WO2003079892A2 - A non-invasive blood analyte measuring system and method utilizing optical absorption - Google Patents

A non-invasive blood analyte measuring system and method utilizing optical absorption Download PDF

Info

Publication number
WO2003079892A2
WO2003079892A2 PCT/US2003/008084 US0308084W WO03079892A2 WO 2003079892 A2 WO2003079892 A2 WO 2003079892A2 US 0308084 W US0308084 W US 0308084W WO 03079892 A2 WO03079892 A2 WO 03079892A2
Authority
WO
WIPO (PCT)
Prior art keywords
radiation
tissue
sensors
blood
concentration
Prior art date
Application number
PCT/US2003/008084
Other languages
French (fr)
Other versions
WO2003079892A3 (en
Inventor
Edward R. Wuori
Original Assignee
Minformed, L.L.C.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Minformed, L.L.C. filed Critical Minformed, L.L.C.
Priority to AU2003220328A priority Critical patent/AU2003220328A1/en
Publication of WO2003079892A2 publication Critical patent/WO2003079892A2/en
Publication of WO2003079892A3 publication Critical patent/WO2003079892A3/en

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/145Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
    • A61B5/1455Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue using optical sensors, e.g. spectral photometrical oximeters
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/145Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
    • A61B5/14532Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue for measuring glucose, e.g. by tissue impedance measurement
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/0002Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network

Definitions

  • the present invention relates to a method and apparatus for non-invasive monitoring of various blood analytes in humans and other animals in the fields of medicine, sports medicine, military hardware, anemia treatment, diabetes treatment, and traumatic injury treatment.
  • This invention relates to a non-invasive apparatus and methods for in vivo monitoring of the concentration levels of various blood analytes within a living subject, using optical absorption spectrophotometry.
  • the device and methods may be used to simultaneously monitor several analytes found in the blood outside of a laboratory setting.
  • the device and methods are able to resolve analytes down to approximately one mg/dL. Further, the device and methods are able to measure all blood analytes present at approximately one mg/dL, including glucose and lactate, for example.
  • Lactate is becoming the measurement of choice in sports and coaching to assess levels of conditioning for athletes and to prevent overtraining.
  • Lactate threshold and other related parameters are used to assess the aerobic and anaerobic status of athletes, are correlated to athletic performance, and may be used to "rank" athletes according to actual performance history.
  • Lactate monitoring, as used in athletics may also be useful for Militarytreus, Army boot camps, and other physical training operations to assess the physical condition of trainees, to improve training programs, and to evaluate the effectiveness of training regimens on specific individuals.
  • Lactate is also widely used to assess the medical condition of injured people. When serum lactate elevates after an injury, whether or not the lactate clears is correlated strongly with mortality, thus, measurement of serum lactate levels is a key tool in assessing treatment.
  • the monitoring of blood glucose has long been an important tool in controlling diabetes in diabetic patients. Diabetes is a high maintenance disease, generally requiring several measurements of blood glucose daily. At present, this is typically accomplished using a glucometer, in which a fresh blood sample must be obtained for each measurement. Each measurement typically requires a new "test strip" for receiving the blood sample, the test strips characteristically being relatively expensive. Such measurements are often painful, cumbersome, and moderately time-consuming.
  • the method of testing blood glucose using a test strip is generally referred to as the "finger stick" method. It specifically involves applying a drop of blood to the test strip, the test strip using molecular sieves to block molecules larger than molecular weight of about 200.
  • the sieves consequently block, for example, large glycosylated proteins from being included in the blood glucose measurement. Due to the inconvenience and expense, many diabetic patients do not monitor their blood glucose levels as often as recommended. About 16 million diabetic patients in the United States need to regularly monitor their blood glucose levels.
  • a non-invasive device enabling painless and convenient monitoring of blood glucose would be of great benefit to diabetic patients.
  • the relative ease of measurement may contribute to a more regular blood glucose monitoring regime by diabetic patients.
  • Various attempts have been made at a blood glucose measurement device using spectroscopy. However, those attempts have generally had problems with "baseline drift" of unknown origin. It is hypothesized that the absorption method used in most spectroscopy devices for measuring glucose in the blood measures all glucose in the blood, both the bound glucose and the free glucose.
  • measurement of the concentration of free glucose is desired. That is, the concentration of free glucose in the blood is generally recommended to be in the range of 80 mg/dL and 120 mg/dL.
  • a diabetic patient will measure their blood glucose level to determine whether the level is within the recommended range. If the blood glucose level is outside of the recommended range, the diabetic patient will typically inject insulin to reduce the blood glucose level. Again, it is the free glucose concentration level that is relevant to determining whether the patient's blood glucose concentration is within the recommended range. Because absorption techniques may measure both free and bound glucose levels as one measurement, there may be an overstatement of the blood glucose level that results in faulty treatment by the patient.
  • the molecular sieves of the test strip glucometers described above correct for the possibility of measuring bound and free glucose by preventing the bound glucose, with a relatively high molecular weight, from passing through the sieve.
  • the finger stick methods take only one measurement of the glucose concentration level in the blood and, for a series of measurements, require a series of blood samples, generally obtained by a series of finger pricks. Consequently, the finger stick methods do not offer an appealing method of continuous measurement of blood glucose concentration in the blood. Continuous measurement of blood glucose levels enable near instant recognition of abnormal blood glucose levels whereas a series of individual measurements inevitably includes periods of time where the precise blood glucose level is unknown. Thus, a diabetic patient may be better able to control blood glucose levels. It may also assist the person in adjusting their lifestyle, diet, and medication for optimum benefits. Providing the easy, non-invasive, and optionally continuous monitoring provides a great improvement in the treatment of the diabetes and allows the treatment to be tailored to the individual.
  • Hemoglobin is important especially in the monitoring of anemia caused by various various factors such as HIN infection and chemotherapy. Anemia treatments need frequent monitoring of hemoglobin to assess effectiveness of various treatments such as Epoetin- Alpha therapy.
  • Spectrophotometry provides a useful method for determining the presence of analytes in a system.
  • a typical spectrometer exposes a dissolved compound to a continuous wavelength range of electromagnetic radiation. The radiation is selectively absorbed by the compound, and a specfrograph is formed of radiation transmitted (or absorbed) as a function of wavelength or wave number. Absorption peaks are usually plotted as minima in optical spectrographs because transmittance or reflectance is plotted with the absorbance scale superimpose, creating IR absorption bands.
  • t fraction of radiation transmitted (or reflected).
  • molar extinction coefficient, cm 2 /mol.
  • C concentration, mol/cc.
  • b thickness presented to radiation, cm.
  • the wavelengths of maximum abso ⁇ tion, ⁇ max , and the corresponding maximum molar extinction coefficient, ⁇ max are identifying properties of a compound. Radiation causes excitation of the quantized molecular vibration states. Several kinds of bond stretching and bond bending modes may be excited, each causing abso ⁇ tion at unique wavelengths. Only vibrations that cause a change in dipole moment give rise to an abso ⁇ tion band. Abso ⁇ tion is only slightly affected by molecular environment of the bond or group. Nevertheless, these small'chemical shifts may aid in uniquely identifying a compound. A "fmge ⁇ rint region" exists between 42 and 24 THz (1400 and 800 cm “1 ) because of the many abso ⁇ tion peaks that occur in this region.
  • NIRS Near Infrared Spectroscopy
  • Invasive devices and methods of quantifying and classifying blood analytes using IR and other optical spectrophotometry methods are very commonly known. Invasive procedures are those where a sample such as blood is taken from the body by puncture or other entry into the body before analysis. Invasive procedures are undesirable because they cause pain and increase the risk of spread of communicable, blood-borne diseases. Further, after the invasive collection of body samples, these samples may need to be further prepared in the laboratory by adding water or ions to the samples to increase the accuracy of the spectrophotometry readings. Thus, these commonly known devices and methods are often only suitable for use under laboratory in vitro conditions and are too difficult to be practically applied in athletic training and military situations. It is noted, of course, that the finger stick method of measuring blood glucose concentration levels using a glucometer has been adapted for home use.
  • U.S. Patent 5,757,002 by Yamasaki relates to a method of and an apparatus for measuring lactic acid in an organism in the field of sports medicine or exercise physiology.
  • U.S. Patent 5,361,758 by Hall relates to a non- invasive device and method for monitoring concentration levels of blood and tissue constituents within a living subject.
  • Previous non-invasive devices and methods typically require time-consuming custom calibrations to account for the differences between individuals and environmental factors which cause variation in energy abso ⁇ tion.
  • the devices may not typically measure the results of two or more analytes at the same time without significant inaccuracies.
  • Each analyte in the blood sample contributes a unique abso ⁇ tion pattern to the overall infrared spectrum, governed by the unique set of molecular vibrations characteristic of each distinct molecular species.
  • the infrared spectral range extends from 780 nm to 25,000 nm and is commonly subdivided further into the near-infrared and mid-infrared regions.
  • Most devices obtain an measurement of an analyte by using only a small portion of the IR spectrum reflecting the particular analyte of interest.
  • IR spectroscopy typically involves radiating light onto a portion of tissue for either transmission through the tissue or reflection from the tissue. The transmitted or reflected radiation is then analyzed to determine concentrations of analytes.
  • the radiation that is transmitted or reflected is not just transmitted through or reflected from the blood, but instead includes transmissions or reflection from the skin, subdermal tissue, and blood.
  • the received radiation is a mixture of abso ⁇ tion signals from skin and tissues and blood.
  • the signals contributed by the skin and tissues make it difficult to accurately measure the presence of blood analytes.
  • These signals need to be separated to eliminate the effects of skin and tissue in order to measure the analytes in the blood.
  • Previous non-invasive devices and methods were unable to separate blood-related readings from body tissue readings. Therefore, there is a need for a device capable of separating the blood-related component of the signal from the tissue component.
  • One method of achieving the separation of a blood-related component of the signal is to accept only the portion of the mixed signal which has a pulse synchronized with the heart pulse, known as a pulsatile technique or synchronous detection.
  • the pulsatile signal is the time varying portion of the whole signal that is synchronized with the heart beat. This method presumes that the pulsations come from the movement of arterial blood or closely related volume and allows a signal associated with the blood to be separated from that of tissue.
  • the synchronous method is widely used for separating blood-related components in pulse oximeters.
  • hematocrit-type method determines the portion of the signal associated with the blood.
  • the hematocrit is the proportion, by volume, of the blood that consists of red blood cells.
  • the hematocrit is typically measured from a blood sample by an automated machine that makes several other measurements at the same time. Most of these machines do not directly measure the hematocrit, but instead calculate it based on the determination of the amount of hemoglobin and the average volume of the red blood cells.
  • Using a hematocrit method generally is faster than using a synchronous method because there is no need to wait for heart beats.
  • the present invention provides an improved apparatus and method for the rapid, non- intrusive determination of the concentration of blood analytes.
  • it provides a portable tabletop unit for measurement of blood analyte concentrations where the subject may walk up to the device for measurement from a body part, such as a finger.
