| I'm the CTO at a relatively well established medical device company (EEG/ECG). Before I arrived at my current company I spent a year of my own time tinkering in the BP space. The article, while relatively, light on details gives a pretty good sense of the problem with trying to replicate the traditional BP measurements using the optical methods used by smartwatches. Smartwatches and similar devices use photoplethysmography (PPG) to measure blood oxygen saturation. The heme units in blood have different reflectance/absorbance spectra depending on their level of oxygen saturation. The only difference between the fingertip pulse oxygen sensors used in clinical settings and those used in smartphones is that the clinical ones use transmission, whereas the watches use reflection. While the methods are different, they arrive at very similar numbers (+/- skin color & racial biases). Unlike pulse oximeters of yore, smart watches can take many thousands of readings per second. And if you offset your photodiodes by a known distance, you can calculate pulse transit time, and a variety of other measures beyond just your spo2. The challenge has been in translating these measures back into systolic and diastolic blood pressure. To be accepted by the FDA you need to be able to show that your device is +/- 3mmHg. That's just not doable right now for the reasons mentioned in the article. That said, the measures that you can get from high-speed PPG are probably not useless. But these measures aren't backed up ~200 years of medical practice. It is a very long road to introduce new measures into the medical system. Not only do you need to get FDA clearance to sell your device, but you need to navigate the reimbursement system to find someone who will pay for your device. Doing this in a 5 year time span would be unheard of. While cardiologists would like a better system than cuff based BP measurement, the upside of a better system is limited by the current medical system. And there's a significant cost and downside risk to anyone pushing for something different. One company that I spoke to and is still working on the problem comes with an impressive biomedical pedigree, and they're starting in the non-diagnostic "wellness" space. Another company is using mm-wave radar to measure pulse waves in a different way, but it appears that they've pivoted from being directly challenging the BP status quo into now selling their hardware sensors to more well established medical device companies. Long story short, I'd be impressed to see blood pressure cuffs retired in my lifetime. |