Regression or Classification? Reflection on BP prediction from PPG data using Deep Neural Networks in the scope of practical applications

Photoplethysmographic (PPG) signals offer diagnostic potential beyond heart rate analysis or blood oxygen level monitoring. In the recent past, research focused extensively on non-invasive PPG-based approaches to blood pressure (BP) estimation. These approaches can be subdivided into regression and classification methods. The latter assign PPG signals to predefined BP intervals that represent clinically relevant ranges. The former predict systolic (SBP) and diastolic (DBP) BP as continuous variables and are of particular interest to the research community. However, the reported accuracies of BP regression methods vary widely among publications with some authors even questioning the feasibility of PPG-based BP regression altogether. In our work, we compare BP regression and classification approaches. We argue that BP classification might provide diagnostic value that is equivalent to regression in many clinically relevant scenarios while being similar or even superior in terms of performance. We compare several established neural architectures using publicly available PPG data for SBP regression and classification with and without personalization using subject-specific data. We found that classification and regression models perform similar before personalization. However, after personalization, the accuracy of classification based methods outperformed regression approaches. We conclude that BP classification might be preferable over BP regression in certain scenarios where a coarser segmentation of the BP range is sufficient.

Assessment of deep learning based blood pressure prediction from PPG and rPPG signals

Exploiting photoplethysmography signals (PPG) for non-invasive blood pressure (BP) measurement is interesting for various reasons. First, PPG can easily be measured using fingerclip sensors. Second, camera-based approaches allow to derive remote PPG (rPPG) signals similar to PPG and therefore provide the opportunity for non-invasive measurements of BP. Various methods relying on machine learning techniques have recently been published. Performances are often reported as the mean average error (MAE) on the data which is problematic. This work aims to analyze the PPG- and rPPG-based BP prediction error with respect to the underlying data distribution. First, we train established neural network (NN) architectures and derive an appropriate parameterization of input segments drawn from continuous PPG signals. Second, we apply this parameterization to a larger PPG dataset and train NNs to predict BP. The resulting prediction errors increase towards less frequent BP values. Third, we use transfer learning to train the NNs for rPPG based BP prediction. The resulting performances are similar to the PPG-only case. Finally, we apply a personalization technique and retrain our NNs with subject-specific data. This slightly reduces the prediction errors.

Similarity based hierarchical clustering of physiological parameters for the identification of health states - a feasibility study

This paper introduces a new unsupervised method for the clustering of physiological data into health states based on their similarity. We propose an iterative hierarchical clustering approach that combines health states according to a similarity constraint to new arbitrary health states. We applied method to experimental data in which the physical strain of subjects was systematically varied. We derived health states based on parameters extracted from ECG data. The occurrence of health states shows a high temporal correlation to the experimental phases of the physical exercise. We compared our method to other clustering algorithms and found a significantly higher accuracy with respect to the identification of health states.