Allen published an interesting review about the applications PPG in clinical physiological measurement. Some of them focus on the specific medical use of PPG like pulse rate, blood pressure, atrial fibrillation, circulatory monitoring, nociception, or on the specific placement of PPG, others instead focused on reviewing the way that the signal has been analyzed or the type of the sensor. Several reviews on the application of PPG signals have been carried out. Web of Science publication and citation report, for the words “Photoplethysmography” OR “Photoplethysmogram”. We relate the exponential growth around 2015 to the reveal of the first Apple watch. Figure 1 shows the number of publications and citations of the words “Photoplethysmography” OR “Photoplethysmogram” from 1968 till now, from the Web of Science report. It could play an important role in developing affordable and effective diagnostic, monitoring and screening tools in several areas of healthcare. It is envisaged that the PPG signal can be clinically helpful to evaluate many physiological characteristics. By processing PPG signals with different algorithms, researchers have acquired valuable information related to respiratory rate, blood pressure, ankle-brachial pressure, cardiovascular diseases, aging, neurological disorder, etc. After reviewing the literature, we identified several other applications of this noninvasive method beyond pulse rate and SpO2. PPG is commonly used in clinical practice to measure the oxygen saturation level (SpO2) in the blood and pulse rate as a vital sign of a patient. The importance of the PPG signal came from the fact that it can be easier to obtain with noninvasive and affordable sensors. This optical waveform, sometimes called digital volume pulse (DVP), is associated with the change in blood volume in the microvascular bed of tissue containing valuable information about the cardiovascular, respiratory, and nervous systems. Photoplethysmography (PPG) measures the amount of light absorbed or reflected by human tissues. Main operation challenges, including performance and robustness obstacles, are identified. The state-of-the-art studies suggest that in the years to come PPG wearables will become pervasive in many fields of medical practices, and the main domains include cardiology, respiratory, neurology, and fitness. We also highlight the potential impact of using PPG signals on an individual’s quality of life and public health. Along with consolidated research areas, recent topics that are growing in popularity are also discovered. To this aim, papers from 1981 to date are reviewed and categorized in terms of the healthcare application domain. The research methodology is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines 2020. This systematic review discusses the current literature on diagnostic features of PPG signal and their applications that might present a potential venue to be adapted into many health and fitness aspects of human life. All these encourage the researchers to estimate its feasibility as an alternative to many expansive, time-wasting, and invasive methods. Recent research indicates that Photoplethysmography (PPG) signals carry more information than oxygen saturation level (SpO2) and can be utilized for affordable, fast, and noninvasive healthcare applications.
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