Evaluation of the signal quality of wrist-based photoplethysmography

Objective: Wearable devices with embedded photoplethysmography (PPG) sensors enable continuous monitoring of cardiovascular activity, allowing for the detection cardiovascular problems, such as arrhythmias. However, the quality of wrist-based PPG is highly variable, and is subject to artifacts from motion and other interferences. The goal of this paper is to evaluate the signal quality obtained from wrist-based PPG when used in an ambulatory setting. Approach: Ambulatory data were collected over a 24 h period for 10 elderly, and 16 non-elderly participants. Visual assessment is used as the gold standard for PPG signal quality, with inter-rater agreement evaluated using Fleiss' Kappa. With this gold standard, 5 classifiers were evaluated using a modified 13-fold cross-validation approach. Main results: A Random Forest quality classification algorithm showed the best performance, with an accuracy of 74.5%, and was then used to evaluate 24 h long ambulatory wrist-based PPG measurements. Significance: In general, data quality was high at night, and low during the day. Our results suggest wrist-based PPG may be best for continuous cardiovascular monitoring applications during the night, but less useful during the day unless methods can be identified to improve low quality signal segments.