  • a body part such as a finger
  • blood analyte measurement must be done outside of a domestic or laboratory environment.
  • another embodiment of the present invention provides a portable system which may be positioned on body tissue and transported on the user's person.
  • Features such as small size, a wireless sensor, battery operation, portability, and downloadability demonstrably increase the utility and range of the analyte measurement apparatus of the present invention beyond the hospital or laboratory setting.
  • the present invention also provides a method and apparatus with increased sensitivity and accuracy.
  • a problem encountered in the area of blood analyte measurement via IR spectroscopy is accuracy and drift.
  • other analytes and various other substances present interfere with the IR measurement of the desired analyte.
  • These analytes vary in concentration and thus vary the IR spectrum in the regions being used to determine specific analyte concentration.
  • the present invention corrects for all other analytes with concentrations sufficient to interfere in the determination of the concentration of the analyte or analytes of interest.
  • Measuring the entire visible and IR spectrum provides enough data to simultaneously determine all of the analytes and thereby compensate for any accuracy or drift problems their concentration may cause in measuring the concentration of the analyte(s) of interest. Data processing using orthogonal functions is used to accomplishing this task.
  • Other properties of blood may also effect the IR measurement of the desired analyte. For example, turbidity of the blood, as may be caused by elevated white cell count or high blood lipids, may affect the measurement. These factors appear in the spectra and are compensated for by the present invention.
  • the analyte measurement apparatus of the present invention is sufficiently sensitive to detect blood glucose or lactate with accuracy within, approximately, 10% of the level actually present, and may do so in a short period of time (e.g.
  • the blood analyte measurement apparatus of the present invention includes a radiation source for generating and transmitting a spectrum of radiation onto a portion of tissue (for transmission therethrough or reflection therefrom), one or more sensors for detecting the radiation either transmitted through or reflected from the tissue over a broad spectrum and generating an output in response to the detected radiation, and a processor for receiving output from the sensors to determine the concentration of blood analytes in the portion of tissue, hi a preferred embodiment, the apparatus also makes use of a mounting device to position the radiation source and the sensors relative to a portion of tissue so the one or more sensors may receive a substantial portion of the radiation produced by the radiation source and transmitted through or reflected by the portion of tissue.
  • the information regarding abso ⁇ tion of the radiation is then algorithmically processed to clarify the signal(s) of the desired blood analytes.
  • the invention in a typical configuration, includes a sensor module which is preferably attached to an earlobe, a pocket monitor for immediate readout and data logging, and a data link to a PC for long term storage and compilation of data.
  • a sensor module which is preferably attached to an earlobe
  • a pocket monitor for immediate readout and data logging
  • a data link to a PC for long term storage and compilation of data.
  • the blood analyte sensor module is integrated as much as possible to reduce the size and weight.
  • the sensor module is completely self-contained.
  • the sensor module illuminates the measurement site with a built-in radiation source tailored to the spectral region of interest.
  • the radiation source and the sensors are each positioned on a chip.
  • the radiation source may be integrated onto a custom chip in transmission mode, or onto the same chip as the sensors in reflection mode. That is, when it is desired to receive and inte ⁇ ret radiation transmitted through the tissue, the apparatus is working in transmission mode and the radiation source is positioned on a chip separate from the chip on which the sensors are positioned.
  • the apparatus when it is desired to receive and inte ⁇ ret radiation that is reflected from the tissue, the apparatus is working in reflection mode and the radiation source may be positioned on the same chip as the chip on which the sensors are positioned.
  • the radiation source is a thermal radiator made up of tungsten or tantalum positioned over a reflective heat shield.
  • the blood analyte measurement apparatus also optionally includes a focusing device for focusing the radiation from the radiation source onto a point on the tissue.
  • a fresnel lens works well in this capacity.
  • the apparatus also optionally includes a collimator to compensate for the scattering that typically occurs when the radiation passes through tissue. The beam divergence of the collimator, if used, should be approximately 5 degrees or less.
  • a filter may also be included to separate the radiation received by the sensors into various wavelengths subsequent to collimation.
  • the preferred filter for this separation is a Fabry-Perot narrow band interference filter comprising a dielectric film between two metal films, where the dielectric film has a graded thickness running from a short wavelength end with a thickness of about 100 nm to a long wavelength end with a thickness of about 2.5 microns. Between the narrow band interference filter and the sensors is a planarizing layer.
  • the spectrophotometer bears sensors which are preferably sensitive to radiation from wavelengths of about 700 nm to about 2500 nm.
  • the sensors within the sensor module are divided into two groups: direct silicon sensors sensitive to radiation of a wavelength range from about 0.4 to 1.1 microns, and infrared sensors sensitive to radiation of a wavelength range from 1 to 10 microns.
  • the apparatus of the present invention preferably uses an array of approximately 1024 elements, for an overall filter passband of about 0.22 percent of its center wavelength or frequency.
  • the direct silicon sensors may be, for example, either photodiodes or charge coupled devices.
  • a charge coupled device array made up of multiple elements sensitive to differing portions of the wavelength range is preferred.
  • the infrared sensors making up the rest of the array may, for example, be extrinsic silicon, pyroelectric, photoconductor, or thermocouple sensors.
  • Thermocouples comprising two layers of metal with an additional layer of gold black are preferred, where the two metal layers may be either nickel-chromium alloy on nickel-copper alloy, for example.
  • the sensor module may include a replaceable, rechargeable battery and use a unique ID code if desired.
  • a processor is provided for processing the output from the sensors. If desired, an RF transmitter or other device may be provided for wirelessly transmitting the signals from the sensors to the processor.
  • This processor is preferably a CMOS microprocessor, which uses a Boolean algorithm to process the output from the sensors.
  • Various processing algorithms are used to enhance the value of the data obtained from the sensors.
  • the blood analyte measurement apparatus may also include a display, typically a liquid crystal display, for the immediate display of data to the user. The data may be downloaded to a computer or other device via an I/O port, typically an RS-232 port.
  • the present invention also discloses a method for measuring the concentration of one or more blood analytes in a portion of tissue with a non-invasive measuring apparatus.
  • the method involves positioning a portion of tissue approximately adjacent one or more sensors and a radiation source, exposing the tissue to radiation from the radiation source, detecting radiation transmitted through or reflected from the tissue with the one or more sensors, generating a signal from the one or more sensors in response to the detected radiation, communicating the signal to the processor, and finally inte ⁇ reting the signal communicated to the processor to determine the concentration of one or more blood analytes.
  • the method of the present invention also includes the step of displaying the results so they may be perceived by the user.
  • the preferred tissue exposed to the radiation in the method is either an earlobe or a finger.
  • the positioning of the tissue is carried out so that the sensors and the radiation source have minimal or no contact with the tissue itself.
  • any analyte which has infrared abso ⁇ tion may be measured by this method, specific examples are lactate/lactic acid, glucose, insulin, ethanol, triglycerides, albumin, proteins, hemoglobin, immunoglobulins, cholesterol, and urea.
  • An important aspect of the present invention is the inte ⁇ reting of the signals communicated to the processor by an algorithm.
  • One type of algorithm used to inte ⁇ ret this data is linear regression.
  • a more preferred algorithm makes use of orthogonal functions.
  • the concept is to use the reference spectrum for each blood analyte as basis functions and determine a weighting function or functions that create an orthogonal set. This permits easy separation algorithms for mixed spectra. The use of algorithms is very helpful for self- calibrating to eliminate data artifacts caused by individual variation in tissue character.
  • the least squares method of orthogonal functions is preferably used to separate the concentrations of the individual analytes from the total spectrum measured. This is also referred to as “principle component analysis” and is similar to “Fourier series decomposition.” Separating the various analyte concentrations is statistically challenging because of an overlap of the spectra which causes interactions and cross-coupling. Trying to evaluate one analyte concentration is affected by the other overlapping concentrations.
  • the orthogonal decomposition is a mathematical way of processing the overlapping concentrations so that they are non-interacting.
  • Beers' law may be used to describe blood as a series where each term in the series represents absorbance of one of the blood analytes.
  • the composite spectrum CS can be calculated directly.
  • the method of the present invention measures the composite spectrum and the reference spectra. Concentration coefficients are determined using the orthogonal function decomposition.
  • Figure 1 is a drawing illustrating the overall concept of the non-invasive blood analyte micromonitor
  • Figure 2 is a drawing illustrating one possible construction for the sensor module
  • Figure 3 is a drawing illustrating the positioning of the basic components of the sensor module with respect to an ear lobe;
  • Figure 4 is a perspective view of an integrated radiation source element;
  • Figure 5 is a drawing illustrating the operation of the collimator
  • Figure 6 is a drawing illustrating the layered components of a narrow band filter integrated directly onto a sensor chip
  • Figure 7 is a drawing illustrating the layout of the sensor circuit and related components
  • FIG 8 is a perspective view of the thermocouple sensor cell
  • Figure 9 is a block diagram of the preliminary schematic diagram for the sensor module
  • Figure 10 is a block diagram of the CMOS custom chip for the sensor arrays; and Figure 11 is a block diagram of the inputs and outputs for the pocket monitor.
  • One preferred embodiment of the present invention is a blood analyte measurement apparatus for measuring the concentration of blood analytes outside of a laboratory setting.
  • the blood analyte measurement apparatus utilizes a sensing unit 1, such as a micromonitor sensor module, that is preferably small and inobtrusive and does not interfere with a user's normal functioning.
  • Figure 1 shows an embodiment of the analyte measurement apparatus, with the sensor module 1, support hardware such as a pocket monitor 2 and an optional computer interface 3.
  • the sensor module contains a small spectrophotometer, which comprises two sensor arrays and a custom graded narrow band interference filter.
  • the sensor module also preferably contains an RF radio transmitter to broadcast the data produced by the sensor, typically only over a limited range, and a rechargeable battery as well as custom optics.
  • the sensor module may be used in an ambulatory application where the user simply clips the sensor module 1 onto an appropriate tissue region, puts the pocket monitor 2 in a pocket/purse and goes about their business.
  • the pocket monitor display give the user immediate data, and stores the data, optionally for later downloading to a computer 3.
  • the micromonitor sensor module 1 shown in detail in Figure 2 is integrated to reduce its size and weight.
  • the sensor module may also be completely self-contained.
  • the sensor module is configured for attachment to the user's ear lobe, the ear lobe being the preferred measurement site.
  • sensor modules intended for attachment to other measuring sites may be configured differently.
  • the target sensor volume is preferably 5 to 10 cc for lactate monitoring, and 1 to 2 cc for glucose monitoring.
  • the sensor module as shown, is configured to illuminate the measurement site and to receive the reflected radiation from the measurement site.
  • the configuration of the sensor module or modules may vary for receiving transmitted radiation from the measurement site.
  • the sensor module of Figure 2 illuminates the measurement site with a radiation source 4 configured to generate radiation in the spectral region of interest.
  • each sensor module may have a unique ID code.
  • the sensor module also preferably contains an RF radio transmitter 9 to broadcast the data received by the sensor as reflection or transmittal of the radiation, that is the transmitted or reflected radiation from the measurement site, and a rechargeable battery 10 as well as custom optics.
