U.S. patent application number 15/192691 was filed with the patent office on 2016-10-20 for processing and detecting baseline changes in signals.
The applicant listed for this patent is Nellcor Puritan Bennett Ireland. Invention is credited to Paul Stanley Addison, James Nicholas Watson.
Application Number | 20160302737 15/192691 |
Document ID | / |
Family ID | 41448293 |
Filed Date | 2016-10-20 |
United States Patent
Application |
20160302737 |
Kind Code |
A1 |
Watson; James Nicholas ; et
al. |
October 20, 2016 |
PROCESSING AND DETECTING BASELINE CHANGES IN SIGNALS
Abstract
Systems and methods for detecting the occurrence of events from
a signal are provided. A signal processing system may analyze
baseline changes and changes in signal characteristics to detect
events from a signal. The system may also detect events by
analyzing energy parameters and artifacts in a scalogram of the
signal. Further, the system may detect events by analyzing both the
signal and its corresponding scalogram.
Inventors: |
Watson; James Nicholas;
(Dunfermline, GB) ; Addison; Paul Stanley;
(Edinburgh, GB) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Nellcor Puritan Bennett Ireland |
Mervue |
|
IE |
|
|
Family ID: |
41448293 |
Appl. No.: |
15/192691 |
Filed: |
June 24, 2016 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
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14020732 |
Sep 6, 2013 |
9378332 |
|
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15192691 |
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12245400 |
Oct 3, 2008 |
8660799 |
|
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14020732 |
|
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61077036 |
Jun 30, 2008 |
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61077130 |
Jun 30, 2008 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 5/6838 20130101;
G16B 5/00 20190201; A61B 5/1495 20130101; A61B 5/0205 20130101;
G16H 40/63 20180101; G06F 19/34 20130101; G16H 40/40 20180101; A61B
5/7282 20130101; A61B 5/726 20130101; A61B 5/6826 20130101; A61B
5/14551 20130101; A61B 5/6814 20130101; G16B 45/00 20190201; G16B
40/00 20190201 |
International
Class: |
A61B 5/00 20060101
A61B005/00; G06F 19/00 20060101 G06F019/00; A61B 5/1495 20060101
A61B005/1495; A61B 5/1455 20060101 A61B005/1455; A61B 5/0205
20060101 A61B005/0205 |
Claims
1. A method for recalibrating a medical monitor based on detection
of a physiological event, the method comprising: receiving a
physiological signal from a physiological sensor attached to a
subject; calculating, using the medical monitor, a physiological
parameter of the subject based on the physiological signal;
transforming, using the medical monitor, the physiological signal
to generate a transformed physiological signal; generating, using
the medical monitor, a scalogram from the transformed physiological
signal; identifying, using the medical monitor, an artifact in the
scalogram; determining, using the medical monitor, at least one of
size and shape of the identified artifact; detecting, using the
medical monitor, an occurrence of the physiological event based on
at least one of the size and the shape of the identified artifact;
and triggering, using the medical monitor, a recalibration of the
medical monitor in response to detecting the occurrence of the
physiological event.
2. The method of claim 1, wherein the medical monitor comprises at
least one of a pulse oximetry monitor, an electrocardiogram
monitor, an electroencephalogram, an electrogastrogram monitor, an
electromyogram monitor, and a multi-parameter monitor.
3. The method of claim 1, wherein the artifact is a high energy
broad-scale cone.
4. The method of claim 1, wherein the physiological event comprises
at least one of a change in blood pressure, a change in body
position, vasodilation, vasoconstriction, sympathetic nervous
response, parasympathetic nervous response, and sleep arousal.
5. The method of claim 1, further comprising calculating an energy
parameter within a region of the scalogram, wherein detecting the
occurrence of the physiological event is based on the energy
parameter.
6. The method of claim 5, wherein the occurrence of the
physiological event is detected if at least one of the energy
parameter, the size of the identified artifact, and the shape of
the identified artifact exceeds a respective threshold.
7. The method of claim 5, wherein the energy parameter comprises
average energy within the region.
8. The method of claim 5, wherein the region comprises a portion of
a pulse band.
9. The method of claim 5, wherein the region comprises a ridge of a
pulse band.
10. A medical monitor system, comprising: a physiological sensor
attached to a subject configured to generate a physiological
signal; and a medical monitor configured to: calculate a
physiological parameter of the subject based on the physiological
signal; transform the physiological signal to generate a
transformed physiological signal; generate a scalogram from the
transformed physiological signal; identify an artifact in the
scalogram; determine at least one of size and shape of the
identified artifact; detect an occurrence of a physiological event
based on at least one of the size and the shape of the identified
artifact; and trigger a recalibration of the medical monitor in
response to detecting the occurrence of the physiological
event.
11. The medical monitor system of claim 10, wherein the medical
monitor comprises at least one of a pulse oximetry monitor, an
electrocardiogram monitor, an electroencephalogram, an
electrogastrogram monitor, an electromyogram monitor, and a
multi-parameter monitor.
12. The medical monitor system of claim 10, wherein the artifact is
a high energy broad-scale cone.
13. The medical monitor system of claim 10, wherein the
physiological event comprises at least one of a change in blood
pressure, a change in body position, vasodilation,
vasoconstriction, sympathetic nervous response, parasympathetic
nervous response, and sleep arousal.
14. The medical monitor system of claim 10, wherein the medical
monitor is further configured to calculate an energy parameter
within a region of the scalogram, and wherein detecting the
occurrence of the physiological event is based on the energy
parameter.
15. The medical monitor system of claim 14, wherein the medical
monitor is further configured to detect the occurrence of the
physiological event if at least one of the energy parameter, the
size of the identified artifact, and the shape of the identified
artifact exceeds a respective threshold.
16. The medical monitor system of claim 14, wherein the energy
parameter is average energy within the region.
17. The medical monitor system of claim 14, wherein the region
comprises a portion of a pulse band.
18. The medical monitor system of claim 14, wherein the region
comprises a ridge of a pulse band.
19. A non-transitory computer-readable medium for use in
recalibrating a medical monitor based on detection of physiological
event the computer-readable medium comprising: computer program
instructions recorded thereon for causing the medical monitor to:
calculate a physiological parameter of the subject based on the
physiological signal; transform the physiological signal to
generate a transformed physiological signal; generate a scalogram
from the transformed physiological signal; identify an artifact in
the scalogram; determine at least one of size and shape of the
identified artifact; detect an occurrence of the physiological
event based on at least one of the size and the shape of the
identified artifact; and trigger a recalibration of the medical
monitor in response to detecting the occurrence of the
physiological event.
20. The non-transitory computer-readable medium system of claim 19,
wherein the computer program instructions cause the medical monitor
to: calculate an energy parameter within a region of the scalogram;
and detect the occurrence of the physiological event if at least
one of the energy parameter, the size of the identified artifact,
and the shape of the identified artifact exceeds a respective
threshold.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application is a continuation of U.S. patent
application Ser. No. 14/020,732, filed Sep. 6, 2013, which is a
continuation of U.S. patent application Ser. No. 12/245,400, filed
Oct. 3, 2008, now U.S. Pat. No. 8,660,799, which claims the benefit
of U.S. Provisional Application No. 61/077,036, entitled
"PROCESSING AND DETECTING BASELINE CHANGES IN SIGNALS" and U.S.
Provisional Application No. 61/077,130, entitled "SYSTEMS AND
METHODS OF SIGNAL PROCESSING," both filed Jun. 30, 2008, all of
which are hereby incorporated by reference herein in their
entireties.
SUMMARY
[0002] The present disclosure is generally directed to detecting
baseline changes in signals and, in an embodiment, detecting events
that cause baseline changes in a photoplethysmogram signal (PPG
signal) and corresponding changes in wavelet transforms of the PPG
signal.
[0003] In accordance with the disclosure, methods and systems are
provided for detecting baseline changes in signals. In an
embodiment, methods and systems are provided for detecting events
that cause baseline changes in a PPG signal and corresponding
changes in wavelet transforms of the PPG signal.
[0004] In an embodiment, a signal processing system may analyze a
signal captured from a user. The signal processing system may
calculate at least one signal characteristic of the signal. For
example, the signal processing system may calculate an average or
median value of an AC component of the signal over a selected
amount of time or over a selected number of cardiac events (e.g.,
cardiac cycles).
[0005] In addition to calculating the signal characteristics of the
signal, the signal processing system may also detect a baseline
change in the signal. For example, the signal processing system may
calculate short term and/or long term changes in the baseline over
time. The signal processing system may detect the rate of change in
the baseline when it is changing and/or the percentage change
and/or magnitude of change in the baseline between two periods
where the baseline is generally constant or is changing below a
threshold. In an embodiment, the signal processing system may
characterize the shape of the baseline change using a linear (e.g.
best-fit line, threshold-crossing) or nonlinear characterization
technique (e.g. curve fitting, template matching, adaptive methods
etc.).
[0006] After calculating the signal characteristics and detecting
the baseline change, the signal processing system may calculate at
least one signal characteristic subsequent to the baseline change.
For example, the signal processing system may analyze the same
signal characteristic that was calculated before the baseline
change.
