EEM423
C. Assessment 1: Essay – Report on health-focused sensor technology
Ramy Badr
190054746
Ramy.Badr@city.ac.uk
Professor Caroline Li
I. I NTRODUCTION
In their paper, Wang, Tian, and Zhu present a novel ap-
proach to continuous blood pressure monitoring via multichan-
nel wrist sensing signals.
This essay seeks to clarify the paper’s contribution, evaluate
the suggested solution critically, examine relevant research in
eHealth and blood pressure monitoring, and pinpoint areas that
could use improvement.
II. D ESCRIPTION
A. Motivation
In response to the widespread prevalence of hypertension,
the authors present an innovative approach to continuous blood
pressure monitoring, recognizing the critical need for accurate
and non-invasive measurements.
B. Proposition
The authors introduce a wrist-worn device that com-
bines photoplethysmography (PPG) and electrical impedance
plethysmography (EIP) to address this challenge and ensure
good generalization. PPG assesses changes in blood volume
via light absorption, whereas EIP assesses changes in electrical
impedance in blood vessels.
The device fuses the detected multichannel signals for real-
time continuous blood pressure estimation using a machine-
learning algorithm.
The accuracy limitations inherent in single-sensor methods
commonly used in existing devices are overcome by this dual-
sensor methodology.
III. R ELATED W ORK
A. Existing Applications
Various methodologies exist in the domain of eHealth and
continuous blood pressure monitoring, ranging from traditional
oscillometric cuffs to modern non-invasive wrist-worn devices
such as smartwatches (Iqbal et al., 2016). Despite this di-
versity, these devices frequently struggle with accuracy and
continuous monitoring issues.
Conventional methods, which frequently involve uncomfort-
able cuffs or invasive procedures, are ineffective for continuous
real-time monitoring.
B. Novelity
The authors’ approach is distinguished by the combination
of photoplethysmography (PPG) and electrical impedance
plethysmography (EIP), which results in a distinct strategy
with the potential for more accurate blood pressure measure-
ments when compared to single-sensor methods.
This contribution is significant, especially when compared
to established commercial applications in terms of convenience
and long-term viability (Hurley et al., 2021).
The incorporation of PPG and EIP not only distinguishes
the authors’ method, but also opens the door to real-time
and continuous blood pressure monitoring. This breakthrough
has far-reaching implications for eHealth and personalized
healthcare, representing a significant step forward in overcom-
ing existing limitations and ensuring effective, non-invasive
continuous monitoring.
C. Limitation of other applications
The selected essay’s introduction section discusses various
existing methods for continuous blood pressure monitoring,
each with its own set of advantages and limitations.
• Volume Clamping and Tonometry:
– Require constant pressure on the skin.
– Long-term use may cause discomfort.
– Volume clamping is inconvenient as it requires the
device to be worn on the finger.
• Pulse Transit Time (PTT):
– Utilizes the time it takes for a pressure wave to
propagate through the arterial tree.
– Requires frequent subject-specific calibrations.
• Pulse Wave Velocity (PWV):
– Based on the arrival time of a pressure wave propa-
gating through the arterial tree.
– Requires calibration with a cuff sphygmomanometer.
• Pulse Wave Analysis (PWA):
– Involves extracting features from an arterial wave-
form.
• Facial Video Method:
– Uses facial video to extract arterial waveform fea-
tures.
 – Relies on PWA or PTT to estimate blood pressure.
• Ultrasound Method:
– Records the diameter of a pulsating blood vessel.
– Requires calibration with a cuff sphygmomanometer.
D. Discussion
While there are a variety of off-the-shelf methods for con-
tinuous blood pressure monitoring, the introduction highlights
a common bottleneck issue: poor generalization across diverse
individuals.
In response to this common problem, the proposed method
aims to overcome these limitations by providing a non-invasive
continuous blood pressure measurement with strong general-
ization. Importantly, this method accomplishes this without the
need for subject-specific calibration.
This strategic approach recognizes and addresses the short-
comings of existing methods, representing a significant step
toward improving the effectiveness and applicability of con-
tinuous blood pressure monitoring across a wide range of user
scenarios.
IV. C RITICAL E VALUATION
A. Idea Prospect
The paper emphasizes the critical importance of accurate
and convenient continuous blood pressure monitoring in the
context of addressing the global health concern of hyper-
tension. This assertion is supported by epidemiological data
highlighting the global severity of cardiovascular diseases.
In keeping with the changing healthcare landscape, the
paper acknowledges the growing demand for wearable devices
in daily home care, laying the groundwork for a solution with
significant potential impact.
The central idea of the paper is to combine (PPG) and (EIP)
for continuous blood pressure monitoring. The paper empha-
sizes the novelty and relevance of this proposed approach by
referring to recent advances in non-invasive blood pressure
measurement tools (Castaneda et al., 2018).