  • an RF radio transmitter 9 to broadcast the data received by the sensor as reflection or transmittal of the radiation, that is the transmitted or reflected radiation from the measurement site, and a rechargeable battery 10 as well as custom optics.
  • a weak RF source is provided since the signal is generally broadcast over only a few feet.
  • the custom CMOS chip 8 e.g., preamplification, data processing, IR data output.
  • the sensor module may analyze the blood spectra, that is illuminate the measurement site and receive the transmitted or reflected radiation therefrom, at fixed time intervals, such as once every minute, and is capable of running an analysis in less than five seconds.
  • a further preferred embodiment of this blood analyte measurement device includes a non-invasive sensor module that utilizes infrared spectrophotometric techniques.
  • a narrow-band interference filter 11 is used as a color separation device in the sensor module. This type of filter is preferred due to its small volume, minimal needs for optics to collimate the radiation, and inherent compatibility with integrated circuit processing techniques. A very small spectrophotometer results when this filter is combined with a CMOS chip bearing an array of sensors.
  • the radiation (typically, visible and IR or near-IR light) sources 4 of the sensor module may be integrated onto a different chip from that bearing the sensor array for transmission mode or onto the same chip for reflection mode, hi one embodiment, the radiation source comprises a series of incandescent elements integrated onto a silicon chip.
  • Existing tungsten/tantalum technology (used in fusible link type EE Prom's) may be combined with Micro-Electro-Mechanical Systems (MEMS) to form an array of radiation sources tailored to the specific needs of this spectrometer.
  • MEMS technology is the integration of mechanical elements, sensors, actuators, and electronics on a common silicon substrate through the utilization of microfabrication technology.
  • Figure 3 illustrates the relationship between the sensor components and a portion of tissue, an ear lobe 13, which is a preferred measurement site. These components are the radiation source 4, the source optics 5, the light collimator 6, the narrow band filter 11, and the integrated sensors 12.
  • the ear lobe is a rich source of blood, and attachment of the sensor module thereto meets the ambulatory monitoring goals to be unobtrusive and not interfere with normal user activity.
  • Figure 3 shows a configuration where radiation is transmitted through the ear lobe 13, rather than reflected from it. This configuration requires components on both sides of the ear lobe, but generally uses the available radiation more efficiently than a configuration where the radiation reflected from the ear lobe is sensed.
  • a configuration for sensing radiation reflected from the ear lobe includes the same components as the configuration illustrated in Figure 3 (a radiation source, source optics, a light collimator, a narrow band filter, and integrated sensors) where all of the components are positioned on one side of the ear lobe.
  • the reflection mode generally requires a stronger radiation source than the transmission mode.
  • Figure 3 also illustrates the positioning of the source optics 5.
  • a cylindrical Fresnel style lens is preferred for the source optics for the analyte measurement apparatus.
  • the source optics focus the radiation from the radiation source onto a point at the center of the ear lobe.
  • a Fresnel lens also has a relatively small volume.
  • the integrated sensors are directly adjacent to the narrow band filter 11 and consist of two types of infrared detectors sensitive to discrete portions of the spectrum: direct silicon sensors sensitive to radiation of a wavelength range from about 0.4 to 1.1 microns, and infrared sensors sensitive to radiation of a wavelength range from 1 to 10 microns.
  • the apparatus of the present invention preferably uses an array of approximately 1024 elements, for an overall filter passband of about 0.22 percent of its center wavelength or frequency.
  • the direct silicon sensors may be, for example, either photodiodes or charge coupled devices.
  • a charge coupled device array made up of multiple elements sensitive to differing portions of the wavelength range is preferred.
  • the infrared sensors making up the rest of the array may, for example, be extrinsic silicon, pyroelectric, photoconductor, or thermocouple sensors.
  • Thermocouples comprising two layers of metal with an additional layer of gold black are preferred, where the two metal layers may be either nickel-chromium alloy on nickel-copper alloy, for example.
  • the integrated radiation source illustrated in Figure 4 provides rapid turn on and off times, a tailored emission spectrum, and may be configured to a relatively small size.
  • the radiation source 4 utilizes a high melting temperature metal such as tungsten or tantalum to form a thermal radiator 14.
  • the radiator is spaced above a silicon wafer by MEMS techniques and supported by the electrical connections and/or auxiliary supports 16. If se ⁇ entine construction is used, the resistance may be adjusted to a convenient value such that it may readily match driver characteristics.
  • a metal reflector layer 15 on the wafer under the thermal radiator element 14 boosts emission efficiency and reduces the heat load to the silicon wafer.
  • the optical color of the emission is set by the temperature of the element, and optical power by the emitting area. Using an array of such elements, each with a different temperature and area, the total emission spectrum may be adjusted to be reasonably flat over the spectrum of interest.
  • the integrated radiation source allows control over the heat leak associated with the supports.
  • the heat leak may be adjusted to achieve almost any desired turn on and turn off times of the light.
  • Each element, when hot, has a relatively small heat capacity, permitting switching times in the millisecond range without exorbitant power expenditure.
  • an electronic "chopper- wheel" with modulation frequency in the range of 1 Khz may be used to reject unwanted background signals.
  • Heat transfer calculations are provided using tungsten (3370 °C melting temperature) film 1000 angstroms thick.
  • a hot resistance in the range of 10-100 ohms is obtained with a resistor length of 10000 to 30000 squares, well within IC capability.
  • An element temperature of 2000 °C emits 2 to 50 mw radiant energy centered at about 1.5 micron wavelength using photolithographic line widths of 1-5 microns. Heat loads due to supports, electrical connections, and other losses may be held to the range of 1-10 mw. Air conduction loss is eliminated by evacuating the hot zone.
  • the small element heat capacitance the order of 30- 770 njoules/°C results in thermal time constants of 0.2-4 milliseconds.
  • Tantalum (2996 °C melting temperature) gives similar results but has less severe inrush currents than tungsten.
  • an integrated radiation source with a total power dissipation in the range of 10-100 mw, battery compatible resistance, millisecond response times, and compatibility with IC processing is clearly possible using tungsten or tantalum.
  • the ear lobe 13 is shown in both figure 3 and figure 5.
  • the analyte measurement device of the present invention compensates for complications of IR spectroscopy inherent in measurement through skin and tissue.
  • the ear lobe infrared abso ⁇ tion spectrum corresponds roughly to two layers of skin; one on the backside of the ear and the other on the front side.
  • the transmission of light through skin is fairly complicated.
  • the skin includes a stratum corneium, about 10 microns thick, an epidermis, about 100 microns thick, and a dermis, about 3 mm thick.
  • the incident radiation suffers a 4% to 7% reflection at the stratum corneum due to change in index of refraction (1.0 for air to 1.55) over the whole spectral range up to 3 microns wavelength for both white and black skin.
  • the stratum comeum also contributes to scattering since it is not flat, and has a certain roughness.
  • the chromophores of the epidermis especially melatonin determine attenuation in the visible range in this layer.
  • Psoriatic skin may also be a significant interfering factor, perhaps requiring clear lipophilic liquids to enhance light penetration in some individuals, h the dermis, blood chromophores Hb, HbO and bilirubin are the primary absorbers.
  • Figures 3 and 5 both illustrate the use of a collimator 6 with the analyte measurement device as well.
  • the radiation received from the illuminated ear lobe 13, either by transmission or reflection, may be scattered.
  • the narrow band filter works more effectively when the radiation has been collimated.
  • a beam divergence of 5 degrees or less is preferred.
  • One method is to use a standard condenser 17 and projector 18 lens arrangement, as illustrated in Figure 5.
  • the scheme illustrated in Figure 5 has a minimum volume of about 2 cc.
  • Microlens arrays may be used to reduce the volume.
  • an array of microlenses may be configured at a fraction of a cubic centimeter.
  • Figure 6 portrays a preferred narrow band filter.
  • the narrow band filter separates the wavelengths of radiation transmitted through the tissue at the measurement site and directs the various wavelengths to the sensing array, which is preferably a linear array of elements.
  • the sensors at one end of the array sense only radiation from one end of the spectrum, for example 0.4 microns, while the sensors at the other end of the array sense only radiation from the other end of the spectrum for example 10 microns.
  • each sensor measures a different color, with color varying linearly with sensor position.
  • a Fabry- Perot narrow band interference filter 19 with a graded dielectric thickness is preferred, where the dielectric film has a graded thickness running from a short wavelength end with a thickness of about 100 nm to a long wavelength end with a thickness of about 2.5 microns.
  • the spectrophotometer bears sensors which are preferably sensitive to radiation from wavelengths of about 700 nm to about 2500 nm.
  • Figure 6 shows a preferred form of filter, a metal- dielectric-metal sandwich.
  • the vertical dimension of the dielectric is a quarter wavelength. Additional layers may be used to suppress higher order resonance modes.
  • the filter may be fabricated on a separate substrate and then affixed to the CMOS chip. Since the sensor array may be only one cm long, a separate filter is manageable. The allowable separation between filter and sensor element is determined by the amount of optical cross-talk tolerable between adjacent sensors. For example, if the sensor dimension is approximately 10 microns and the incoming light has a divergence of 5 degrees, then a separation of 25 microns (1 mil) would result in up to 22% cross talk between adjacent elements due to the parallax effects. If a larger separation or lower cross talk is needed, then the incoming light may be better collimated.
  • Figure 6 shows the narrow band filter integrated directly onto the CMOS chip 12, rather than as a separate substrate.
  • filter-to-sensor spacing is very small, and cross talk between adjacent elements due to parallax is less than 10% for the layer thickness' used.
  • a planarizing layer may be preferable to accommodate the filter.
  • the first partially transmitting metal layer 22 of the optical filter is then placed on the planarizing layer 23, followed by the dielectric layer 21 and then the top partially transmitting metal layer 20.
  • a wide range of pass band widths may be obtained.
  • Such a filter typically resonates at l A wavelength, corresponding to the dielectric thickness.
  • typical dielectric thickness is 100 nm at the short wavelength end and 2.5 microns at the long wavelength end, for the preferred spectral range of 0.4 to 10 microns.
  • most metals e.g. gold or aluminum
  • the tapered dielectric layer may be readily fabricated using fixturing (i.e. using a moving aperture) with standard semiconductor equipment.
  • fixturing i.e. using a moving aperture
  • the expected thicknesses and materials may be patterned if desired by standard semiconductor processes.
  • the sensing array operates over a wide wavelength range of 0.4 to 10 microns.
  • Silicon sensors are sensitive to radiation only over a wavelength range of about 0.4 to 1.1 microns. Beyond 1.1 microns, silicon is generally not useful as a radiation sensor and other methods than direct silicon sensing must be used.
  • Two kinds of arrays are preferably used in the present invention, a direct silicon photo-sensing array and a thermocouple array. Over its range, silicon generates a much stronger signal than other sensing means. The rest of the wavelength range, from 1 to 10 microns, is sensed by the thermocouple array. Both photodiodes and CCDs may be used for direct silicon sensing.