[0007] After calculating the signal characteristic subsequent to
the baseline change, the signal processing system may analyze the
baseline change and the signal characteristic to detect an
occurrence of an event. For example, the system may determine that
the AC component of the signal increased before and after the
baseline change. In response to determining the change in the
signal characteristic, the signal processing system may determine
that an event occurred causing the baseline change (e.g., the user
raised his arm).
[0008] In an embodiment, the signal processing system may transform
the signal captured from a user to generate a transformed signal.
For example, the signal processing system may perform a wavelet
transform of the signal. After generating the transformed signal,
the signal processing system may generate a scalogram based on the
transformed signal. The scalogram may include a pulse band, which
is a series of dominant coalescing features across the
scalogram.
[0009] The signal processing system may calculate characteristics
of the scalogram. The characteristics may be an energy parameter
such as, for example, the average or median energy within the
region. The size and shape of the region may be selected in any
suitable way. For example, the height and location of the first
region may be selected to cover the pulse band (e.g., centered over
the ridge of the pulse band). As another example, the height and
location of the first region may be fixed to cover the range of
scales where the pulse band is expected to be located.
[0010] In addition to calculating the characteristics within a
region of the scalogram, the signal processing system may detect an
artifact within the scalogram. In an embodiment, the artifact may
appear as a high energy broad-scale cone. The system may detect the
artifact using any suitable techniques, such as, for example, image
processing techniques. In addition, the artifact may be detected in
response to detecting a large change in the average energy or
detecting peak values in the pulse band that are inconsistent with
previous peak values.
[0011] In response to calculating the characteristics of the
scalogram and detecting the artifact within the scalogram, the
signal processing system may analyze the calculated characteristics
and detected artifact to detect an event. In an embodiment, the
signal processing system may monitor the energy parameter within a
region of the scalogram over time and the occurrence of artifacts
within the scalogram.
[0012] In an embodiment, the signal processing system may detect
the occurrence of an event using either the calculated
characteristics (e.g., energy parameters) or the detected artifact.
For example, based at least in part on a portion of the wavelet
transform, the signal processing system may calculate or use one or
more predetermined thresholds. If the calculated characteristic or
detected artifact exceeds a threshold, the signal processing system
may determine that an event has occurred.
[0013] After detecting an event, the signal processing system may
perform an action based on the detected event. For example, the
signal processing system may recalibrate a device based on the
detected event. As another example, the signal processing system
may set a flag of the detected event.
BRIEF DESCRIPTION OF THE DRAWINGS
[0014] The patent or application file contains at least one drawing
executed in color. Copies of this patent or patent application
publication with color drawing(s) will be provided by the Office
upon request and payment of the necessary fee.
[0015] Features of the disclosure, its nature and various
advantages, will be apparent upon consideration of the following
detailed description, taken in conjunction with the accompanying
drawings, in which like reference characters refer to like parts
throughout, and in which:
[0016] FIG. 1 shows an illustrative pulse oximetry system in
accordance with an embodiment;
[0017] FIG. 2 is a block diagram of the illustrative pulse oximetry
system of FIG. 1 coupled to a patient in accordance with an
embodiment;
[0018] FIGS. 3(a) and 3(b) show illustrative views of a scalogram
derived from a PPG signal in accordance with an embodiment;
[0019] FIG. 3(c) shows an illustrative scalogram derived from a
signal containing two pertinent components in accordance with an
embodiment;
[0020] FIG. 3(d) shows an illustrative schematic of signals
associated with a ridge in FIG. 3(c) and illustrative schematics of
a further wavelet decomposition of these newly derived signals in
accordance with an embodiment;
[0021] FIGS. 3(e) and 3(f) are flow charts of illustrative steps
involved in performing an inverse continuous wavelet transform in
accordance with embodiments;
[0022] FIG. 4 is a block diagram of an illustrative continuous
wavelet processing system in accordance with some embodiments;
[0023] FIG. 5 shows signal characteristics of a PPG signal in
accordance with an embodiment;
[0024] FIG. 6 shows a scalogram of a PPG signal in accordance with
an embodiment;
[0025] FIGS. 7A and 7B show an exemplary PPG signal and a
corresponding scalogram in accordance with an embodiment;
[0026] FIGS. 8A and 8B show another exemplary PPG signal and a
corresponding scalogram in accordance with an embodiment;
[0027] FIG. 9 shows a flowchart of an illustrative process for
detecting an event in a signal in accordance with an embodiment;
and
[0028] FIG. 10 shows a flowchart of an illustrative process for
detecting an event in a scalogram in accordance with an
embodiment.
DETAILED DESCRIPTION
[0029] In medicine, a plethysmograph is an instrument that measures
physiological parameters, such as variations in the size of an
organ or body part, through an analysis of the blood passing
through or present in the targeted body part, or a depiction of
these variations. An oximeter is an instrument that may determine
the oxygen saturation of the blood. One common type of oximeter is
a pulse oximeter, which determines oxygen saturation by analysis of
an optically sensed plethysmograph.
[0030] A pulse oximeter is a medical device that may indirectly
measure the oxygen saturation of a patient's blood (as opposed to
measuring oxygen saturation directly by analyzing a blood sample
taken from the patient) and changes in blood volume in the skin.
Ancillary to the blood oxygen saturation measurement, pulse
oximeters may also be used to measure the pulse rate of the
patient. Pulse oximeters typically measure and display various
blood flow characteristics including, but not limited to, the
oxygen saturation of hemoglobin in arterial blood.
[0031] An oximeter may include a light sensor that is placed at a
site on a patient, typically a fingertip, toe, forehead or earlobe,
or in the case of a neonate, across a foot. The oximeter may pass
light using a light source through blood perfused tissue and
photoelectrically sense the absorption of light in the tissue. For
example, the oximeter may measure the intensity of light that is
received at the light sensor as a function of time. A signal
representing light intensity versus time or a mathematical
manipulation of this signal (e.g., a scaled version thereof, a log
taken thereof, a scaled version of a log taken thereof, etc.) may
be referred to as the photoplethysmograph (PPG) signal. In
addition, the term "PPG signal," as used herein, may also refer to
an absorption signal (i.e., representing the amount of light
absorbed by the tissue) or any suitable mathematical manipulation
thereof. The light intensity or the amount of light absorbed may
then be used to calculate the amount of the blood constituent
(e.g., oxyhemoglobin) being measured as well as the pulse rate and
when each individual pulse occurs.
[0032] The light passed through the tissue is selected to be of one
or more wavelengths that are absorbed by the blood in an amount
representative of the amount of the blood constituent present in
the blood. The amount of light passed through the tissue varies in
accordance with the changing amount of blood constituent in the
tissue and the related light absorption. Red and infrared
wavelengths may be used because it has been observed that highly
oxygenated blood will absorb relatively less red light and more
infrared light than blood with a lower oxygen saturation. By
comparing the intensities of two wavelengths at different points in
the pulse cycle, it is possible to estimate the blood oxygen
saturation of hemoglobin in arterial blood.
[0033] When the measured blood parameter is the oxygen saturation
of hemoglobin, a convenient starting point assumes a saturation
calculation based on Lambert-Beer's law. The following notation
will be used herein:
I(.lamda.,t)=I.sub.o(.lamda.)exp(-(s.beta..sub.o(.lamda.)+(1-s).beta..su-
b.r(.lamda.))l(t)) (1)
where: .lamda.=wavelength; t=time; I=intensity of light detected;
I.sub.o=intensity of light transmitted; s=oxygen saturation;
.beta..sub.o, .beta..sub.r=empirically derived absorption
coefficients; and l(t)=a combination of concentration and path
length from emitter to detector as a function of time.
[0034] The traditional approach measures light absorption at two
wavelengths (e.g., red and infrared (IR)), and then calculates
saturation by solving for the "ratio of ratios" as follows.
1. First, the natural logarithm of (1) is taken ("log" will be used
to represent the natural logarithm) for IR and Red
log I=log I.sub.o-(s.beta..sub.o+(1-s).beta..sub.r)l (2)
2. (2) is then differentiated with respect to time
log I t = - ( s .beta. o + ( 1 - s ) .beta. r ) l t ( 3 )
##EQU00001##
3. Red (3) is divided by IR (3)
log I ( .lamda. R ) / t log I ( .lamda. IR ) / t = s .beta. o (
.lamda. R ) + ( 1 - s ) .beta. r ( .lamda. R ) s .beta. o ( .lamda.
