Evaluation of pulse oximeter performance under varying skin tones in bench tests and using Monte Carlo simulations

Suvvi K. Narayana Swamy; Chenyang He; Chong Liu; Ricardo G. Correia; Barrie R. Hayes-Gill; Daniel J. Clark; Sarah Green; Stephen P. Morgan

doi:10.1117/12.3000705

12 March 2024 Evaluation of pulse oximeter performance under varying skin tones in bench tests and using Monte Carlo simulations

Suvvi K. Narayana Swamy, Chenyang He, Chong Liu, Ricardo G. Correia, Barrie R. Hayes-Gill, Daniel J. Clark, Sarah Green, Stephen P. Morgan

Author Affiliations +

Proceedings Volume 12833, Design and Quality for Biomedical Technologies XVII; 1283304 (2024) https://doi.org/10.1117/12.3000705
Event: SPIE BiOS, 2024, San Francisco, California, United States

Abstract

Pulse oximeters’ varying performance based on skin tones has been highly publicised. Pulse oximeters tend to overestimate oxygen saturation values for people with darker skin (occult hypoxemia). The study aimed to construct a test bench to assess commercially available home based pulse oximeters. A laboratory simulator was used to mimic different oxygen saturation values (~70% to 100%). Four synthetic melanin filters were used to reproduce the effects of varying melanin attenuation levels. Three commercially available pulse oximeters (Biolight, N=13; ChoiceMMed, N = 18; MedLinket, N = 9) were reviewed and their response documented. All pulse oximeters’ responses under the effects of melanin attenuation did not change across various simulated oxygen saturation values. This does not match with the clinically observed data and one reason is that the light scattering due to tissue had not been fully replicated in the test bench. To investigate this further a Monte Carlo simulation of light propagation through the finger has been developed considering pulsatile flow and different skin tones. In reflection mode, the simulations highlight differences in measured R value and oxygen saturation with change in skin tone in the epidermal layer. However, in case of transmission mode, no change in the measured R value and oxygen saturation was observed. Further validation of these results from simulations is required to help us design pulse oximeters that are reliable and equitable for all users, regardless of skin tone.

Conference Presentation

(2024) Published by SPIE. Downloading of the abstract is permitted for personal use only.

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Suvvi K. Narayana Swamy, Chenyang He, Chong Liu, Ricardo G. Correia, Barrie R. Hayes-Gill, Daniel J. Clark, Sarah Green, and Stephen P. Morgan "Evaluation of pulse oximeter performance under varying skin tones in bench tests and using Monte Carlo simulations", Proc. SPIE 12833, Design and Quality for Biomedical Technologies XVII, 1283304 (12 March 2024); https://doi.org/10.1117/12.3000705

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