  • FIG. 7 illustrates a preferred CCD structure 24 for use in the present invention.
  • the CCD may be viewed as a collection of MOS capacitors that collect photo-induced charges over a controlled integration time, then transfer the collected charges into readout registers 25 (also CCDs) which shift the data serially to an output port 26 where the analog signal is connected to an analog-to-digital converter.
  • Photo-sites 27 are indicated in the figure with radiation impinging on the silicon through transparent polysilicon electrodes.
  • thermocouple IR sensor cell 28 illustrates a thermocouple IR sensor cell 28.
  • a variety of devices maybe utilized for sensing over the IR part of the range (1 to 10 microns): extrinsic silicon, pyroelectric sensors (such as LiTaO ), various photoconductors, and thermocouples, for example.
  • the preferred embodiment of the present invention uses thin film thermocouple sensors. D*, the normalized detectivity figure, may be very high in integrated thermocouples, as high as 10 16 .
  • Thin film thermocouple sensors are very compatible with IC processing and may be patterned using standard photolithographic techniques.
  • thermocouple The sensitivity to infrared energy is constant over the entire IR range from about 0.7 - 50 microns.
  • the signal levels are good at 63 ⁇ v/°C with very low source impedance, since they are metal films, h a preferred embodiment the two metal layers of the thermocouple are nickel - chromium 29 and copper - nickel 30 alloys, as shown, with an additional layer of about 60 ⁇ g/cm 2 of gold black 31.
  • the thermocouple sensor is thermally isolated from the substrate and exposed to the incident radiation.
  • the cold junctions, not shown, are thermally connected to the substrate as a heat sink and shielded from the light. Additional layers may be used to connect several thermocouples in series to produce larger signals.
  • the thin film thermocouples have a low heat capacity which produces fast response times of about a millisecond. This fast response time allows use of an amplifier tuned to the "chopper" frequency to reduce unwanted background signals, hi an alternative embodiment, 2D thermal imaging maybe used. An array of such elements are placed on the photo sites 27 of Figure 7 and inject charge into the CCD.
  • Each component shown Figure 3 has a characteristic that is strongly dependent on wavelength. To achieve the desired accuracy (e.g. 10% for glucose) these dependencies must be accounted for.
  • Integrated radiation sources may easily have an emission spectrum that varies by a factor of 10 or more over wavelength range. This variation is partially compensated for by the design of the emitting array.
  • Use of the narrow band filter with constant percentage passband significantly compensates at the IR end of the spectrum.
  • the ear lobe has absorbances that are strongly wavelength dependent and have both skin tissue and blood components.
  • the analyte measurement device of the present invention uses an automatic compensation scheme to account for the varying skin dependencies among individuals, hi one embodiment, a ratiometric technique against a known spectral shape component such as water or albumin yields suitable correction factors.
  • the source optics, collimator optics, narrow band filter and sensor wavelength dependencies are calibrated and thereby taken into account.
  • Non-invasive glucose monitoring in diabetic patients has shown a more than 50% variation of transmittance in some cases at 900 nm for glucose over the physiological range (2.7 to 27.7 mmol/L). Achieving a glucose measurement accurate to within 10% thus implies a transmittance accuracy of at least 2%. To achieve this accuracy, absorbance measurements accurate or repeatable to 0.1% give a sufficient margin. A 13 bit analog to digital converter is therefore recommended. In a preferred embodiment of the present invention, a 16 bit integrated converter is used.
  • the present invention uses radiation either reflected or transmitted through tissue at the measuring site, including skin, sub-dermal tissue, and blood, so the received signal is a mixture of signals from blood and tissue.
  • One embodiment of the present invention achieves the separation of the blood-related component of the signal from the tissue component of the signal by accepting only the portion of the mixed signal which has a pulse synchronized with the heart pulse. This presumes that the pulsations come from the moving arterial blood or closely related matter and thus allows a signal associated with the blood to be separated from that associated with the tissue. Pulse oximeters, for example, operate using this method. In a preferred embodiment, hematocrit is used to determine the portion of the signal associated with the blood. This technique has two advantages. First, it results in a faster response time because there is no need to wait for heart beats. Second, there is less signal loss due to synchronous signal extraction (the synchronous method removes some blood associated signal unnecessarily).
  • Figure 9 shows a preliminary schematic diagram for a sensor module.
  • the sensor module is the portion of the analyte measuring device which is positioned on the target tissue and bears the radiation source and sensors, among other things. Everything is integrated onto a single CMOS chip 8 as shown, except the battery 10, radio antenna 9, and one or more capacitors (used, for example, as power filter and charge pump).
  • Figure 9 shows the sensor arrays integrated on the chip as well.
  • Figure 3 depicted a separate light source mounted on the other side of the ear for measuring the transmission TR spectra transmitted.
  • the schematic shown in Figure 9 depicts the alternate embodiment, in which the light sources are also integrated onto the chip. While Figure 3 shows transmission and Figure 9 implies a reflection mode, both embodiments are fully encompassed by the present invention.
  • Figure 10 shows a block diagram of functions inco ⁇ orated into the CMOS chip and the sensor arrays; one for visible light (e.g. a silicon CCD array), and one for the IR region (e.g. a thermocouple array). Preamplifiers are included for each sensor. The spectral data output from the sensors is digitized by the analog-to-digital converter. A charge pump to stabilize operating voltages and a gated RIP oscillator for the data transmitter are preferably included in the CMOS chip as well. One embodiment also includes integrated light sources.
  • the block diagram shows a microprocessor embedded in the chip. However, a state table design is a viable alternative embodiment.
  • a “pocket monitor” is provided in a preferred embodiment for displaying analyte measurements in the field.
  • a block diagram for the pocket monitor is shown in Figure 11.
  • a pocket monitor may be dedicated to a specific individual for data logging and downloading (optional) to a computer at a more convenient time.
  • the pocket monitor contains a radio receiver tuned to a specific sensor transmitter frequency. Data from the sensor module is received and processed for prompt display and storage.
  • the pocket monitor also preferably utilizes an LCD display screen where data may be presented.
  • a graphics mode showing analyte readings for the recent past can also be displayed.
  • the first utilizes existing IRDa hardware available in some personal computers. This embodiment eliminates the need for a separate receiver to be supplied by the personal computer.
  • the second embodiment has a separate receiver that plugs into an existing I/O port in the personal computer.
  • the receiver accepts the low-power radio frequency transmissions either from the sensor module directly or from the pocket monitor, translates the tramsission into an acceptable I/O format (e.g. RS-232), and then sends the information to the host personal computer via an I O port.
  • an acceptable I/O format e.g. RS-232
  • the software package for the personal computer is based on a user-friendly platform (e.g. Windows 95).
  • the software uses simple GUI (Graphic User Interface, e.g. Visual Basic) that allows for quick and easy results evaluation.
  • GUI Graphic User Interface, e.g. Visual Basic
  • the software takes the information received from the I/O port (e.g. an IRDa port or RS-232 port) and imports this information into a database.
  • Algorithms evaluate the spectra data and provide the individual with readily understood information on concentrations of the analytes of interest. These results may be displayed on a "screen" on the personal computer monitor.
  • the software enables further analysis and manipulation of the analyte measurement data on the display.
  • An alternative embodiment inco ⁇ orates a modem feature that would allow a personal computer to transmit some or all of the information to a main computing center via information transmission means (e.g. a phone line).
  • Information transmission means e.g. a phone line.
  • Spectrophotometry is an important aspect of the present invention.
  • spectroscopic methods are in use covering all regions of the electromagnetic spectrum from x-ray to radio wavelengths.
  • the x-ray and UV regions are not preferred because of the greater possibility of damage to the region of the body being tested.
  • the radio region of the spectrum is also not preferred because the physical structures required to generate and sense radio signals differ substantially from those of the preferred embodiments.
  • the preferred spectral regions for use by the analyte measuring device are thus the visible, near-infrared, and infrared regions of the spectrum.
  • ⁇ -D-glucopyranose shows abso ⁇ tion peaks in the IR finge ⁇ rint region at 1458, 1435, 1365, 1325, 1235, 1205, 1152, 1109, 1080, 1035, and 996 cm '1 , and a mere listing of the peaks leaves out a great deal of the complexity of the actual spectra.
  • Very high order polynomials for example, with hundreds of terms
  • tabular methods fitted to individual species spectra are used alongside multivariate analysis techniques or orthogonal function methods to capitalize on this inherent complexity.
  • Table 1 shows the basic separation of blood constituents into solids (formed elements) and liquids (blood plasma). The solids represent about 45% of the blood while liquids (55%) represents the rest.
  • the components of interest for the present invention are contained in the plasma. As seen in Table 1, plasma is about 90% water, with another 8% as plasma proteins, leaving about 2% of the plasma for the analytes of interest. That is, 2% of 55% or roughly 1% of whole blood.
  • the sensor module is configured to measure spectral amplitude significantly better than 1% (first estimate) in order to obtain data sufficiently accurate to resolve the analytes of interest.
  • Erythrocytes anucleate contain hemoglobin
  • Neutrophils granulocytes, polymo ⁇ honuclear
  • Eosinophils granulocytes, bilobed nucleus Eosinophils granulocytes, bilobed nucleus:
  • Basophils 0.5- granulocytes, 2-5 lobed nucleus
  • Lymphocytes agranulocytes, circular nucleus
  • T cells (20-25%) T cells, B cells; immune response, antibodies agranulocytes, large kidney-
  • Table 2 shows these blood components arranged in order of molar concentration.
  • the components are arranged this way because the spectrum of each, as related by Beers' Law, is typically normalized against molar concentration. Supposing that the relative strength of the spectra correlates with molar concentration (not always true), the table provides an approximate ranking of the components that can be used to decide which ones must be retained for compensation when measuring an analyte (such as glucose). As seen in Table 2, glucose ranks 10 th and lactate ranks 16 th .
  • the other analyte ranking in Table 2 is by mass concentration.
  • the larger molecules, such as hemoglobin or albumin, may have multiple absorbing sites per molecule.
  • the absorbance, A is the logarithm of the transmittance.
  • the molar extinction coefficient, ⁇ is a function of wavelength, ⁇ , alone.
  • the molar extinction coefficient ⁇ is measured over a range of wavelengths to form the abso ⁇ tion spectrum that would be associated with the particular analyte.
  • the molar extinction coefficient, ⁇ is measured for each analyte of interest to form a set of spectra, ( ⁇ j, ⁇ 2 , ..., ⁇ ) over the wavelength range of interest.
  • Beers' Law allows simple addition of the absorbance of each one.
  • a t otai A ⁇ + A 2 +...+ A r .
  • Atotai / b Ci ⁇ i + C 2 ⁇ + ... + CN ⁇ N
  • Fribrinogen 200 400 mg/dL
  • Triglyceriedes 10 190 mg/dL
  • the total absorbance divided by path length is seen to be a linear supe ⁇ osition of spectra, ⁇ j, according to the molar concentration of each one, Q. Note that the definition can be shifted to use mass concentration rather than molar concentration, even term-by-term, and Beers' law will still apply.