IR ) + ( 1 - s ) .beta. r ( .lamda. IR ) ( 4 ) ##EQU00002##
4. Solving for s
[0035] s = log I ( .lamda. IR ) t .beta. r ( .lamda. R ) - log I (
.lamda. R ) t .beta. r ( .lamda. IR ) log I ( .lamda. IR ) t (
.beta. o ( .lamda. IR ) - .beta. r ( .lamda. IR ) ) - log I (
.lamda. IR ) t ( .beta. o ( .lamda. R ) - .beta. r ( .lamda. R ) )
##EQU00003##
Note in discrete time
log I ( .lamda. , t ) t log I ( .lamda. , t 2 ) - log I ( .lamda. ,
t 1 ) ##EQU00004##
Using log A-log B=log A/B,
[0036] log I ( .lamda. , t ) t log ( I ( t 2 , .lamda. ) I ( t 1 ,
.lamda. ) ) ##EQU00005##
So, (4) can be rewritten as
log I ( .lamda. R ) t log I ( .lamda. IR ) t log ( I ( t 1 ,
.lamda. R ) I ( t 2 , .lamda. R ) ) log ( I ( t 1 , .lamda. IR ) I
( t 2 , .lamda. IR ) ) = R ( 5 ) ##EQU00006##
where R represents the "ratio of ratios." Solving (4) for s using
(5) gives
s = .beta. r ( .lamda. R ) - R .beta. r ( .lamda. IR ) R ( .beta. o
( .lamda. IR ) - .beta. r ( .lamda. IR ) ) - .beta. o ( .lamda. R )
+ .beta. r ( .lamda. R ) . ##EQU00007##
From (5), R can be calculated using two points (e.g., PPG maximum
and minimum), or a family of points. One method using a family of
points uses a modified version of (5). Using the relationship
log I t = I t I ( 6 ) ##EQU00008##
now (5) becomes
log I ( .lamda. R ) t log I ( .lamda. IR ) t I ( t 2 , .lamda. R )
- I ( t 1 , .lamda. R ) I ( t 1 , .lamda. R ) I ( t 2 , .lamda. IR
) - I ( t 1 , .lamda. IR ) I ( t 1 , .lamda. IR ) = [ I ( t 2 ,
.lamda. R ) - I ( t 1 , .lamda. R ) ] I ( t 1 , .lamda. IR ) [ I (
t 2 , .lamda. IR ) - I ( t 1 , .lamda. IR ) ] I ( t 1 , .lamda. R )
= R ( 7 ) ##EQU00009##
which defines a cluster of points whose slope of y versus x will
give R where
x(t)=[I(t.sub.2,.lamda..sub.IR)-I(t.sub.1,.lamda..sub.IR)]I(t.sub.1,.lam-
da..sub.R)
y(t)=[I(t.sub.2,.lamda..sub.R)-I(t.sub.1,.lamda..sub.R)]I(t.sub.1,.lamda-
..sub.IR)
y(t)=Rx(t) (8)
[0037] FIG. 1 is a perspective view of an embodiment of a pulse
oximetry system 10. System 10 may include a sensor 12 and a pulse
oximetry monitor 14. Sensor 12 may include an emitter 16 for
emitting light at two or more wavelengths into a patient's tissue.
A detector 18 may also be provided in sensor 12 for detecting the
light originally from emitter 16 that emanates from the patient's
tissue after passing through the tissue.
[0038] According to another embodiment and as will be described,
system 10 may include a plurality of sensors forming a sensor array
in lieu of single sensor 12. Each of the sensors of the sensor
array may be a complementary metal oxide semiconductor (CMOS)
sensor. Alternatively, each sensor of the array may be charged
coupled device (CCD) sensor. In another embodiment, the sensor
array may be made up of a combination of CMOS and CCD sensors. The
CCD sensor may comprise a photoactive region and a transmission
region for receiving and transmitting data whereas the CMOS sensor
may be made up of an integrated circuit having an array of pixel
sensors. Each pixel may have a photodetector and an active
amplifier.
[0039] According to an embodiment, emitter 16 and detector 18 may
be on opposite sides of a digit such as a finger or toe, in which
case the light that is emanating from the tissue has passed
completely through the digit. In an embodiment, emitter 16 and
detector 18 may be arranged so that light from emitter 16
penetrates the tissue and is reflected by the tissue into detector
18, such as a sensor designed to obtain pulse oximetry data from a
patient's forehead.
[0040] In an embodiment, the sensor or sensor array may be
connected to and draw its power from monitor 14 as shown. In
another embodiment, the sensor may be wirelessly connected to
monitor 14 and include its own battery or similar power supply (not
shown). Monitor 14 may be configured to calculate physiological
parameters based at least in part on data received from sensor 12
relating to light emission and detection. In an alternative
embodiment, the calculations may be performed on the monitoring
device itself and the result of the oximetry reading may be passed
to monitor 14. Further, monitor 14 may include a display 20
configured to display the physiological parameters or other
information about the system. In the embodiment shown, monitor 14
may also include a speaker 22 to provide an audible sound that may
be used in various other embodiments, such as for example, sounding
an audible alarm in the event that a patient's physiological
parameters are not within a predefined normal range.
[0041] In an embodiment, sensor 12, or the sensor array, may be
communicatively coupled to monitor 14 via a cable 24. However, in
other embodiments, a wireless transmission device (not shown) or
the like may be used instead of or in addition to cable 24.
[0042] In the illustrated embodiment, pulse oximetry system 10 may
also include a multi-parameter patient monitor 26. The monitor may
be cathode ray tube type, a flat panel display (as shown) such as a
liquid crystal display (LCD) or a plasma display, or any other type
of monitor now known or later developed. Multi-parameter patient
monitor 26 may be configured to calculate physiological parameters
and to provide a display 28 for information from monitor 14 and
from other medical monitoring devices or systems (not shown). For
example, multiparameter patient monitor 26 may be configured to
display an estimate of a patient's blood oxygen saturation
generated by pulse oximetry monitor 14 (referred to as an
"SpO.sub.2" measurement), pulse rate information from monitor 14
and blood pressure from a blood pressure monitor (not shown) on
display 28.
[0043] Monitor 14 may be communicatively coupled to multi-parameter
patient monitor 26 via a cable 32 or 34 that is coupled to a sensor
input port or a digital communications port, respectively and/or
may communicate wirelessly (not shown). In addition, monitor 14
and/or multi-parameter patient monitor 26 may be coupled to a
network to enable the sharing of information with servers or other
workstations (not shown). Monitor 14 may be powered by a battery
(not shown) or by a conventional power source such as a wall
outlet.
[0044] FIG. 2 is a block diagram of a pulse oximetry system, such
as pulse oximetry system 10 of FIG. 1, which may be coupled to a
patient 40 in accordance with an embodiment. Certain illustrative
components of sensor 12 and monitor 14 are illustrated in FIG. 2.
Sensor 12 may include emitter 16, detector 18, and encoder 42. In
the embodiment shown, emitter 16 may be configured to emit at least
two wavelengths of light (e.g., RED and IR) into a patient's tissue
40. Hence, emitter 16 may include a RED light emitting light source
such as RED light emitting diode (LED) 44 and an IR light emitting
light source such as IR LED 46 for emitting light into the
patient's tissue 40 at the wavelengths used to calculate the
patient's physiological parameters. In one embodiment, the RED
wavelength may be between about 600 nm and about 700 nm, and the IR
wavelength may be between about 800 nm and about 1000 nm. In
embodiments where a sensor array is used in place of single sensor,
each sensor may be configured to emit a single wavelength. For
example, a first sensor emits only a RED light while a second only
emits an IR light.
[0045] It will be understood that, as used herein, the term "light"
may refer to energy produced by radiative sources and may include
one or more of ultrasound, radio, microwave, millimeter wave,
infrared, visible, ultraviolet, gamma ray or X-ray electromagnetic
radiation. As used herein, light may also include any wavelength
within the radio, microwave, infrared, visible, ultraviolet, or
X-ray spectra, and that any suitable wavelength of electromagnetic
radiation may be appropriate for use with the present techniques.
Detector 18 may be chosen to be specifically sensitive to the
chosen targeted energy spectrum of the emitter 16.
[0046] In an embodiment, detector 18 may be configured to detect
the intensity of light at the RED and IR wavelengths.
Alternatively, each sensor in the array may be configured to detect
an intensity of a single wavelength. In operation, light may enter
detector 18 after passing through the patient's tissue 40. Detector
18 may convert the intensity of the received light into an
electrical signal. The light intensity is directly related to the
absorbance and/or reflectance of light in the tissue 40. That is,
when more light at a certain wavelength is absorbed or reflected,
less light of that wavelength is received from the tissue by the
detector 18. After converting the received light to an electrical
signal, detector 18 may send the signal to monitor 14, where
physiological parameters may be calculated based on the absorption
of the RED and IR wavelengths in the patient's tissue 40.
[0047] In an embodiment, encoder 42 may contain information about
sensor 12, such as what type of sensor it is (e.g., whether the
sensor is intended for placement on a forehead or digit) and the
wavelengths of light emitted by emitter 16. This information may be
used by monitor 14 to select appropriate algorithms, lookup tables
and/or calibration coefficients stored in monitor 14 for
calculating the patient's physiological parameters.
[0048] Encoder 42 may contain information specific to patient 40,
such as, for example, the patient's age, weight, and diagnosis.
This information may allow monitor 14 to determine, for example,
patient-specific threshold ranges in which the patient's
physiological parameter measurements should fall and to enable or
disable additional physiological parameter algorithms. Encoder 42
may, for instance, be a coded resistor which stores values
corresponding to the type of sensor 12 or the type of each sensor
in the sensor array, the wavelengths of light emitted by emitter 16
on each sensor of the sensor array, and/or the patient's
characteristics. In another embodiment, encoder 42 may include a
memory on which one or more of the following information may be
stored for communication to monitor 14: the type of the sensor 12;
the wavelengths of light emitted by emitter 16; the particular
wavelength each sensor in the sensor array is monitoring; a signal
threshold for each sensor in the sensor array; any other suitable
information; or any combination thereof.
