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. 2024 May 22;24(11):3301.
doi: 10.3390/s24113301.

Effect of Skin Pigmentation and Finger Choice on Accuracy of Oxygen Saturation Measurement in an IoT-Based Pulse Oximeter

Shyqyri Haxha  1 , Chike Nwibor  1 , Mian Ali  1 , Mohamed Sakel  2 , Karen Saunders  2 , Vladimir Dyo  1 , Shakira Nabakooza  3
Affiliations

Effect of Skin Pigmentation and Finger Choice on Accuracy of Oxygen Saturation Measurement in an IoT-Based Pulse Oximeter

Shyqyri Haxha et al. Sensors (Basel). .

Abstract

Pulse oximeters are widely used in hospitals and homes for measurement of blood oxygen saturation level (SpO2) and heart rate (HR). Concern has been raised regarding a possible bias in obtaining pulse oximeter measurements from different fingertips and the potential effect of skin pigmentation (white, brown, and dark). In this study, we obtained 600 SpO2 measurements from 20 volunteers using three UK NHS-approved commercial pulse oximeters alongside our custom-developed sensor, and used the Munsell colour system (5YR and 7.5YR cards) to classify the participants' skin pigmentation into three distinct categories (white, brown, and dark). The statistical analysis using ANOVA post hoc tests (Bonferroni correction), a Bland-Altman plot, and a correlation test were then carried out to determine if there was clinical significance in measuring the SpO2 from different fingertips and to highlight if skin pigmentation affects the accuracy of SpO2 measurement. The results indicate that although the three commercial pulse oximeters had different means and standard deviations, these differences had no clinical significance.

Keywords: Internet of Things; optical sensors; photoplethysmography; pulse oximetry.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Reflection measurement mode [32].
Figure 2
Figure 2
The extinction coefficients for the four different types of haemoglobin and their relationships within red and IR light wavelengths [2].
Figure 3
Figure 3
Beer–Lambert model and component [33].
Figure 4
Figure 4
The sensor prototype development timeline [24]. (a) Alpha version of the sensor using Velcro tape and bulky 3D case; (b) beta version of the sensor; (c) the final version of the sensor with 0.91-inch OLED display and remote monitoring capacity.
Figure 5
Figure 5
Hue 5YR and 7.5YR hues were used to identify skin colour [54,55].
Figure 6
Figure 6
Dark, brown, and white skin pigments with 3 different PO sensors placed on the fingertips of volunteers.
Figure 7
Figure 7
SpO2 readings from the 10 different fingertips using different commercial POs, with error bars.
Figure 8
Figure 8
Bland–Altman plot of Ailie and Acurio measurements.
Figure 9
Figure 9
Bland–Altman plot of Braun and Ailie measurements.
Figure 10
Figure 10
Bland–Altman plot of Braun and Acurio measurements.
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References

    1. Ortega R., Hansen C.J., Elterman K., Woo A. Pulse Oximetry. N. Engl. J. Med. 2011;364:e33. doi: 10.1056/NEJMvcm0904262. - DOI - PubMed
    1. Chan E.D., Chan M.M., Chan M.M. Pulse oximetry: Understanding its basic principles facilitates appreciation of its limitations. Respir. Med. 2013;107:789–799. doi: 10.1016/j.rmed.2013.02.004. - DOI - PubMed
    1. Allen J., Overbeck K., Nath A.F., Murray A., Stansby G. A prospective comparison of bilateral photoplethysmography versus the ankle-brachial pressure index for detecting and quantifying lower limb peripheral arterial disease. J. Vasc. Surg. 2008;47:794–802. doi: 10.1016/j.jvs.2007.11.057. - DOI - PubMed
    1. Yelderman M., New W. Evaluation of pulse oximetry. Anesthesiology. 1983;59:349–352. doi: 10.1097/00000542-198310000-00015. - DOI - PubMed
    1. Severinghaus J.W., Kelleher J.F. Recent developments in pulse oximetry. Anesthesiology. 1992;76:1018–1038. - PubMed

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