Smartphone tristimulus colorimetry for skin-tone analysis at common pulse oximetry anatomical sites

Abstract: Significance: Smartphones hold great potential in point-of-care settings due to their accessibility and computational capabilities. This is critical as clinicians increasingly seek to quantify skin-tone, a characteristic which has been shown to impact the accuracy of pulse oximetry readings, particularly for dark skin tones, and hence, disproportionately affect patient outcomes. Aim: This study presents a smartphone-based imaging technique for determining individual typology angle (ITA) and compares these results to those obtained using an industry-standard tristimulus colorimeter, particularly for the finger, a common site for pulse oximetry measurements. Approach: We employ a smartphone-based imaging method to extract ITA values from four volunteers with diverse skin-tones. The study provides recommendations for minimizing errors caused by ambient light scattering, which can affect skin-tone readings. Results: The smartphone-based ITA (SITA) measurements with camera flash disabled and minimal ambient lighting correlates well with the industry-standard colorimeter without the need for auxiliary adapters and complex calibration. The method presented enables wide-field ITA mapping for skin-tone quantification that is accessible to clinicians. Conclusions: Our findings demonstrate that smartphone-based imaging provides an effective alternative for assessing skin-tone in clinical settings. The reduced complexity of the approach presented makes it highly accessible to the clinical community and others interested in carrying out pulse oximetry across a diversity of skin-tones in a manner that standardizes skin-tone assessment.