  • the set of spectra ( ⁇ i, ⁇ 2 , ..., ⁇ >j) is assumed to be known by prior laboratory measurement.
  • the optical path length, b is also assumed to be known, (hi the lab, b ⁇ ab can be fixed precisely. But in the embodiment where analytes in the ear lobe are being measured and focusing is used , b ea may be a function of ⁇ also.
  • the composite spectrum and reference spectra are measured.
  • concentration coefficients are determined using Beers' law.
  • Table 2 lists about 28 primary blood components. A molar extinction coefficient can be determined for each component so that all 28 terms are included. Of course, analytes beyond those listed in Table 2 may also be measured using the present invention. Determination of all 28 molar extenction coefficients, ⁇ , is preferred. Alternately, the calculation may be limited to only the components that are prominent with respect to the analyte of interest. For example, glucose ranks 10 th in Table 2 molar concentration. Limiting the calculation to the analytes with 20% or more prominence with respect to glucose will give a model with sufficient accuracy for glucose determination, using perhaps only 25 or 30 terms.
  • Near IR spectroscopy has been used to extract the concentration of blood analytes such as albumin, glucose, triglycerides and others. Using this method, linear indications of the analyte concentration can be obtained, provided that everything is held constant except the analyte being measured. Usually a “baseline” or reference level must be established through other means. Attempts to measure glucose concentration using near IR spectroscopy have encountered difficulty, primarily from “baseline drift". As other analytes in the blood vary - for example, albumin - the measurement of glucose changes also. The glucose "baseline” shifts because of the albumin change, for example, causing erroneous glucose readings.
  • the present invention preferably uses self calibration to compensate for the various problems encountered in the near-IR determination of blood analyte concentration.
  • Self calibration relies on the ratio of analyte measurement against a reference material. For analyte measurement in blood, there are two reference materials present in all animals, namely hemoglobin and water. Measuring the concentrations of hemoglobin and water simultaneously with the analyte of interest, an arithmetic ratio may be calculated. This provides a number of advantages.
  • the ratio conforms better to commonly accepted definition of concentration, i.e., the amount of analyte per unit of blood. Hemoglobin and water account for about 94% of blood, providing a good basis for the assessing of the amount of blood in the test volume.
  • concentration i.e., the amount of analyte per unit of blood.
  • Hemoglobin and water account for about 94% of blood, providing a good basis for the assessing of the amount of blood in the test volume.
  • measurement of hemoglobin and water at the same time as the analyte of interest means that variations that affect the analyte measurement also affects hemoglobin and water. Thus, the ratio should automatically compensate a substantial part of these variations.
  • hemoglobin occurs only in the blood, it can be used to make a hematocrit determination, based on the proportion of blood by volume made up of erythrocytes, to separate blood and tissue.
  • the pulsatile method is used to determine a signal associated with the arterial blood movement using the hemoglobin signal, then a ratio of pulsatile hemoglobin to total hemoglobin can be made. Call this ratio the P/B ratio. If the pulsatile component of the analyte of interest is found, the same moving volume is assumed and the P/B ratio used to determine how much of the analyte is in the blood, and how much is in the tissue. For a given analyte, once its fractions are known, the largest signal (usually the tissue signal) can be used to imply blood concentration because the fraction in the blood is not be expected to change very rapidly. The smaller pulsatile signal may then be re-measured over a longer time period, to improve accuracy, with the analyte fraction updated periodically. This method improves accuracy while allowing faster measurements and maintaining self calibration.
  • the method and apparatus of the present invention compensates for individual variation in measurement due to skin and tissue characteristics. Since the spectra of water and hemoglobin are well known, the spectrum of the skin and tissue may be determined simultaneously with the measurement of other analytes. A reference color is chosen corresponding to a prominent abso ⁇ tion peak (e.g., of water). For example, if water is the dominant absorber at a particular wavelength, then the rest of the spectrum may be corrected based on the known spectrum of water, at least over the wavelengths down to perhaps 700 nm where water becomes transparent. Similarly, the spectra may be corrected using other dominant absorbers at a particular wavelength.
  • a prominent abso ⁇ tion peak e.g., of water
  • hemoglobin becomes the dominant absorber and can be used to extend the correction based on the known spectrum for hemoglobin down to near 450 nm. Correcting factors are thereby used to extract the dominant features of the skin and tissue. As additional analytes are extracted from the skin and tissue spectrum, a large spectrum remains that is associated only with the skin that exhibits a roughly constant absorbance of about 2. This spectral pattern is associated with chemical components not present in the blood. If the original reference wavelength were to produce an appreciable absorbance error, this would show up as a constant error over wavelength. Computing the ratio for the analyte of interest would cause this type of error to disappear since the analyte is affected the same way.
  • the calculation may be corroborated by performing a similar calculation on the pulsatile spectra. Overlapping peaks have previously made computing the concentration of a particular analyte using IR spectroscopy difficult, as it hard to distinguish between the portion of the peak caused by the analyte and that caused by other components present.
  • One technique used to combat this problem is to compute the second derivative of the spectra to sha ⁇ en the peaks. This reduces the problem by reducing the amount of overlap, but does not solve it completely, because of the very large ratio between the concentration of interfering analytes and the analytes of interest. This effect is typically the major source of error in attempting to extract a single analyte such as glucose, or any analyte for that matter.
  • the apparatus and method of the present invention preferably uses Linear Regression techniques (including partial least squares methods) and Orthogonal functions to correct for the problem of overlapping peaks and other spectral defects.
  • the present invention preferably utilizes linear regression or least squares technique. These methods produce an accurate measurement of analytes provided all the interaction terms are included. Hall and Pollard, referenced earlier, includes an excellent discussion of least squares fitting of data and the method of partial least squares for including interactions. The disclosure of this reference is hereby inco ⁇ orated. These methods are useful in their own right, and may be used to determine the weighting function, w, described below.
  • a preferred embodiment of the present invention utilizes orthogonal function techniques. Orthogonal functions behave very much like vectors, and an "inner product" may be defined,
  • the two functions ⁇ i, and ⁇ 2 are said to be orthogonal if ⁇ ⁇ i
  • ⁇ 2 > 0 for the weighting function w.
  • the weighting function, w acts to make the basis functions, or analyte spectra, orthogonal over the wavelength, ⁇ , of interest.
  • the weighting function is positive.
  • adjustable candidate weighting functions include quadratics.
  • at least one of the basis functions must change sign over the interval in order for the defining integral to be zero.
  • the basis functions, or analyte spectra in the present invention are based upon abso ⁇ tion, which is always a positive number.
  • the first or second derivatives of the basis functions, or analyte spectra may be taken.
  • the "ac" component (wherein the average value is subtracted) of the basis function, or analyte spectra may be used.
  • a single adjustable parameter is needed to find a weighting function.
  • the water spectrum (which absorbs primarily at long wavelengths) can be made orthogonal to the deoxyhemoglobin spectrum (which absorbs primarily in the 500-600 nm region) if the "ac" method is used and the weighting function (x- a) 2 is used.
  • the parameter, a is adjusted until the defining integral is zero.
  • the four hemoglobin sub-types have sufficient features that they may also be made mutually orthogonal.
  • 378 (or 28 x 27 / 2) adjustable parameters are necessary to find a weighting function. Other methods for finding weighting functions may also be used.
  • one weighting function can be found that makes water orthogonal to the other 27 basis functions, which then requires only 27 adjustable parameters. This weighting function may then be used to decompose the water portion of the spectrum. Another weighting function may be found which makes Hb orthogonal to the remaining 26 basis functions (water already being removed). This second weighting function requires only 26 adjustable parameters. And so on for the remaining basis functions. The result is a set of 26 weighting functions rather than just one which accomplishes the same decomposition. Further, because the concentrations of the analytes drop off quickly, another possibility is to remove the analytes in groups. For example, water and the four kinds of hemoglobin may be removed first and the residual spectrum examined thereafter for another group of analytes.
  • any specific coefficient of interest for example, the molar concentration of the nth component, CN
  • the composite spectrum, CS is multiplied by the weighting function w and by the basis function, in the present invention the analyte spectra, associated with the coefficient of interest, for example, the molar extinction coefficient of the nth component, ⁇ n.
  • IR and near-IR spectra may be analyzed using orthogonal functions as described above.
  • the spectra for the blood analytes are used as basis functions and made orthogonal by proper selection of weighting function w.
  • the weighting function or functions are found that make the basis functions orthogonal over the wavelength range of interest. Note that the bulk of the calculations involving reference spectra and weighting functions are performed in the laboratory.
  • the processor of the analyte measuring device can then calculate the result in as little time as a few seconds.
  • the calculations necessary "in the field" consist of only one integration of the spectrum for each analyte. If 28 analytes are being considered, for example, and the integrations take only a millisecond or so (which is within the capacity of available processors), the 28 integrations necessary may be accomplished in under one second.
  • the method and apparatus of the present invention can account for perhaps 100 analytes or more.
  • the number of coefficients needed to determine the weighting function may then be on the order of several thousand.
  • the invention makes use of a matrix that is 1000 x 1000 or larger that must be inverted to determine the weighting function. This may be readily accomplished, as SPICE circuit simulations, for example, routinely invert matrices this size and larger, especially for transient simulations where the typical simulation inverts large matrices thousands of times in a typical run.
  • Polynomial fitting of the spectra for glucose and albumin has also been accomplished using the Microsoft EXCEL matrix inverter.
  • Microsoft EXCEL has built in functions to invert matrices up to 256 x 256 elements, which allows up to 256 data points to fit the spectra.
  • orthogonal polynomials in this invention provides a distinct advantage over the use of linear regression.
  • w ⁇ ⁇ > is determined at the lab or factory, and only one integration, ⁇ CS
  • linear regression requires an iterative solution of multiple analytes simultaneously to extract the one of interest.
  • the orthogonal function method also yields a weighted least squares fit of the data. Any of the currently used techniques, such as second derivative peak sha ⁇ ening, may also be used to improve performance of the invention. Compensating for the 20 or 30 dominant background components eliminates the accuracy and baseline drift issues existing in previous efforts in this area.
  • the data processing of the present invention resolves numerous other problems as well. For example, overlapping peaks are corrected for by using orthogonal functions. Sample density variations are dealt with by measuring the sample average concentration. Over- fitting of the data may be a statistical problem and should be avoided in determining which ⁇ s should be used.
  • Computational problems may also have a negative impact on accuracy.
  • a significant example of this is large concentration differences.
  • comparing albumin at 5 g/dL and glucose at 100 mg/dL represents a 50:1 concentration ratio. This has implications on the measurement accuracy required.
  • Glucose absorbs at wavelengths where albumin does not, for example, so that the problem in this particular case is abated somewhat.
  • the net numerical effect may be that albumin, measured at its abso ⁇ tion peaks, is used to compensate for albumin effects at the glucose peaks. Since ⁇ for albumin is known, the method of orthogonal functions provides a strong advantage because it inherently compensates for the albumin effects at the glucose peak. Obtaining 10% glucose accuracy requires spectral absorbance measurements of 1% or better because of the concentration differences, but as mentioned earlier this is within the capability of the method and apparatus of the present invention.