[0049] In an embodiment, signals from detector 18 and encoder 42
may be transmitted to monitor 14. In the embodiment shown, monitor
14 may include a general-purpose microprocessor 48 connected to an
internal bus 50. Microprocessor 48 may be adapted to execute
software, which may include an operating system and one or more
applications, as part of performing the functions described herein.
Also connected to bus 50 may be a read-only memory (ROM) 52, a
random access memory (RAM) 54, user inputs 56, display 20, and
speaker 22.
[0050] RAM 54 and ROM 52 are illustrated by way of example, and not
limitation. Any suitable computer-readable media may be used in the
system for data storage. Computer-readable media are capable of
storing information that can be interpreted by microprocessor 48.
This information may be data or may take the form of
computer-executable instructions, such as software applications,
that cause the microprocessor to perform certain functions and/or
computer-implemented methods. Depending on the embodiment, such
computer-readable media may include computer storage media and
communication media. Computer storage media may include volatile
and non-volatile, removable and non-removable media implemented in
any method or technology for storage of information such as
computer-readable instructions, data structures, program modules or
other data. Computer storage media may include, but is not limited
to, RAM, ROM, EPROM, EEPROM, flash memory or other solid state
memory technology, CD-ROM, DVD, or other optical storage, magnetic
cassettes, magnetic tape, magnetic disk storage or other magnetic
storage devices, or any other medium which can be used to store the
desired information and which can be accessed by components of the
system.
[0051] In the embodiment shown, a time processing unit (TPU) 58 may
provide timing control signals to a light drive circuitry 60, which
may control when emitter 16 is illuminated and multiplexed timing
for the RED LED 44 and the JR LED 46. TPU 58 may also control the
gating-in of signals from detector 18 through an amplifier 62 and a
switching circuit 64. These signals are sampled at the proper time,
depending upon which light source is illuminated. The received
signal from detector 18 may be passed through an amplifier 66, a
low pass filter 68, and an analog-to-digital converter 70. The
digital data may then be stored in a queued serial module (QSM) 72
(or buffer) for later downloading to RAM 54 as QSM 72 fills up. In
one embodiment, there may be multiple separate parallel paths
having amplifier 66, filter 68, and A/D converter 70 for multiple
light wavelengths or spectra received.
[0052] In an embodiment, microprocessor 48 may determine the
patient's physiological parameters, such as SpO.sub.2 and pulse
rate, using various algorithms and/or look-up tables based on the
value of the received signals and/or data corresponding to the
light received by detector 18. Signals corresponding to information
about patient 40, and particularly about the intensity of light
emanating from a patient's tissue over time, may be transmitted
from encoder 42 to a decoder 74. These signals may include, for
example, encoded information relating to patient characteristics.
Decoder 74 may translate these signals to enable the microprocessor
to determine the thresholds based on algorithms or look-up tables
stored in ROM 52. User inputs 56 may be used to enter information
about the patient, such as age, weight, height, diagnosis,
medications, treatments, and so forth. In an embodiment, display 20
may exhibit a list of values which may generally apply to the
patient, such as, for example, age ranges or medication families,
which the user may select using user inputs 56.
[0053] The optical signal through the tissue can be degraded by
noise, among other sources. One source of noise is ambient light
that reaches the light detector. Another source of noise is
electromagnetic coupling from other electronic instruments.
Movement of the patient also introduces noise and affects the
signal. For example, the contact between the detector and the skin,
or the emitter and the skin, can be temporarily disrupted when
movement causes either to move away from the skin. In addition,
because blood is a fluid, it responds differently than the
surrounding tissue to inertial effects, thus resulting in momentary
changes in volume at the point to which the oximeter probe is
attached.
[0054] Noise (e.g., from patient movement) can degrade a pulse
oximetry signal relied upon by a physician, without the physician's
awareness. This is especially true if the monitoring of the patient
is remote, the motion is too small to be observed, or the doctor is
watching the instrument or other parts of the patient, and not the
sensor site. Processing pulse oximetry (i.e., PPG) signals may
involve operations that reduce the amount of noise present in the
signals or otherwise identify noise components in order to prevent
them from affecting measurements of physiological parameters
derived from the PPG signals.
[0055] It will be understood that the present disclosure is
applicable to any suitable signals and that PPG signals are used
merely for illustrative purposes. Those skilled in the art will
recognize that the present disclosure has wide applicability to
other signals including, but not limited to other biosignals (e.g.,
electrocardiogram, electroencephalogram, electrogastrogram,
electromyogram, heart rate signals, pathological sounds,
ultrasound, or any other suitable biosignal), dynamic signals,
non-destructive testing signals, condition monitoring signals,
fluid signals, geophysical signals, astronomical signals,
electrical signals, financial signals including financial indices,
sound and speech signals, chemical signals, meteorological signals
including climate signals, and/or any other suitable signal, and/or
any combination thereof.
[0056] In one embodiment, a PPG signal may be transformed using a
continuous wavelet transform. Information derived from the
transform of the PPG signal (i.e., in wavelet space) may be used to
provide measurements of one or more physiological parameters.
[0057] The continuous wavelet transform of a signal x(t) in
accordance with the present disclosure may be defined as
T ( a , b ) = 1 a .intg. - .infin. + .infin. x ( t ) .psi. * ( t -
b a ) t ( 9 ) ##EQU00010##
where .psi.*(t) is the complex conjugate of the wavelet function
.psi.(t), a is the dilation parameter of the wavelet and b is the
location parameter of the wavelet. The transform given by equation
(9) may be used to construct a representation of a signal on a
transform surface. The transform may be regarded as a time-scale
representation. Wavelets are composed of a range of frequencies,
one of which may be denoted as the characteristic frequency of the
wavelet, where the characteristic frequency associated with the
wavelet is inversely proportional to the scale a. One example of a
characteristic frequency is the dominant frequency. Each scale of a
particular wavelet may have a different characteristic frequency.
The underlying mathematical detail required for the implementation
within a time-scale can be found, for example, in Paul S. Addison,
The Illustrated Wavelet Transform Handbook (Taylor & Francis
Group 2002), which is hereby incorporated by reference herein in
its entirety.
[0058] The continuous wavelet transform decomposes a signal using
wavelets, which are generally highly localized in time. The
continuous wavelet transform may provide a higher resolution
relative to discrete transforms, thus providing the ability to
garner more information from signals than typical frequency
transforms such as Fourier transforms (or any other spectral
techniques) or discrete wavelet transforms. Continuous wavelet
transforms allow for the use of a range of wavelets with scales
spanning the scales of interest of a signal such that small scale
signal components correlate well with the smaller scale wavelets
and thus manifest at high energies at smaller scales in the
transform. Likewise, large scale signal components correlate well
with the larger scale wavelets and thus manifest at high energies
at larger scales in the transform. Thus, components at different
scales may be separated and extracted in the wavelet transform
domain. Moreover, the use of a continuous range of wavelets in
scale and time position allows for a higher resolution transform
than is possible relative to discrete techniques.
[0059] In addition, transforms and operations that convert a signal
or any other type of data into a spectral (i.e., frequency) domain
necessarily create a series of frequency transform values in a
two-dimensional coordinate system where the two dimensions may be
frequency and, for example, amplitude. For example, any type of
Fourier transform would generate such a two-dimensional spectrum.
In contrast, wavelet transforms, such as continuous wavelet
transforms, are required to be defined in a three-dimensional
coordinate system and generate a surface with dimensions of time,
scale and, for example, amplitude. Hence, operations performed in a
spectral domain cannot be performed in the wavelet domain; instead
the wavelet surface must be transformed into a spectrum (i.e., by
performing an inverse wavelet transform to convert the wavelet
surface into the time domain and then performing a spectral
transform from the time domain). Conversely, operations performed
in the wavelet domain cannot be performed in the spectral domain;
instead a spectrum must first be transformed into a wavelet surface
(i.e., by performing an inverse spectral transform to convert the
spectral domain into the time domain and then performing a wavelet
transform from the time domain). Nor does a cross-section of the
three-dimensional wavelet surface along, for example, a particular
point in time equate to a frequency spectrum upon which
spectral-based techniques may be used. At least because wavelet
space includes a time dimension, spectral techniques and wavelet
techniques are not interchangeable. It will be understood that
converting a system that relies on spectral domain processing to
one that relies on wavelet space processing would require
significant and fundamental modifications to the system in order to
accommodate the wavelet space processing (e.g., to derive a
representative energy value for a signal or part of a signal
requires integrating twice, across time and scale, in the wavelet
domain while, conversely, one integration across frequency is
required to derive a representative energy value from a spectral
domain. As a further example, to reconstruct a temporal signal
requires integrating twice, across time and scale, in the wavelet
domain while, conversely, one integration across frequency is
required to derive a temporal signal from a spectral domain). It is
well known in the art that, in addition to or as an alternative to
amplitude, parameters such as energy density, modulus, phase, among
others may all be generated using such transforms and that these
parameters have distinctly different contexts and meanings when
defined in a two-dimensional frequency coordinate system rather
than a three-dimensional wavelet coordinate system. For example,
the phase of a Fourier system is calculated with respect to a
single origin for all frequencies while the phase for a wavelet
system is unfolded into two dimensions with respect to a wavelet's
location (often in time) and scale.