The paper introduces an innovative wristwatch device with
dual PPG sensors and custom-made interface sensors, which
effectively communicates the limitations of existing methods
(Hurley et al., 2021). The comprehensive discussion of this
proposed solution unfolds as a multifaceted approach to ad-
dressing the challenges that traditional methods face.
Most significantly, the elimination of subject-specific cal-
ibration contributes to the generalization of blood pressure
measurements, aligning with the evolving landscape of con-
tinuous monitoring technologies (Wallen et al., 2016).
However, the paper acknowledges potential concerns about
the practicality and comfort of prolonged wear, prompting
further investigation.
Despite these potential limitations, the paper successfully
addresses the common bottleneck problem of poor gener-
alization encountered by existing continuous blood pressure
monitoring methods, highlighting its significant contribution
to the field (Wallen et al., 2016).
B. Evaluation
The evaluation is consistent with the sentiments expressed
by Iqbal et al. (2016), who emphasize the importance of
rigorous validation in wearable technology in medicine. Ac-
cording to Jokinen, Stolt, & Suhonen (2020), the ethical
review prompts considerations about patient safety and the
potential implications of continuous monitoring technologies,
complicating the critical evaluation.
While recognizing the paper’s significant contribution to
eHealth, it emphasizes the importance of comprehensive vali-
dation through extensive clinical trials and real-world testing.
The lack of such validation raises concerns about the proposed
system’s reliability and accuracy, necessitating further discus-
sion of potential limitations in real-world scenarios, such as
device placement and signal interference.
Finally, the paper’s critical assessment reveals a compelling
contribution to continuous blood pressure monitoring. The
significance of the paper is substantiated by well-reasoned
arguments supported by literature, and the proposed solution
holds promise for addressing current challenges in the field. To
ensure the practicality and reliability of the proposed solution,
a thorough validation process and detailed exploration of
potential real-world limitations are required.
V. P OTENTIAL I MPROVEMENTS
The proposed continuous blood pressure monitoring device
presents a noteworthy advancement, but certain criteria could
be enhanced for increased effectiveness and versatility:
1. Enhanced Wearability: The authors address the device’s
comfort, but further advancements in materials or design could
improve long-term wearability. Investigating softer materials
or ergonomic designs may alleviate concerns about practicality
over long periods of time.
2. Validation and Accuracy Studies: While the paper
emphasizes good generalization, more validation studies using
established methods are required. Conducting rigorous accu-
racy tests and comparisons with traditional monitoring devices
would boost the device’s credibility.
3. User-Friendly Interface: A more user-friendly interface
could enhance the device’s accessibility, especially for individ-
uals with varying levels of technological proficiency. Intuitive
displays or integration with widely used smart devices could
improve user engagement and ease of operation.
4. Power Consumption Optimization: The paper does not
extensively discuss power consumption. Optimizing energy
efficiency could extend the device’s battery life, making it
more practical for continuous monitoring without frequent
recharging.
5. Integration with Health Ecosystems: Exploring seam-
less integration with existing health ecosystems, such as elec-
tronic health records or health apps, could enhance the device’s
utility. This integration would provide users with a more
comprehensive health profile and facilitate communication
with healthcare professionals.
6. Exploration of Alternate Sensor Technologies: While
combining PPG and EIP is innovative, exploring additional
sensor technologies or modalities could provide complemen-
tary data for a more holistic health assessment. For instance,
incorporating additional biometric sensors might open avenues
for comprehensive health monitoring beyond blood pressure.
7. Adaptability to Diverse Physiological Conditions:
Further research on the device’s performance under various
physiological conditions, such as during physical activities or
in different environmental settings, would provide insights into
its adaptability and reliability across diverse scenarios.
8. Exploration in Telehealth Applications: Considering
the increasing popularity of telehealth, adapting the device for
remote patient monitoring could extend its impact. Enhancing
connectivity features and ensuring data security would position
the device for integration into telehealth platforms.
The paper’s future work section outlines directions for
improvement, such as device miniaturization and algorithm
refinement. However, additional emphasis on enhancing device
comfort and wearability and addressing potential challenges
in real-world scenarios should be considered. Collaborations
with healthcare professionals and extensive clinical trials are
pivotal for validating the method’s effectiveness and suitability
for medical use.
VI. C ONCLUSION
In conclusion, the paper presents a groundbreaking approach
to continuous blood pressure monitoring. While promising,
the solution demands rigorous validation, consideration of
potential limitations, and enhancements for practical applica-
bility. The research opens avenues for the future of eHealth,
emphasizing the pivotal role of accurate and non-invasive
continuous blood pressure monitoring for enhanced patient
care.
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