Abstract

A device and method for measuring the concentration of analytes in the blood of a portion of tissue. The device includes a sensor module, a monitor, and a processor (separate from or integral with the sensor module). The sensor module includes a radiation source for emitting radiation to the tissue; a collimator and narrow band filter for processing the radiation after it has transmitted through or been reflected by the tissue; and one or more sensors for sensing the transmitted or reflected radiation. The one or more sensors send a signal to the processor which algorithmically converts the radiation using linear regression or orthogonal functions to determine the concentration of one or more blood analytes. The device self-calibrates to eliminate error caused by variables such as skin character. The sensor module is integrated to reduce size and weight such that it is inobtrusive, and the monitor is compact for transport.

Description

A NON-INNASINE BLOOD ANALYTE MEASURING SYSTEM AND METHOD
UTILIZING OPTICAL ABSORPTION
Cross-Reference to Related Applications This application is entitled to the benefit of U.S. Patent Application No. 10/104,782, entitled, "Noninvasive Blood Analyte Measuring System and Method Utilizing Optical Absorption" by Edward Wuori, filed March 21, 2002.
Field of the Invention The present invention relates to a method and apparatus for non-invasive monitoring of various blood analytes in humans and other animals in the fields of medicine, sports medicine, military hardware, anemia treatment, diabetes treatment, and traumatic injury treatment.
Background of the Invention
This invention relates to a non-invasive apparatus and methods for in vivo monitoring of the concentration levels of various blood analytes within a living subject, using optical absorption spectrophotometry. The device and methods may be used to simultaneously monitor several analytes found in the blood outside of a laboratory setting. The device and methods are able to resolve analytes down to approximately one mg/dL. Further, the device and methods are able to measure all blood analytes present at approximately one mg/dL, including glucose and lactate, for example.
Information concerning the concentrations of blood analytes is widely used to assess the health characteristics of people. For example, lactate is becoming the measurement of choice in sports and coaching to assess levels of conditioning for athletes and to prevent overtraining. Lactate threshold and other related parameters are used to assess the aerobic and anaerobic status of athletes, are correlated to athletic performance, and may be used to "rank" athletes according to actual performance history. Lactate monitoring, as used in athletics, may also be useful for Military Academies, Army boot camps, and other physical training operations to assess the physical condition of trainees, to improve training programs, and to evaluate the effectiveness of training regimens on specific individuals. Lactate is also widely used to assess the medical condition of injured people. When serum lactate elevates after an injury, whether or not the lactate clears is correlated strongly with mortality, thus, measurement of serum lactate levels is a key tool in assessing treatment.
Likewise, the monitoring of blood glucose has long been an important tool in controlling diabetes in diabetic patients. Diabetes is a high maintenance disease, generally requiring several measurements of blood glucose daily. At present, this is typically accomplished using a glucometer, in which a fresh blood sample must be obtained for each measurement. Each measurement typically requires a new "test strip" for receiving the blood sample, the test strips characteristically being relatively expensive. Such measurements are often painful, cumbersome, and moderately time-consuming. The method of testing blood glucose using a test strip is generally referred to as the "finger stick" method. It specifically involves applying a drop of blood to the test strip, the test strip using molecular sieves to block molecules larger than molecular weight of about 200. The sieves consequently block, for example, large glycosylated proteins from being included in the blood glucose measurement. Due to the inconvenience and expense, many diabetic patients do not monitor their blood glucose levels as often as recommended. About 16 million diabetic patients in the United States need to regularly monitor their blood glucose levels.
A non-invasive device enabling painless and convenient monitoring of blood glucose would be of great benefit to diabetic patients. The relative ease of measurement may contribute to a more regular blood glucose monitoring regime by diabetic patients. Various attempts have been made at a blood glucose measurement device using spectroscopy. However, those attempts have generally had problems with "baseline drift" of unknown origin. It is hypothesized that the absorption method used in most spectroscopy devices for measuring glucose in the blood measures all glucose in the blood, both the bound glucose and the free glucose. For the purpose of diabetes management, measurement of the concentration of free glucose is desired. That is, the concentration of free glucose in the blood is generally recommended to be in the range of 80 mg/dL and 120 mg/dL. A diabetic patient will measure their blood glucose level to determine whether the level is within the recommended range. If the blood glucose level is outside of the recommended range, the diabetic patient will typically inject insulin to reduce the blood glucose level. Again, it is the free glucose concentration level that is relevant to determining whether the patient's blood glucose concentration is within the recommended range. Because absorption techniques may measure both free and bound glucose levels as one measurement, there may be an overstatement of the blood glucose level that results in faulty treatment by the patient. The molecular sieves of the test strip glucometers described above correct for the possibility of measuring bound and free glucose by preventing the bound glucose, with a relatively high molecular weight, from passing through the sieve.
It is notable, however, that the finger stick methods take only one measurement of the glucose concentration level in the blood and, for a series of measurements, require a series of blood samples, generally obtained by a series of finger pricks. Consequently, the finger stick methods do not offer an appealing method of continuous measurement of blood glucose concentration in the blood. Continuous measurement of blood glucose levels enable near instant recognition of abnormal blood glucose levels whereas a series of individual measurements inevitably includes periods of time where the precise blood glucose level is unknown. Thus, a diabetic patient may be better able to control blood glucose levels. It may also assist the person in adjusting their lifestyle, diet, and medication for optimum benefits. Providing the easy, non-invasive, and optionally continuous monitoring provides a great improvement in the treatment of the diabetes and allows the treatment to be tailored to the individual.
Many other blood analytes with concentrations similar to or greater than lactate and glucose are of fundamental importance; for example, hemoglobin and its sub-types, albumin, globulins, electrolytes, and others. Hemoglobin is important especially in the monitoring of anemia caused by various various factors such as HIN infection and chemotherapy. Anemia treatments need frequent monitoring of hemoglobin to assess effectiveness of various treatments such as Epoetin- Alpha therapy.
Spectrophotometry provides a useful method for determining the presence of analytes in a system. A typical spectrometer exposes a dissolved compound to a continuous wavelength range of electromagnetic radiation. The radiation is selectively absorbed by the compound, and a specfrograph is formed of radiation transmitted (or absorbed) as a function of wavelength or wave number. Absorption peaks are usually plotted as minima in optical spectrographs because transmittance or reflectance is plotted with the absorbance scale superimpose, creating IR absorption bands.
At a given wavelength the absorption of radiation follows Beers' Law, an exponential law of the form: A = ε C b Where: A = absorbance = -logι0(t ).
t = fraction of radiation transmitted (or reflected). ε = molar extinction coefficient, cm2/mol. C = concentration, mol/cc. b = thickness presented to radiation, cm.
The wavelengths of maximum absoφtion, λmax, and the corresponding maximum molar extinction coefficient, εmax, are identifying properties of a compound. Radiation causes excitation of the quantized molecular vibration states. Several kinds of bond stretching and bond bending modes may be excited, each causing absoφtion at unique wavelengths. Only vibrations that cause a change in dipole moment give rise to an absoφtion band. Absoφtion is only slightly affected by molecular environment of the bond or group. Nevertheless, these small'chemical shifts may aid in uniquely identifying a compound. A "fmgeφrint region" exists between 42 and 24 THz (1400 and 800 cm"1) because of the many absoφtion peaks that occur in this region. It is virtually impossible for two different organic compounds to have the same infrared (IR) spectrum, because of the large number of peaks in the spectrum. While the peaks and valleys are the traditional features used in this type of spectrophotometry, the overall shape of the spectra may also provide useful information, especially in mathematically separating mixed spectra where more than one analyte is present. In addition to the IR absoφtion bands, absoφtion peaks also occur in the near-IR region (700 - 2500 nm). Absoφtions in this region are most often associated with the overtone and combination bands of the fundamental molecular vibrations of -OH, -NH, and -CH functional groups that are also seen in the mid IR region. As a result, most biochemical species will exhibit unique absoφtions in the near-IR. In addition, a few weak electronic transitions of organometallic molecules, such as hemoglobin, myoglobin, and cytochrome, also appear in the near-IR. These highly overlapping, weakly absorbing bands were initially perceived to be too complex for inteφretation and too weak for practical application. However, recent improvements in instrumentation and advances in multivariate chemometric data analysis techniques, which may extract vast amounts of chemical information from near- IR spectra, allow meaningful results to be obtained from a complex spectrum. Absoφtion bands also occur in the visible range (400 - 700 nm). For example, hemoglobin and bilirubin absorb strongly in this region.
Traditionally, Near Infrared Spectroscopy (NIRS) has been used to estimate the nutrient content of agricultural commodities. More recently NIRS has become widely applied in the food processing, chemical, pulp and paper, pharmaceutical, polymer, and petrochemical industries.
Invasive devices and methods of quantifying and classifying blood analytes using IR and other optical spectrophotometry methods are very commonly known. Invasive procedures are those where a sample such as blood is taken from the body by puncture or other entry into the body before analysis. Invasive procedures are undesirable because they cause pain and increase the risk of spread of communicable, blood-borne diseases. Further, after the invasive collection of body samples, these samples may need to be further prepared in the laboratory by adding water or ions to the samples to increase the accuracy of the spectrophotometry readings. Thus, these commonly known devices and methods are often only suitable for use under laboratory in vitro conditions and are too difficult to be practically applied in athletic training and military situations. It is noted, of course, that the finger stick method of measuring blood glucose concentration levels using a glucometer has been adapted for home use.
Recently, non-invasive devices for monitoring levels of blood analytes using infrared spectroscopy have been developed. For example, U.S. Patent 5,757,002 by Yamasaki relates to a method of and an apparatus for measuring lactic acid in an organism in the field of sports medicine or exercise physiology. Also, U.S. Patent 5,361,758 by Hall relates to a non- invasive device and method for monitoring concentration levels of blood and tissue constituents within a living subject. Previous non-invasive devices and methods typically require time-consuming custom calibrations to account for the differences between individuals and environmental factors which cause variation in energy absoφtion. There are several factors that may result in variation in energy absoφtion; for example, environmental factors such as temperatures and humidity that may affect the equipment, and individual factors such as skin coloration, skin weathering, skin blemishes or other physical or medical conditions. This need for custom calibration to each individual makes it impractical to use previous devices on demand in training situations or at the scene of accidents. A universal or self-calibrating device that is capable of taking into account these variations would be useful. Further, many previous non-invasive devices and methods accurately measure only a single blood analyte at a time. Most typically, the devices are designed to measure blood glucose. To measure a different analyte, the device must be reprogrammed or otherwise altered. Even with such reprogramming or alteration, the devices may not typically measure the results of two or more analytes at the same time without significant inaccuracies. Each analyte in the blood sample contributes a unique absoφtion pattern to the overall infrared spectrum, governed by the unique set of molecular vibrations characteristic of each distinct molecular species. The infrared spectral range extends from 780 nm to 25,000 nm and is commonly subdivided further into the near-infrared and mid-infrared regions. Most devices obtain an measurement of an analyte by using only a small portion of the IR spectrum reflecting the particular analyte of interest. In those devices that do attempt to use a wider spectrum to obtain multiple analyte readings, relatively ineffective methods are used to separate and account for multiple analyte spectral interferences, leading to decreased accuracy. Thus, there exists a need for a device that may successfully use a wider spectrum to accurately and simultaneously isolate and determine the concentrations of multiple analytes.