[0060] The energy density function of the wavelet transform, the
scalogram, is defined as
S(a,b)=|T(a,b)|.sup.2 (10)
where `.parallel.` is the modulus operator. The scalogram may be
rescaled for useful purposes. One common rescaling is defined
as
S R ( a , b ) = T ( a , b ) 2 a ( 11 ) ##EQU00011##
[0061] and is useful for defining ridges in wavelet space when, for
example, the Morlet wavelet is used. Ridges are defined as the
locus of points of local maxima in the plane. Any reasonable
definition of a ridge may be employed in the method. Also included
as a definition of a ridge herein are paths displaced from the
locus of the local maxima. A ridge associated with only the locus
of points of local maxima in the plane are labeled a "maxima
ridge".
[0062] For implementations requiring fast numerical computation,
the wavelet transform may be expressed as an approximation using
Fourier transforms. Pursuant to the convolution theorem, because
the wavelet transform is the cross-correlation of the signal with
the wavelet function, the wavelet transform may be approximated in
terms of an inverse FFT of the product of the Fourier transform of
the signal and the Fourier transform of the wavelet for each
required a scale and then multiplying the result by {square root
over (a)}.
[0063] In the discussion of the technology which follows herein,
the "scalogram" may be taken to include all suitable forms of
rescaling including, but not limited to, the original unsealed
wavelet representation, linear rescaling, any power of the modulus
of the wavelet transform, or any other suitable rescaling. In
addition, for purposes of clarity and conciseness, the term
"scalogram" shall be taken to mean the wavelet transform, T(a,b)
itself, or any part thereof. For example, the real part of the
wavelet transform, the imaginary part of the wavelet transform, the
phase of the wavelet transform, any other suitable part of the
wavelet transform, or any combination thereof is intended to be
conveyed by the term "scalogram".
[0064] A scale, which may be interpreted as a representative
temporal period, may be converted to a characteristic frequency of
the wavelet function. The characteristic frequency associated with
a wavelet of arbitrary a scale is given by
f = f c a ( 12 ) ##EQU00012##
where f.sub.c, the characteristic frequency of the mother wavelet
(i.e., at a=1), becomes a scaling constant and f is the
representative or characteristic frequency for the wavelet at
arbitrary scale a.
[0065] Any suitable wavelet function may be used in connection with
the present disclosure. One of the most commonly used complex
wavelets, the Morlet wavelet, is defined as:
.psi.(t)=.pi..sup.-1/4(e.sup.i2.pi.f.sup.0.sup.t-e.sup.-(2.pi.f.sup.0.su-
p.).sup.2.sup./2)e.sup.-t.sup.2.sup./2 (13)
where f.sub.0 is the central frequency of the mother wavelet. The
second term in the parenthesis is known as the correction term, as
it corrects for the non-zero mean of the complex sinusoid within
the Gaussian window. In practice, it becomes negligible for values
of f.sub.0>>0 and can be ignored, in which case, the Morlet
wavelet can be written in a simpler form as
.psi. ( t ) = 1 .pi. 1 / 4 2.pi. f 0 t - t 2 / 2 ( 14 )
##EQU00013##
[0066] This wavelet is a complex wave within a scaled Gaussian
envelope. While both definitions of the Morlet wavelet are included
herein, the function of equation (14) is not strictly a wavelet as
it has a non-zero mean (i.e., the zero frequency term of its
corresponding energy spectrum is non-zero). However, it will be
recognized by those skilled in the art that equation (14) may be
used in practice with f.sub.0>>0 with minimal error and is
included (as well as other similar near wavelet functions) in the
definition of a wavelet herein. A more detailed overview of the
underlying wavelet theory, including the definition of a wavelet
function, can be found in the general literature. Discussed herein
is how wavelet transform features may be extracted from the wavelet
decomposition of signals. For example, wavelet decomposition of PPG
signals may be used to provide clinically useful information within
a medical device.
[0067] Pertinent repeating features in a signal give rise to a
time-scale band in wavelet space or a rescaled wavelet space. For
example, the pulse component of a PPG signal produces a dominant
band in wavelet space at or around the pulse frequency. FIGS. 3(a)
and (b) show two views of an illustrative scalogram derived from a
PPG signal, according to an embodiment. The figures show an example
of the band caused by the pulse component in such a signal. The
pulse band is located between the dashed lines in the plot of FIG.
3(a). The band is formed from a series of dominant coalescing
features across the scalogram. This can be clearly seen as a raised
band across the transform surface in FIG. 3(b) located within the
region of scales indicated by the arrow in the plot (corresponding
to 60 beats per minute). The maxima of this band with respect to
scale is the ridge. The locus of the ridge is shown as a black
curve on top of the band in FIG. 3(b). By employing a suitable
rescaling of the scalogram, such as that given in equation (11),
the ridges found in wavelet space may be related to the
instantaneous frequency of the signal. In this way, the pulse rate
may be obtained from the PPG signal. Instead of rescaling the
scalogram, a suitable predefined relationship between the scale
obtained from the ridge on the wavelet surface and the actual pulse
rate may also be used to determine the pulse rate.
[0068] By mapping the time-scale coordinates of the pulse ridge
onto the wavelet phase information gained through the wavelet
transform, individual pulses may be captured. In this way, both
times between individual pulses and the timing of components within
each pulse may be monitored and used to detect heart beat
anomalies, measure arterial system compliance, or perform any other
suitable calculations or diagnostics. Alternative definitions of a
ridge may be employed. Alternative relationships between the ridge
and the pulse frequency of occurrence may be employed.
[0069] As discussed above, pertinent repeating features in the
signal give rise to a time-scale band in wavelet space or a
rescaled wavelet space. For a periodic signal, this band remains at
a constant scale in the time-scale plane. For many real signals,
especially biological signals, the band may be non-stationary;
varying in scale, amplitude, or both over time. FIG. 3(c) shows an
illustrative schematic of a wavelet transform of a signal
containing two pertinent components leading to two bands in the
transform space, according to an embodiment. These bands are
labeled band A and band B on the three-dimensional schematic of the
wavelet surface. In an embodiment, the band ridge is defined as the
locus of the peak values of these bands with respect to scale. For
purposes of discussion, it may be assumed that band B contains the
signal information of interest. This will be referred to as the
"primary band". In addition, it may be assumed that the system from
which the signal originates, and from which the transform is
subsequently derived, exhibits some form of coupling between the
signal components in band A and band B. When noise or other
erroneous features are present in the signal with similar spectral
characteristics of the features of band B then the information
within band B can become ambiguous (i.e., obscured, fragmented or
missing). In this case, the ridge of band A may be followed in
wavelet space and extracted either as an amplitude signal or a
scale signal which will be referred to as the "ridge amplitude
perturbation" (RAP) signal and the "ridge scale perturbation" (RSP)
signal, respectively. The RAP and RSP signals may be extracted by
projecting the ridge onto the time-amplitude or time-scale planes,
respectively. The top plots of FIG. 3(d) show a schematic of the
RAP and RSP signals associated with ridge A in FIG. 3(c). Below
these RAP and RSP signals are schematics of a further wavelet
decomposition of these newly derived signals. This secondary
wavelet decomposition allows for information in the region of band
B in FIG. 3(c) to be made available as band C and band D. The
ridges of bands C and D may serve as instantaneous time-scale
characteristic measures of the signal components causing bands C
and D. This technique, which will be referred to herein as
secondary wavelet feature decoupling (SWFD), may allow information
concerning the nature of the signal components associated with the
underlying physical process causing the primary band B (FIG. 3(c))
to be extracted when band B itself is obscured in the presence of
noise or other erroneous signal features.
[0070] In some instances, an inverse continuous wavelet transform
may be desired, such as when modifications to a scalogram (or
modifications to the coefficients of a transformed signal) have
been made in order to, for example, remove artifacts. In one
embodiment, there is an inverse continuous wavelet transform which
allows the original signal to be recovered from its wavelet
transform by integrating over all scales and locations, a and
b:
x ( t ) = 1 C g .intg. - .infin. .infin. .intg. 0 .infin. T ( a , b
) 1 a .psi. ( t - b a ) a b a 2 ( 15 ) ##EQU00014##
which may also be written as:
x ( t ) = 1 C g .intg. - .infin. .infin. .intg. 0 .infin. T ( a , b
) .psi. a , b ( t ) a b a 2 ( 16 ) ##EQU00015##
where C.sub.g is a scalar value known as the admissibility
constant. It is wavelet type dependent and may be calculated
from:
C g = .intg. 0 .infin. .psi. ^ ( f ) 2 f f ( 17 ) ##EQU00016##
FIG. 3(e) is a flow chart of illustrative steps that may be taken
to perform an inverse continuous wavelet transform in accordance
with the above discussion. An approximation to the inverse
transform may be made by considering equation (15) to be a series
of convolutions across scales. It shall be understood that there is
no complex conjugate here, unlike for the cross correlations of the
forward transform. As well as integrating over all of a and b for
each time t, this equation may also take advantage of the
convolution theorem which allows the inverse wavelet transform to
be executed using a series of multiplications. FIG. 3(f) is a flow
chart of illustrative steps that may be taken to perform an
approximation of an inverse continuous wavelet transform. It will
be understood that any other suitable technique for performing an
inverse continuous wavelet transform may be used in accordance with
the present disclosure.
