A Programmable Gain Calibration Method to Mitigate Skin Tone Bias in PPG Sensors

Photoplethysmography (PPG) is a widely adopted optical technique for cardiovascular monitoring, but its accuracy is often compromised by skin pigmentation, which attenuates the signal in individuals with darker skin tones. This research addresses the challenge of skin pigmentation by developing a PPG sensor system with a novel gain calibration strategy. We present a hardware prototype integrating a programmable gain amplifier (PGA), specifically the OPA3S328 operational amplifier, controlled by a microcontroller. The system performs a one-time gain adjustment at initialization based on the user's skin tone, which is quantified using RGB image analysis. This "set-and-hold" approach normalizes the signal amplitude across various skin tones while effectively preserving the native morphology of the PPG waveform, which is essential for advanced cardiovascular diagnostics. Experimental validation with over 70 human volunteers demonstrated the PGA's ability to apply calibrated gain levels, derived from a first-degree polynomial relationship between skin pigmentation and red light absorption. This approach significantly improved signal consistency across different skin tones. The findings highlight the efficacy of pre-measurement gain correction for achieving reliable PPG sensing in diverse populations and lay the groundwork for future optimization of PPG sensor designs to improve reliability in wearable health monitoring devices.