IR spectroscopy typically involves radiating light onto a portion of tissue for either transmission through the tissue or reflection from the tissue. The transmitted or reflected radiation is then analyzed to determine concentrations of analytes. However, the radiation that is transmitted or reflected is not just transmitted through or reflected from the blood, but instead includes transmissions or reflection from the skin, subdermal tissue, and blood. Thus, the received radiation is a mixture of absoφtion signals from skin and tissues and blood. The signals contributed by the skin and tissues make it difficult to accurately measure the presence of blood analytes. These signals need to be separated to eliminate the effects of skin and tissue in order to measure the analytes in the blood. Previous non-invasive devices and methods were unable to separate blood-related readings from body tissue readings. Therefore, there is a need for a device capable of separating the blood-related component of the signal from the tissue component.
One method of achieving the separation of a blood-related component of the signal is to accept only the portion of the mixed signal which has a pulse synchronized with the heart pulse, known as a pulsatile technique or synchronous detection. The pulsatile signal is the time varying portion of the whole signal that is synchronized with the heart beat. This method presumes that the pulsations come from the movement of arterial blood or closely related volume and allows a signal associated with the blood to be separated from that of tissue. The synchronous method is widely used for separating blood-related components in pulse oximeters.
Another possible method for achieving separation of the blood related components of the signal from tissue and skin related components uses a hematocrit-type method to determine the portion of the signal associated with the blood. The hematocrit is the proportion, by volume, of the blood that consists of red blood cells. The hematocrit is typically measured from a blood sample by an automated machine that makes several other measurements at the same time. Most of these machines do not directly measure the hematocrit, but instead calculate it based on the determination of the amount of hemoglobin and the average volume of the red blood cells. Using a hematocrit method generally is faster than using a synchronous method because there is no need to wait for heart beats. Further, there is less signal loss associated with hematocrit methods than with the synchronous method, the synchronous method removing some blood associated signal unnecessarily. Finally, many non-invasive devices for in vivo monitoring of blood analyte concentrations do not allow for an ambulatory application. They typically utilize permanent equipment set up in a laboratory or other test site, which makes it impossible to use while away from the laboratory or other test site. Thus, there is a need for a device that may be easily transported and used away from the laboratory. The device would preferably not interfere with the user's normal functioning and would greatly increase the utility and range of analyte concentration monitoring beyond the laboratory setting.
Summary of the Invention
The present invention provides an improved apparatus and method for the rapid, non- intrusive determination of the concentration of blood analytes. In one embodiment, it provides a portable tabletop unit for measurement of blood analyte concentrations where the subject may walk up to the device for measurement from a body part, such as a finger. However, there are many situations where blood analyte measurement must be done outside of a domestic or laboratory environment. Thus, another embodiment of the present invention provides a portable system which may be positioned on body tissue and transported on the user's person. Features such as small size, a wireless sensor, battery operation, portability, and downloadability demonstrably increase the utility and range of the analyte measurement apparatus of the present invention beyond the hospital or laboratory setting. The present invention also provides a method and apparatus with increased sensitivity and accuracy. A problem encountered in the area of blood analyte measurement via IR spectroscopy is accuracy and drift. In general, other analytes and various other substances present interfere with the IR measurement of the desired analyte. These analytes vary in concentration and thus vary the IR spectrum in the regions being used to determine specific analyte concentration. The present invention corrects for all other analytes with concentrations sufficient to interfere in the determination of the concentration of the analyte or analytes of interest. Measuring the entire visible and IR spectrum provides enough data to simultaneously determine all of the analytes and thereby compensate for any accuracy or drift problems their concentration may cause in measuring the concentration of the analyte(s) of interest. Data processing using orthogonal functions is used to accomplishing this task. Other properties of blood may also effect the IR measurement of the desired analyte. For example, turbidity of the blood, as may be caused by elevated white cell count or high blood lipids, may affect the measurement. These factors appear in the spectra and are compensated for by the present invention. The analyte measurement apparatus of the present invention is sufficiently sensitive to detect blood glucose or lactate with accuracy within, approximately, 10% of the level actually present, and may do so in a short period of time (e.g. 5 seconds or less). Due to the non-intrusive nature of the measurement and its relative rapidity, it is also possible to monitor blood analyte levels essentially continuously. The blood analyte measurement apparatus of the present invention includes a radiation source for generating and transmitting a spectrum of radiation onto a portion of tissue (for transmission therethrough or reflection therefrom), one or more sensors for detecting the radiation either transmitted through or reflected from the tissue over a broad spectrum and generating an output in response to the detected radiation, and a processor for receiving output from the sensors to determine the concentration of blood analytes in the portion of tissue, hi a preferred embodiment, the apparatus also makes use of a mounting device to position the radiation source and the sensors relative to a portion of tissue so the one or more sensors may receive a substantial portion of the radiation produced by the radiation source and transmitted through or reflected by the portion of tissue. In a further preferred embodiment, the information regarding absoφtion of the radiation is then algorithmically processed to clarify the signal(s) of the desired blood analytes. Thus, the invention, in a typical configuration, includes a sensor module which is preferably attached to an earlobe, a pocket monitor for immediate readout and data logging, and a data link to a PC for long term storage and compilation of data. Thus, blood analyte levels may be continuously monitored without the constraints of attachment wires or bulky apparatus.
The blood analyte sensor module is integrated as much as possible to reduce the size and weight. In one embodiment, the sensor module is completely self-contained. The sensor module illuminates the measurement site with a built-in radiation source tailored to the spectral region of interest. The radiation source and the sensors are each positioned on a chip. The radiation source may be integrated onto a custom chip in transmission mode, or onto the same chip as the sensors in reflection mode. That is, when it is desired to receive and inteφret radiation transmitted through the tissue, the apparatus is working in transmission mode and the radiation source is positioned on a chip separate from the chip on which the sensors are positioned. In contrast, when it is desired to receive and inteφret radiation that is reflected from the tissue, the apparatus is working in reflection mode and the radiation source may be positioned on the same chip as the chip on which the sensors are positioned. Preferably, the radiation source is a thermal radiator made up of tungsten or tantalum positioned over a reflective heat shield.
The blood analyte measurement apparatus also optionally includes a focusing device for focusing the radiation from the radiation source onto a point on the tissue. A fresnel lens, for example, works well in this capacity. The apparatus also optionally includes a collimator to compensate for the scattering that typically occurs when the radiation passes through tissue. The beam divergence of the collimator, if used, should be approximately 5 degrees or less.
A filter may also be included to separate the radiation received by the sensors into various wavelengths subsequent to collimation. The preferred filter for this separation is a Fabry-Perot narrow band interference filter comprising a dielectric film between two metal films, where the dielectric film has a graded thickness running from a short wavelength end with a thickness of about 100 nm to a long wavelength end with a thickness of about 2.5 microns. Between the narrow band interference filter and the sensors is a planarizing layer. The spectrophotometer bears sensors which are preferably sensitive to radiation from wavelengths of about 700 nm to about 2500 nm. The sensors within the sensor module are divided into two groups: direct silicon sensors sensitive to radiation of a wavelength range from about 0.4 to 1.1 microns, and infrared sensors sensitive to radiation of a wavelength range from 1 to 10 microns. Using both types of sensors, the apparatus of the present invention preferably uses an array of approximately 1024 elements, for an overall filter passband of about 0.22 percent of its center wavelength or frequency. The direct silicon sensors may be, for example, either photodiodes or charge coupled devices. A charge coupled device array made up of multiple elements sensitive to differing portions of the wavelength range is preferred. The infrared sensors making up the rest of the array may, for example, be extrinsic silicon, pyroelectric, photoconductor, or thermocouple sensors. Thermocouples comprising two layers of metal with an additional layer of gold black are preferred, where the two metal layers may be either nickel-chromium alloy on nickel-copper alloy, for example. The sensor module may include a replaceable, rechargeable battery and use a unique ID code if desired. A processor is provided for processing the output from the sensors. If desired, an RF transmitter or other device may be provided for wirelessly transmitting the signals from the sensors to the processor. This processor is preferably a CMOS microprocessor, which uses a Boolean algorithm to process the output from the sensors. Various processing algorithms are used to enhance the value of the data obtained from the sensors. The blood analyte measurement apparatus may also include a display, typically a liquid crystal display, for the immediate display of data to the user. The data may be downloaded to a computer or other device via an I/O port, typically an RS-232 port.
The present invention also discloses a method for measuring the concentration of one or more blood analytes in a portion of tissue with a non-invasive measuring apparatus. The method involves positioning a portion of tissue approximately adjacent one or more sensors and a radiation source, exposing the tissue to radiation from the radiation source, detecting radiation transmitted through or reflected from the tissue with the one or more sensors, generating a signal from the one or more sensors in response to the detected radiation, communicating the signal to the processor, and finally inteφreting the signal communicated to the processor to determine the concentration of one or more blood analytes. Preferably, the method of the present invention also includes the step of displaying the results so they may be perceived by the user.
The preferred tissue exposed to the radiation in the method is either an earlobe or a finger. Preferably, the positioning of the tissue is carried out so that the sensors and the radiation source have minimal or no contact with the tissue itself. While any analyte which has infrared absoφtion may be measured by this method, specific examples are lactate/lactic acid, glucose, insulin, ethanol, triglycerides, albumin, proteins, hemoglobin, immunoglobulins, cholesterol, and urea. An important aspect of the present invention is the inteφreting of the signals communicated to the processor by an algorithm. One type of algorithm used to inteφret this data is linear regression. A more preferred algorithm makes use of orthogonal functions. The concept is to use the reference spectrum for each blood analyte as basis functions and determine a weighting function or functions that create an orthogonal set. This permits easy separation algorithms for mixed spectra. The use of algorithms is very helpful for self- calibrating to eliminate data artifacts caused by individual variation in tissue character.
The least squares method of orthogonal functions is preferably used to separate the concentrations of the individual analytes from the total spectrum measured. This is also referred to as "principle component analysis" and is similar to "Fourier series decomposition." Separating the various analyte concentrations is statistically challenging because of an overlap of the spectra which causes interactions and cross-coupling. Trying to evaluate one analyte concentration is affected by the other overlapping concentrations. The orthogonal decomposition is a mathematical way of processing the overlapping concentrations so that they are non-interacting.
Beers' law, described above, may be used to describe blood as a series where each term in the series represents absorbance of one of the blood analytes. As an example, if the blood contains fixed known concentrations of the analytes, and if the absoφtion spectrum is known for each of these analytes, then the composite spectrum CS can be calculated directly. The method of the present invention measures the composite spectrum and the reference spectra. Concentration coefficients are determined using the orthogonal function decomposition.