[0071] FIG. 4 is an illustrative continuous wavelet processing
system in accordance with an embodiment. In an embodiment, input
signal generator 410 generates an input signal 416. As illustrated,
input signal generator 410 may include oximeter 420 coupled to
sensor 418, which may provide as input signal 416, a PPG signal. It
will be understood that input signal generator 410 may include any
suitable signal source, signal generating data, signal generating
equipment, or any combination thereof to produce signal 416. Signal
416 may be any suitable signal or signals, such as, for example,
biosignals (e.g., electrocardiogram, electroencephalogram,
electrogastrogram, electromyogram, heart rate signals, pathological
sounds, ultrasound, or any other suitable biosignal), dynamic
signals, non-destructive testing signals, condition monitoring
signals, fluid signals, geophysical signals, astronomical signals,
electrical signals, financial signals including financial indices,
sound and speech signals, chemical signals, meteorological signals
including climate signals, and/or any other suitable signal, and/or
any combination thereof.
[0072] In an embodiment, signal 416 may be coupled to processor
412. Processor 412 may be any suitable software, firmware, and/or
hardware, and/or combinations thereof for processing signal 416.
For example, processor 412 may include one or more hardware
processors (e.g., integrated circuits), one or more software
modules, computer-readable media such as memory, firmware, or any
combination thereof. Processor 412 may, for example, be a computer
or may be one or more chips (i.e., integrated circuits). Processor
412 may perform the calculations associated with the continuous
wavelet transforms of the present disclosure as well as the
calculations associated with any suitable interrogations of the
transforms. Processor 412 may perform any suitable signal
processing of signal 416 to filter signal 416, such as any suitable
band-pass filtering, adaptive filtering, closed-loop filtering,
and/or any other suitable filtering, and/or any combination
thereof.
[0073] Processor 412 may be coupled to one or more memory devices
(not shown) or incorporate one or more memory devices such as any
suitable volatile memory device (e.g., RAM, registers, etc.),
non-volatile memory device (e.g., ROM, EPROM, magnetic storage
device, optical storage device, flash memory, etc.), or both. The
memory may be used by processor 412 to, for example, store data
corresponding to a continuous wavelet transform of input signal
416, such as data representing a scalogram. In one embodiment, data
representing a scalogram may be stored in RAM or memory internal to
processor 412 as any suitable three-dimensional data structure such
as a three-dimensional array that represents the scalogram as
energy levels in a time-scale plane. Any other suitable data
structure may be used to store data representing a scalogram.
[0074] Processor 412 may be coupled to output 414. Output 414 may
be any suitable output device such as, for example, one or more
medical devices (e.g., a medical monitor that displays various
physiological parameters, a medical alarm, or any other suitable
medical device that either displays physiological parameters or
uses the output of processor 412 as an input), one or more display
devices (e.g., monitor, PDA, mobile phone, any other suitable
display device, or any combination thereof), one or more audio
devices, one or more memory devices (e.g., hard disk drive, flash
memory, RAM, optical disk, any other suitable memory device, or any
combination thereof), one or more printing devices, any other
suitable output device, or any combination thereof.
[0075] It will be understood that system 400 may be incorporated
into system 10 (FIGS. 1 and 2) in which, for example, input signal
generator 410 may be implemented as parts of sensor 12 and monitor
14 and processor 412 may be implemented as part of monitor 14.
[0076] In accordance with an embodiment, baseline changes and
corresponding events may be detected in signals such as PPG
signals. FIG. 5 shows an exemplary PPG signal 500 that may be
analyzed in accordance with the present disclosure. PPG signal 500
is an oscillating signal having pulses such as pulses 502. Each
pulse of PPG signal 500 may correspond to a cardiac cycle. PPG
signal 500 has AC component 504, which oscillates around a
baseline. For example, as shown in FIG. 5, during time period 506,
PPG signal 500 is oscillating around baseline 508. As another
example, during time period 510, PPG signal 500 is oscillating
around a different baseline 512. The baseline of a signal may be
calculated using any suitable technique. For example, the baseline
may be calculated as an average of the signal over a selected
amount of time or over a selected number of cardiac cycles.
[0077] AC component 504 may be caused in part by a change in blood
volume at a sensor location. The change in blood volume may be
caused by the pressure wave generated by each heart beat. The size
of AC component 504 may correspond to the change in blood pressure
at the sensor location (e.g., the difference between systolic and
diastolic pressure in the arteries). As shown in FIG. 5, the
amplitude of AC component 504 is higher during time period 510 than
during time period 506. In one example, PPG signal 500 may have
been generated using a sensor on a user's finger. During time
period 506, the user may have his arm at his side which may cause
the arteries to swell due to gravity causing blood to pool in the
user's arm. As a result, AC component 504 caused by each heart beat
may be small because the expansion in the swollen arteries may be
limited. When the user raises his arm above his head during time
period 516, gravity caused blood and other body fluids to drain
from the arm. As a result, AC component 504 during time period 510
may be greater because the arteries may be able to expand more
easily.
[0078] In addition to the AC component, PPG signal 500 also has
amplitude component 514, which may be attributed to the total
amount of absorption and/or transmission between the sensor emitter
and detector. FIG. 5 represents an increase in light received at
the sensor detector as a decrease in amplitude. As shown in FIG. 5,
amplitude component 514 also changes between time period 506 and
time period 510. For example, during time period 506, amplitude
component 514 oscillates about baseline 508. When the user changes
his arm position (e.g., raises his arm) during time period 516,
amplitude component 514 may significantly decrease. The decrease
may be attributed to a decrease in fluids such as blood within the
user's arm as a result of gravity causing fluids to flow out of the
arm, thus allowing more light to be received at the sensor
detector. Finally, at the beginning of time period 510, amplitude
component 514 begins to settle into a new steady state oscillation
about baseline 512.
[0079] In accordance with an embodiment, by calculating signal
characteristics of PPG signal 500 and detecting changes in the
baseline and the signal characteristics, an event can be detected
by a signal processing system, such as signal processing system 400
of FIG. 4. The signal processing system may calculate a signal
characteristic by calculating, for example, a signal characteristic
of the AC component of PPG signal 500. The calculated signal
characteristic may be any suitable characteristic such as an
average or median amplitude of the AC component over a selected
amount of time or over a selected number of cardiac events. It will
be understood that the signal processing system may use any other
suitable algorithm to calculate the desired signal
characteristic.
[0080] The signal processing system may also calculate the baseline
and the baseline changes in PPG signal 500. For example, the signal
processing system may continuously or periodically calculate the
baseline of PPG signal 500. The signal processing system may also
calculate short term and/or long term changes in the baseline over
time. For example, in FIG. 5, the signal processing system may
calculate that the baseline is generally constant during time
period 506, is changing at a particular rate during time period
516, and is generally constant during time period 510. The signal
processing system may detect the rate of change in the baseline
when it is changing and/or the percentage change and/or magnitude
of change in the baseline between two periods where the baseline is
generally constant or is changing below a threshold. In an
embodiment, the signal processing system may characterize the shape
of the baseline change during time period 516 using a linear (e.g.
best-fit line or threshold-crossing) or nonlinear characterization
technique (e.g. curve fitting, template matching, adaptive methods,
etc.). The characteristics of the shape of the baseline may, for
example, provide information on the type of physiological event
causing the baseline change. In addition, non-linear parameters
associated with the baseline may also be calculated. Any other
suitable processing techniques may be used in analyzing the
baseline of PPG signal 500.
[0081] The signal processing system may also calculate whether
there are any other signal characteristic changes before, during,
and/or after a baseline change. For example, the signal processing
system may calculate the amplitude of the AC component of PPG
signal 500. For example, the signal processing system may calculate
the average or median amplitude of the AC component over a selected
amount of time or over a selected number of cardiac cycles.
[0082] The signal processing system may monitor one or more signal
characteristics to detect that an event has occurred. For example,
as shown in FIG. 5, both the baseline and AC component of PPG
signal 500 changed between time period 506 and time period 510. The
signal processing system may analyze these changes and determine
that an event has occurred. For example, the signal processing
system may detect that the patient has moved his position.
[0083] It will be understood that although a PPG signal is used to
detect events in the discussion above, any suitable signals or
devices may be used to detect events such as, for example, an
electrocardiogram, electroencephalogram (EEG), electrogastrogram,
electromyogram (EMG), heart rate signals, pathological sounds,
ultrasound, or any other suitable biosignal, dynamic signals,
non-destructive testing signals, condition monitoring signals,
fluid signals, geophysical signals, astronomical signals,
electrical signals, financial signals including financial indices,
sound and speech signals, chemical signals, meteorological signals
including climate signals, any other suitable signal, or any
combination thereof.
