Key result
Absolute systolic blood pressure estimation using photoplethysmography and xgboost regression yielded a mean absolute error of 9.456 mmHg and correlation of 0.730 with strict subject separation.
Why the study?
Existing methods for absolute BP estimation using photoplethysmography differ widely in features, classifiers, and results, prompting the need for an interpretable machine learning method and critical appraisal.
Can machine learning algorithms accurately estimate absolute beat-to-beat blood pressure using photoplethysmography (PPG) signals?
Can machine learning algorithms accurately estimate absolute beat-to-beat blood pressure using photoplethysmography (PPG) signals?
Effect estimate: MAE 9.456mmHg, r 0.730
Machine learning applied to PPG signals can estimate absolute systolic blood pressure, but performance is highly dependent on data selection and training/testing separation methods.
ML-based PPG BP estimation remains exploratory; leaves open clinical validity versus cuff standards.
Blood pressure (BP) is among the most important vital signals. Estimation of absolute BP solely using photoplethysmography (PPG) has gained immense attention over the last years. Available works differ in terms of used features as well as classifiers and bear large differences in their results. This work aims to provide a machine learning method for absolute BP estimation, its interpretation using computational methods and its critical appraisal in face of the current literature. We used data from three different sources including 273 subjects and 259,986 single beats. We extracted multiple features from PPG signals and its derivatives. BP was estimated by xgboost regression. For interpretation we used Shapley additive values (SHAP). Absolute systolic BP estimation using a strict separation of subjects yielded a mean absolute error of 9.456mmHg and correlation of 0.730. The results markedly improve if data separation is changed (MAE: 6.366mmHg, r: 0.874). Interpretation by means of SHAP revealed four features from PPG, its derivation and its decomposition to be most relevant. The presented approach depicts a general way to interpret multivariate prediction algorithms and reveals certain features to be valuable for absolute BP estimation. Our work underlines the considerable impact of data selection and of training/testing separation, which must be considered in detail when algorithms are to be compared. In order to make our work traceable, we have made all methods available to the public.
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Fleischhauer et al. (2022) studied Blood pressure estimation (n=273). Photoplethysmography (PPG) based machine learning was evaluated on Absolute systolic BP estimation (MAE 9.456mmHg, r 0.730). Absolute systolic blood pressure estimation using photoplethysmography and xgboost regression yielded a mean absolute error of 9.456 mmHg and correlation of 0.730 with strict subject separation.
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