsequently the complexity features were used in regression models (artificial neural network (ANN), support vector machine (SVM) and LASSO) to predict the BP. The performance of the approach was evaluated by calculating the mean absolute error and the standard deviation of the predicted results and compared with the recommendations made by the British Hypertension Society (BHS) and Association for the Advancement of Medical Instrumentation. Complexity features from the ECG and PPG were investigated independently, along with the combined dataset. It was observed that the complexity features obtained from the combination of ECG and PPG signals resulted to an improved estimation accuracy for the BP. The most accurate DBP result of 5.15 ± 6.46 mmHg was obtained from ANN model, and SVM generated the most accurate prediction for the SBP which was estimated as 7.33 ± 9.53 mmHg. Results for DBP fall within recommended performance of the BHS but SBP is outside the range. Although initial results are promising, further improvements are required before the potential of this approach is fully realised

The 2023 wearable photoplethysmography roadmap

Photoplethysmography is a key sensing technology which is used in wearable devices such as smartwatches and fitness trackers. Currently, photoplethysmography sensors are used to monitor physiological parameters including heart rate and heart rhythm, and to track activities like sleep and exercise. Yet, wearable photoplethysmography has potential to provide much more information on health and wellbeing, which could inform clinical decision making. This Roadmap outlines directions for research and development to realise the full potential of wearable photoplethysmography. Experts discuss key topics within the areas of sensor design, signal processing, clinical applications, and research directions. Their perspectives provide valuable guidance to researchers developing wearable photoplethysmography technology

Deep Learning Algorithms for Time Series Analysis of Cardiovascular Monitoring Systems

This thesis investigates and develops methods to enable ubiquitous monitoring of the most examined cardiovascular signs, blood pressure, and heart rate. Their continuous measurement can help improve health outcomes, such as the detection of hypertension, heart attack, or stroke, which are the leading causes of death and disability. Recent research into wearable blood pressure monitors sought predominately to utilise a hypothesised relationship with pulse transit time, relying on quasiperiodic pulse event extractions from photoplethysmography local signal characteristics and often used only a fraction of typically bivariate time series. This limitation has been addressed in this thesis by developing methods to acquire and utilise fused multivariate time series without the need for manual feature engineering by leveraging recent advances in data science and deep learning methods that showed great data analysis potential in other domains

Blood Pressure Estimation from Speech Recordings: Exploring the Role of Voice-over Artists

Hypertension, a prevalent global health concern, is associated with cardiovascular diseases and significant morbidity and mortality. Accurate and prompt Blood Pressure monitoring is crucial for early detection and successful management. Traditional cuff-based methods can be inconvenient, leading to the exploration of non-invasive and continuous estimation methods. This research aims to bridge the gap between speech processing and health monitoring by investigating the relationship between speech recordings and Blood Pressure estimation. Speech recordings offer promise for non-invasive Blood Pressure estimation due to the potential link between vocal characteristics and physiological responses. In this study, we focus on the role of Voice-over Artists, known for their ability to convey emotions through voice. By exploring the expertise of Voice-over Artists in controlling speech and expressing emotions, we seek valuable insights into the potential correlation between speech characteristics and Blood Pressure. This research sheds light on presenting an innovative and convenient approach to health assessment. By unraveling the specific role of Voice-over Artists in this process, the study lays the foundation for future advancements in healthcare and human-robot interactions. Through the exploration of speech characteristics and emotional expression, this investigation offers valuable insights into the correlation between vocal features and Blood Pressure levels. By leveraging the expertise of Voice-over Artists in conveying emotions through voice, this study enriches our understanding of the intricate relationship between speech recordings and physiological responses, opening new avenues for the integration of voice-related factors in healthcare technologies

Hybrid Wearable Signal Processing/Learning via Deep Neural Networks

Wearable technologies are gaining considerable attention in recent years as a potential post-smartphone platform with several applications of significant engineering importance. Wearable technologies are expected to become more prevalent in a variety of areas, including modern healthcare practices, robotic prosthesis control, Artificial Reality (AR) and Virtual Reality (VR) applications, Human Machine Interface/Interaction (HMI), and remote support for patients and chronically ill patients at home. The emergence of wearable technologies can be attributed to the advancement of flexible electronic materials; the availability of advanced cloud and wireless communication systems, and; the Internet of Things (IoT) coupled with high demand from the tech-savvy population and the elderly population for healthcare management. Wearable devices in the healthcare realm gather various biological signals from the human body, among which Electrocardiogram (ECG), Photoplethysmogram (PPG), and surface Electromyogram (sEMG), are the most widely non-intrusive monitored signals. Utilizing these widely used non-intrusive signals, the primary emphasis of the proposed dissertation is on the development of advanced Machine Learning (ML), in particular Deep Learning (DL), algorithms to increase the accuracy of wearable devices in specific tasks. In this context and in the first part, using ECG and PPG bio-signals, we focus on development of accurate subject-specific solutions for continuous and cuff-less Blood Pressure (BP) monitoring. More precisely, a deep learning-based framework known as BP-Net is proposed for predicting continuous upper and lower bounds of blood pressure, respectively, known as Systolic BP (SBP) and Diastolic BP (DBP). Furthermore, by capitalizing on the fact that datasets used in recent literature are not unified and properly defined, a unified dataset is constructed from the MIMIC-I and MIMIC-III databases obtained from PhysioNet. In the second part, we focus on hand gesture recognition utilizing sEMG signals, which have the potential to be used in the myoelectric prostheses control systems or decoding Myo Armbands data to interpret human intent in AR/VR environments. Capitalizing on the recent advances in hybrid architectures and Transformers in different applications, we aim to enhance the accuracy of sEMG-based hand gesture recognition by introducing a hybrid architecture based on Transformers, referred to as the Transformer for Hand Gesture Recognition (TraHGR). In particular, the TraHGR architecture consists of two parallel paths followed by a linear layer that acts as a fusion center to integrate the advantage of each module. The ultimate goal of this work is to increase the accuracy of gesture classifications, which could be a major step towards the development of more advanced HMI systems that can improve the quality of life for people with disabilities or enhance the user experience in AR/VR applications. Besides improving accuracy, decreasing the number of parameters in the Deep Neural Network (DNN) architectures plays an important role in wearable devices. In other words, to achieve the highest possible accuracy, complicated and heavy-weighted Deep Neural Networks (DNNs) are typically developed, which restricts their practical application in low-power and resource-constrained wearable systems. Therefore, in our next attempt, we propose a lightweight hybrid architecture based on the Convolutional Neural Network (CNN) and attention mechanism, referred to as Hierarchical Depth-wise Convolution along with the Attention Mechanism (HDCAM), to effectively extract local and global representations of the input. The key objective behind the design of HDCAM was to ensure its resource efficiency while maintaining comparable or better performance than the current state-of-the-art methods