[0084] In some embodiments, the signal processing system may detect
the occurrence of an event based only on changes in the signal
characteristics or changes in the baseline (e.g., changes in
baseline level, rate of change of the baseline, non-linear
parameters associated with the baseline, shape of the baseline
change, or any combination thereof). For example, based at least in
part on a portion of the signal (e.g., PPG signal 500 during time
period 506), the signal processing system may calculate or use one
or more predetermined thresholds. In some embodiments, if there
exists a number of ordered discrete states, the signal processing
system may determine that an event has occurred based on whether
the signal characteristics or the baseline falls below, equals, or
exceeds the threshold.
[0085] In some embodiments, the signal processing system may also
detect an event by transforming the received signal. For example,
the signal processing system may transform the signal using a
continuous wavelet transform. FIG. 6 shows a simplified view of a
scalogram 600 generated from a continuous wavelet transform of PPG
signal 500 of FIG. 5. Although the continuous wavelet transform is
used in this example, any other suitable types of transforms may
also be used. It will be understood that, for the sake of clarity,
only the pulse band and the effect of the baseline change of PPG
signal 500 is shown in FIG. 6. It will also be understood that
lower energy or amplitude values in scalogram 600 are represented
as lighter shades of gray and higher energy or amplitude values in
scalogram 600 are represented as darker shades of gray.
[0086] For time periods 506, 510, and 516, the pulse band 602 of
the PPG signal is generally located between a lower scale S.sub.1
and an upper scale S.sub.2 of the scalogram. As shown in FIG. 6,
the lower amplitude of the AC component of PPG signal 500 during
time period 506 has been transformed to lower energy or amplitude
values in pulse band 602 during the same time period. Likewise, the
higher amplitude of the AC component of PPG signal 500 during time
period 510 has been transformed to higher energy or amplitude
values in pulse band 602 during the same time period. In addition,
the change in baseline of the PPG signal 500 during time period 516
has been transformed to an artifact 606 (e.g., a high energy
broad-scale cone). Thus, by analyzing particular artifacts and
characteristics in various regions of the scalogram, events may be
detected. For example, the signal processing system may analyze the
real part, imaginary part, and/or phase of the artifact in the
various regions. As another example, the signal processing system
may analyze characteristics such as energy parameters in the
various regions.
[0087] The signal processing system may calculate any suitable
energy parameter within a region on the scalogram (e.g., region
608). The size and shape of region 608 may be selected in any
suitable way. For example, the height and location of region 608
may be selected to cover the pulse band 602. Pulse band 602 may
vary its location and size over time. Therefore, in an embodiment,
region 608 may be centered over ridge 604 of pulse band 602. The
ridge of pulse band 602 may be identified, for example, using ridge
following techniques or any other suitable technique such as using
heart rate calculated from the PPG signal. The ridge of the pulse
band may be identified, for example, using the techniques described
in Watson et al., U.S. patent application Ser. No. 12/245,326
(Attorney Docket No. H-RM-01197-01 (COV-2-01)), filed Oct. 3, 2008,
entitled "SYSTEMS AND METHODS FOR RIDGE SELECTION IN SCALOGRAMS OF
SIGNALS," which is incorporated by reference herein in its
entirety. With the ridge location known, the height of region 608
may be selected to span a selected number of scales above and below
the ridge. The number of scales may be selected such that region
608 spans only a portion of pulse band 602, all of pulse band 602,
or all of the pulse band plus an additional amount. In an
embodiment, the height and location of region 608 may be fixed to
cover the range of scales where the pulse band is expected to be
located. For example, the height of region 608 may span from a
scale whose characteristic frequency is about 0.5 Hz to a scale
whose characteristic frequency is about 4 Hz or equivalently 30-240
bpm. The width of region 608 may be selected to cover any suitable
length of time, such as 1, 2, 3, 4, 5, etc. seconds. Region 608 may
slide across the scalogram calculating the energy parameter in
real-time or off-line. The energy parameter calculated within
region 608 may be, for example, the average or median energy within
the region. It will be understood that any other suitable energy
parameter may also be used. The signal processing system may also
calculate percent or magnitude changes in the energy parameter over
time. In an embodiment, the amplitude of the ridge of the pulse
band may be analyzed in place of or in addition to the energy of
the pulse band.
[0088] In addition to calculating the energy parameter, the signal
processing system may also detect artifacts within the scalogram,
which may represent baseline changes. Artifacts may appear as a
high energy broad-scale cone such as artifact 606. The system may
detect the artifact in any suitable way. For example, the system
may detect the artifact in response to detecting a large change in
the average energy across one or more scales. As another example,
the system may detect the artifact using image processing
techniques. As yet another example, the system may detect the
artifact in response to detecting peak values in the pulse band
that are inconsistent with previous peak values. Artifacts in the
scalogram may also be detected using the techniques described in
Watson et al., U.S. patent application Ser. No. 12/242,861
(Attorney Docket No. H-RM-01192-01 (COV-3-01)), filed Sep. 30,
2008, entitled "SYSTEMS AND METHODS FOR ARTIFACT DETECTION IN
SIGNALS," which is incorporated by reference herein in its
entirety. The signal processing system may calculate
characteristics of an artifact such as its size, shape, and its
energy parameter.
[0089] The signal processing system may monitor one or more
characteristics of the scalogram to detect that an event occurred.
In an embodiment, the signal processing system may monitor the
energy parameter within region 608 as the region moves across
scalogram 600 and the occurrence of artifacts within scalogram 600.
For example, the signal processing system may determine that the
energy parameter calculated for region 608 increased from time
period 506 to time period 510. In addition, the signal processing
system may detect an artifact during time period 516. As a result,
the signal processing system may determine that an event has
occurred. For example, the signal processing system may detect that
the patient moved his position during time period 516.
[0090] In some embodiments, the signal processing system may detect
the occurrence of an event using either the calculated energy
parameters or the detected artifact. For example, based at least in
part on a portion of wavelet transform 600 (e.g., a portion of
region 608), the signal processing system may calculate or use one
or more predetermined thresholds. If the calculated energy
parameter or detected artifact exceeds a threshold, the signal
processing system may determine that an event has occurred.
[0091] In some embodiments, PPG signal 500 and scalogram 600 may be
used together to detect events. For example, the signal processing
system may detect the event by analyzing features of both the PPG
and its corresponding scalogram. As another example, the signal
processing system may detect the event by utilizing portions of PPG
signal 500 and wavelet transform 600. For instance, the signal
processing system may determine when an artifact occurs in
scalogram 600 (e.g., during time period 516). Based at least in
part on this information, the signal processing system may compare
signal characteristics of PPG signal 500 in the time period before
the artifact (time period 506) and with signal characteristic of
PPG signal 500 after the artifact (time period 510). Furthermore,
the signal processing system may determine when the baseline change
occurs in PPG signal 500. Based at least in part on this
information, the signal processing system may calculate changes in
the characteristics (e.g., energy parameters) of wavelet transform
600 in the time period before the baseline change and after the
baseline change.
[0092] The detection of an event may indicate a physiological
change in the user such as, for example, changes in blood pressure
(systolic and diastolic changes), changes in body position (e.g.,
arm movement), sleep arousal, vasodilation, vasoconstriction, a
sympathetic nervous response, or a parasympathetic nervous
response.
[0093] In an embodiment, detection of changes in the PPG signal
and/or changes in the scalogram may be used to detect a change in
blood pressure. Blood pressure changes may manifest as a pronounced
and sustained change in baseline with an associated change in PPG
peak to peak amplitude. For example, the administration of a
vasoconstriction drug may increase blood pressure while
constricting the blood vessels. The constriction of the blood
vessels may manifest in a baseline change of the PPG signal (e.g.,
decrease in baseline), an AC component change in the pulsatile part
of the PPG signal, or any combination thereof. The constriction of
the blood vessels will also manifest in the detection of one or
more artifacts combined with a change in the energy characteristics
in the region of the scalogram associated with pulsatile activity.
For example, FIG. 7A shows an exemplary PPG signal 700 obtained
from a probe that has been placed on a user's index finger. When an
ice cube is placed on the back of the user's hand at time 702, the
baseline of PPG signal 700 and the amplitude of the AC component
decreases due to vasoconstriction. Once the ice cube is removed at
time 704, the baseline and the amplitude of the AC component
increases to normal levels. As shown in FIG. 7B, artifacts and
changes in the energy characteristics may be detected in region 706
during time period 708 (while the ice cube is on the user's
hand).
[0094] In an embodiment, following a change in posture, the blood
pressure may slowly return to (or near) its original level as a
cardiovascular response to the change in posture. This may manifest
in changes in calculated signal characteristics in the PPG signal,
changes in baseline in the PPG signal, the detection of one or more
artifacts in the scalogram, changes in characteristics in the
scalogram, or any combination thereof. A change in body position
may be identified through the detection of pronounced movement
(e.g. high energy artifact across multiple scales of the scalogram
of a the PPG) followed by baseline changes characteristic of a
change in blood pressure and/or vasotone--changes associated with a
change in posture. These interpretations may also be improved
through the use of other monitoring devices (e.g., movement sensors
(accelerometers, EMG, etc.) on the patient. For example, as shown
in FIG. 8A, changes in signal characteristics in PPG signal 800 may
be detected during time periods 802, 804, 806, 808, and 810.
Changes in signal characteristics and changes in the baseline may
be caused by changes in the height of a subject's hand. At time
850, the subject's hand was raised 0.5 meters. At time 852, the
subject's hand was lowered 1.0 meter. At time 854, the subject's
hand was raised 1.0 meter. At time 856, the subject's hand was
dropped 0.5 meter. These changes may cause baseline changes to
occur that may detected during time periods 812, 814, 816, and 818.
In addition, a cardiovascular response following a change in
posture may be detected as PPG signal 800 settles into a new
relatively steady state condition. The cardiovascular response may
be seen, for example, during time period 820. As shown in FIG. 8B,
artifacts 822 may be detected on scalogram 824 during each posture
change. In some cases, once a change in posture has been detected,
further analysis may be performed to characterize the
sympathetic/parasympathetic responsiveness of the user
[0095] A sympathetic response to a stimulus or stimuli may manifest
as a vasoconstriction with an associated rapid increase in blood
pressure which may be observed as baseline change in the PPG. A
change in heart rate and/or breathing rate and/or decreasing PPG
peak to peak amplitude may also be associated with the sympathetic
response and may be observed in the scalogram or by another
suitable means. A parasympathetic response may also be observed.
This is related to a decrease in blood pressure and associated
vasodilatation with a decreased baseline (blood pressure,
vasodilatation, etc.) heart rate, and respiratory rate, and/or an
increase in the PPG peak to peak amplitude. The measurement of the
sympathetic-parasympathetic balance in response to a stimulus may
prove clinically useful for the evaluation of the autonomic nervous
system of a subject. Vasodilation and vasoconstriction may be
typically associated with changes in blood pressure. However,
changes in PPG peak to peak amplitudes without an associated change
in baseline may suggest a change in vasotone without a change in
blood pressure. The observance of such events in the PPG may be
particularly useful following the administration of a drug, in
particular a vasoactive drug, for example in monitoring its
efficacy.
[0096] In an embodiment, the change in vasomotor tone and/or blood
pressure during sleep can be an indicator of one or more types of
events such as for example arousals, changes from one sleep stage
to another, or sleep apnea events. Thus, the detection of vasomotor
tone and/or blood pressure changes may manifest through changes in
calculated signal characteristics in the PPG signal, changes in
baseline in the PPG signal, the detection of one or more artifacts
in the scalogram, changes in characteristics in the scalogram, or
any combination thereof. The detection of this event may be used in
a diagnostic and/or therapeutic sleep setting. For example, a
polysomnograph, which may include a pulse oximeter sensor or the
equivalent and other sensors, may capture a user's PPG signal while
the user is participating in a sleep study. Thus, by analyzing the
PPG signal and the scalogram derived from the PPG signal, the
device may detect an event when the user wakes up or transitions
from one sleep stage to another. Arousal during sleep, for example,
may manifest as an increase in blood pressure and movement along
with an increase in heart rate and respiratory rate. It is also
likely that events in a PPG baseline may be correlated with other
known indicators of arousal within a polysomnograph. For example,
increased arousal may be correlated with increases in baseline
which may indicate an increase in blood pressure which may also
correlate with increased EMG and EEG activity.
[0097] In an embodiment, deep inspiratory gasps may cause marked
baseline shifts. Hence, in an embodiment, the effect of irregular
breaths (e.g. gasps, or single deep or shallow breaths) may be
detected by changes in the baseline in either the original or
transformed signal. This information is useful in the monitoring of
user respiration and/or the effect of ventilation devices on the
user. The inter-thoracic pressure changes caused by deep
inspiratory gasps may cause associated modulations in the blood
pressures of the vascular tree. These modulations may, for example,
cause the modulation of the PPG baseline thereby allowing
individual breaths to be monitored. Hence irregular breathing
patterns may be distinguished from patterns observed in the
baseline.
[0098] The foregoing detections of events may also cause an action
to be performed. For example, a flag may be set that indicates that
further analysis needs to be performed. As another example, the
recalibration of a device may be triggered by the detection. For
instance, a continuous, non-invasive blood pressure (CNIBP) monitor
may be monitoring the diastolic/systolic blood pressure of a user.
In response to the detection of an event (e.g., the user moving the
body part attached to a probe of the CNIBP to a different
location), recalibration of the CNIBP monitor may be automatically
triggered.
[0099] FIG. 9 shows a flowchart of an illustrative process for
detecting an event in a signal in accordance with an embodiment of
the present disclosure. Process 900 starts at step 902. After the
process starts at step 902, the process may perform steps 904 and
906 in parallel. At step 904, the signal processing system may
calculate one or more signal characteristics of a signal (e.g., PPG
signal 500 of FIG. 5). For example, the signal processing system
may calculate the average or median value of an AC component of the
signal.
[0100] At step 906, the signal processing system may calculate the
baseline of the signal. The baseline may be calculated as an
average or median of the signal over a selected amount of time or
over any other suitable metric.
[0101] After calculating the one or more signal characteristics and
the baseline of the signal, the process 900 may move to step 908.
At step 908, the signal processing system may calculate changes in
the one or more signal characteristics and the baseline. For
example, the signal processing system may calculate the percentage
or magnitude changes in the one or more signal characteristics and
the baseline. After calculating the changes, process 900 may move
to step 910.
[0102] At step 910, the signal processing system may analyze the
calculated signal characteristics and the baseline, the baseline
changes, and the changes in the signal characteristics to detect an
event. For example, the system may analyze whether the changes
occurred during the same time period or in a particular order. The
signal processing system may use the baseline changes, the changes
in the signal characteristics, the calculated signal
characteristics, the calculated baseline, or any combination
thereof to determine that an event has occurred. For example, the
system may detect a posture change when the AC component of the
signal increases after the baseline of the signal decreases. After
detecting the event, process 900 moves to step 912.
[0103] In an embodiment, at step 912, the signal processing system
may perform an action based at least in part on the detected event.
For example, the signal processing system may recalibrate a device
(e.g., a CNIBP monitor) based on the detected event. As another
example, the signal processing system may set a flag at the
detected event so that further analysis of the signal can be
performed. For instance, if the detected event is sleep arousal,
the signal processing system may perform an analysis of the sleep
patterns of the user. After the action has been performed, process
900 ends at step 914.
[0104] FIG. 10 shows a flowchart of an illustrative process for
detecting an event in a scalogram in accordance with an embodiment
of the present disclosure. Process 1000 starts at step 1002.
[0105] At step 1004, a scalogram may be generated from a signal.
The signal may be any suitable signal such as for example a PPG
signal (e.g., PPG signal 500 of FIG. 5). The scalogram may be
generated by performing a wavelet transformation of the PPG signal.
The wavelet transform may, for example, be a continuous or discrete
wavelet transform. After the scalogram has been generated, the
process may perform steps 1006 and 1008 in parallel.
[0106] At step 1006, the signal processing system may calculate
characteristics of the scalogram such as an energy parameter within
a region (e.g., region 608 of FIG. 6) of the scalogram. The size
and shape of the region may be selected in any suitable way. For
example, the height and location of the region may be fixed or may
be dynamically changed to cover a band or region of interest in the
scalogram.
[0107] At step 1008, the signal processing system may detect an
artifact within the scalogram. For example, the signal processing
system may detect a high energy broad-scale cone (e.g., artifact
606 of FIG. 6) on the scalogram.
[0108] After calculating the characteristics and detecting the
artifact within the scalogram, the process may move to step 1010.
At step 1010, the signal processing system may analyze the
calculated characteristics and the detected artifact to detect an
event. In an embodiment, the system may use calculated energy
parameters, the detected artifact, or any combination thereof to
determine that an event has occurred. After detecting the event,
process 1000 moves to step 1012.
[0109] At step 1012, the signal processing system may perform an
action based at least in part on the detected event. The actions
that may be performed may be similar to actions described in step
912 of process 900 (FIG. 9). For example, the signal processing
system may recalibrate a device based on the detected event. As
another example, the signal processing system may set a flag at the
detected event so that further analysis of the signal can be
performed. After the action has been performed, process 1000 then
ends at step 1014.
[0110] The signal processing system may also detect the event by
analyzing an original signal and the transform of that signal. For
example, the signal processing system may determine when an
artifact in the transform occurs. Based at least in part on this
information, the signal processing system may analyze changes in
the signal characteristics of the original signal before and after
the occurrence of the artifact to determine whether an event
occurs. For example, the signal characteristics (e.g., the AC
component) of the original signal prior to the occurrence of the
artifact may be compared to the signal characteristics (e.g., the
AC component) of the original signal after the occurrence of the
artifact. In addition, the signal processing system may determine
when the baseline change occurs in the original signal. Based at
least in part on this information, the signal processing system may
analyze changes in a characteristic of the wavelet transform (e.g.,
energy within a particular region) before and after the baseline
change to determine whether an event occurs.
[0111] It will be understood that the foregoing is only
illustrative of the principles of the disclosure, and that the
disclosure can be practiced by other than the described
embodiments, which are presented for purposes of illustration and
not of limitation.
* * * * *