Brief Description of the Drawings Figure 1 is a drawing illustrating the overall concept of the non-invasive blood analyte micromonitor;
Figure 2 is a drawing illustrating one possible construction for the sensor module;
Figure 3 is a drawing illustrating the positioning of the basic components of the sensor module with respect to an ear lobe; Figure 4 is a perspective view of an integrated radiation source element;
Figure 5 is a drawing illustrating the operation of the collimator;
Figure 6 is a drawing illustrating the layered components of a narrow band filter integrated directly onto a sensor chip; Figure 7 is a drawing illustrating the layout of the sensor circuit and related components;
Figure 8 is a perspective view of the thermocouple sensor cell; Figure 9 is a block diagram of the preliminary schematic diagram for the sensor module;
Figure 10 is a block diagram of the CMOS custom chip for the sensor arrays; and Figure 11 is a block diagram of the inputs and outputs for the pocket monitor.
Detailed Description of Preferred Embodiments The following detailed description is to be read with reference to the drawings, in which like elements in different drawings have been given like reference numerals. The drawings, which are not necessarily to scale, depict selected embodiments and are not intended to limit the scope of the invention.
One preferred embodiment of the present invention is a blood analyte measurement apparatus for measuring the concentration of blood analytes outside of a laboratory setting. The blood analyte measurement apparatus utilizes a sensing unit 1, such as a micromonitor sensor module, that is preferably small and inobtrusive and does not interfere with a user's normal functioning. Figure 1 shows an embodiment of the analyte measurement apparatus, with the sensor module 1, support hardware such as a pocket monitor 2 and an optional computer interface 3. The sensor module contains a small spectrophotometer, which comprises two sensor arrays and a custom graded narrow band interference filter. The sensor module also preferably contains an RF radio transmitter to broadcast the data produced by the sensor, typically only over a limited range, and a rechargeable battery as well as custom optics. The sensor module may be used in an ambulatory application where the user simply clips the sensor module 1 onto an appropriate tissue region, puts the pocket monitor 2 in a pocket/purse and goes about their business. The pocket monitor display give the user immediate data, and stores the data, optionally for later downloading to a computer 3.
The micromonitor sensor module 1 shown in detail in Figure 2 is integrated to reduce its size and weight. The sensor module may also be completely self-contained. As shown, the sensor module is configured for attachment to the user's ear lobe, the ear lobe being the preferred measurement site. Of course, sensor modules intended for attachment to other measuring sites may be configured differently. The target sensor volume is preferably 5 to 10 cc for lactate monitoring, and 1 to 2 cc for glucose monitoring. The sensor module, as shown, is configured to illuminate the measurement site and to receive the reflected radiation from the measurement site. The configuration of the sensor module or modules may vary for receiving transmitted radiation from the measurement site. The sensor module of Figure 2 illuminates the measurement site with a radiation source 4 configured to generate radiation in the spectral region of interest. As wide a spectrum as practical is generated, preferably with a wavelength range as wide as 0.4 - 10 microns. Adjacent to the radiation source 4 are source optics 5 which help to direct and focus the radiation. As shown, the sensor also has collimator optics 6, as well as an integrated narrow band filter, and individual sensors. The individual sensors may be, for example, thermocouple sensors and/or charge couple device (CCD) sensors 7. The sensors are preferably built directly onto a CMOS chip 8. If desired, each sensor module may have a unique ID code.
The sensor module also preferably contains an RF radio transmitter 9 to broadcast the data received by the sensor as reflection or transmittal of the radiation, that is the transmitted or reflected radiation from the measurement site, and a rechargeable battery 10 as well as custom optics. Typically, only a weak RF source is provided since the signal is generally broadcast over only a few feet. Preferably, as much functionality as possible is integrated onto the custom CMOS chip 8 (e.g., preamplification, data processing, IR data output). The sensor module may analyze the blood spectra, that is illuminate the measurement site and receive the transmitted or reflected radiation therefrom, at fixed time intervals, such as once every minute, and is capable of running an analysis in less than five seconds. A further preferred embodiment of this blood analyte measurement device includes a non-invasive sensor module that utilizes infrared spectrophotometric techniques.
A narrow-band interference filter 11 is used as a color separation device in the sensor module. This type of filter is preferred due to its small volume, minimal needs for optics to collimate the radiation, and inherent compatibility with integrated circuit processing techniques. A very small spectrophotometer results when this filter is combined with a CMOS chip bearing an array of sensors.
The radiation (typically, visible and IR or near-IR light) sources 4 of the sensor module may be integrated onto a different chip from that bearing the sensor array for transmission mode or onto the same chip for reflection mode, hi one embodiment, the radiation source comprises a series of incandescent elements integrated onto a silicon chip. Existing tungsten/tantalum technology (used in fusible link type EE Prom's) may be combined with Micro-Electro-Mechanical Systems (MEMS) to form an array of radiation sources tailored to the specific needs of this spectrometer. MEMS technology is the integration of mechanical elements, sensors, actuators, and electronics on a common silicon substrate through the utilization of microfabrication technology.
Figure 3 illustrates the relationship between the sensor components and a portion of tissue, an ear lobe 13, which is a preferred measurement site. These components are the radiation source 4, the source optics 5, the light collimator 6, the narrow band filter 11, and the integrated sensors 12. The ear lobe is a rich source of blood, and attachment of the sensor module thereto meets the ambulatory monitoring goals to be unobtrusive and not interfere with normal user activity. Figure 3 shows a configuration where radiation is transmitted through the ear lobe 13, rather than reflected from it. This configuration requires components on both sides of the ear lobe, but generally uses the available radiation more efficiently than a configuration where the radiation reflected from the ear lobe is sensed. A configuration for sensing radiation reflected from the ear lobe, not illustrated, includes the same components as the configuration illustrated in Figure 3 (a radiation source, source optics, a light collimator, a narrow band filter, and integrated sensors) where all of the components are positioned on one side of the ear lobe. The reflection mode generally requires a stronger radiation source than the transmission mode.
Figure 3 also illustrates the positioning of the source optics 5. A cylindrical Fresnel style lens is preferred for the source optics for the analyte measurement apparatus. The source optics focus the radiation from the radiation source onto a point at the center of the ear lobe. A Fresnel lens also has a relatively small volume. Once the radiation has been transmitted or reflected from the measurement site, it is run through a collimator 6, followed by a narrow band filter 11, and then finally is received by the integrated sensors 12.
The integrated sensors are directly adjacent to the narrow band filter 11 and consist of two types of infrared detectors sensitive to discrete portions of the spectrum: direct silicon sensors sensitive to radiation of a wavelength range from about 0.4 to 1.1 microns, and infrared sensors sensitive to radiation of a wavelength range from 1 to 10 microns. Using both types of sensors, the apparatus of the present invention preferably uses an array of approximately 1024 elements, for an overall filter passband of about 0.22 percent of its center wavelength or frequency. The direct silicon sensors may be, for example, either photodiodes or charge coupled devices. A charge coupled device array made up of multiple elements sensitive to differing portions of the wavelength range is preferred. The infrared sensors making up the rest of the array may, for example, be extrinsic silicon, pyroelectric, photoconductor, or thermocouple sensors. Thermocouples comprising two layers of metal with an additional layer of gold black are preferred, where the two metal layers may be either nickel-chromium alloy on nickel-copper alloy, for example.
The integrated radiation source illustrated in Figure 4 provides rapid turn on and off times, a tailored emission spectrum, and may be configured to a relatively small size.
Preferably, the radiation source 4 utilizes a high melting temperature metal such as tungsten or tantalum to form a thermal radiator 14. The radiator is spaced above a silicon wafer by MEMS techniques and supported by the electrical connections and/or auxiliary supports 16. If seφentine construction is used, the resistance may be adjusted to a convenient value such that it may readily match driver characteristics.
Presuming that sufficient thermal isolation is achieved, the element is allowed to become very hot. A metal reflector layer 15 on the wafer under the thermal radiator element 14 boosts emission efficiency and reduces the heat load to the silicon wafer. The optical color of the emission is set by the temperature of the element, and optical power by the emitting area. Using an array of such elements, each with a different temperature and area, the total emission spectrum may be adjusted to be reasonably flat over the spectrum of interest.
The integrated radiation source allows control over the heat leak associated with the supports. The heat leak may be adjusted to achieve almost any desired turn on and turn off times of the light. Each element, when hot, has a relatively small heat capacity, permitting switching times in the millisecond range without exorbitant power expenditure. With rapid turn on and turn off times, an electronic "chopper- wheel" with modulation frequency in the range of 1 Khz, may be used to reject unwanted background signals.
Heat transfer calculations are provided using tungsten (3370 °C melting temperature) film 1000 angstroms thick. A hot resistance in the range of 10-100 ohms is obtained with a resistor length of 10000 to 30000 squares, well within IC capability. An element temperature of 2000 °C emits 2 to 50 mw radiant energy centered at about 1.5 micron wavelength using photolithographic line widths of 1-5 microns. Heat loads due to supports, electrical connections, and other losses may be held to the range of 1-10 mw. Air conduction loss is eliminated by evacuating the hot zone. The small element heat capacitance the order of 30- 770 njoules/°C results in thermal time constants of 0.2-4 milliseconds. Tantalum (2996 °C melting temperature) gives similar results but has less severe inrush currents than tungsten. Thus, an integrated radiation source with a total power dissipation in the range of 10-100 mw, battery compatible resistance, millisecond response times, and compatibility with IC processing is clearly possible using tungsten or tantalum.
The ear lobe 13 is shown in both figure 3 and figure 5. The analyte measurement device of the present invention compensates for complications of IR spectroscopy inherent in measurement through skin and tissue. The ear lobe infrared absoφtion spectrum corresponds roughly to two layers of skin; one on the backside of the ear and the other on the front side. The transmission of light through skin is fairly complicated. The skin includes a stratum corneium, about 10 microns thick, an epidermis, about 100 microns thick, and a dermis, about 3 mm thick. The incident radiation suffers a 4% to 7% reflection at the stratum corneum due to change in index of refraction (1.0 for air to 1.55) over the whole spectral range up to 3 microns wavelength for both white and black skin. The stratum comeum also contributes to scattering since it is not flat, and has a certain roughness. The chromophores of the epidermis especially melatonin determine attenuation in the visible range in this layer. Psoriatic skin may also be a significant interfering factor, perhaps requiring clear lipophilic liquids to enhance light penetration in some individuals, h the dermis, blood chromophores Hb, HbO and bilirubin are the primary absorbers. Scattering by collagen fibers in the dermis is a strong influence on transparency. Attenuation exceeding 90% may be expected. An optical window exists between 0.6 and 1.8 microns wavelengths where the skin is most transparent. While the ear lobe is a preferable portion of tissue for the measurement site, the present invention is by no means limited to this particular tissue.
Figures 3 and 5 both illustrate the use of a collimator 6 with the analyte measurement device as well. The radiation received from the illuminated ear lobe 13, either by transmission or reflection, may be scattered. The narrow band filter works more effectively when the radiation has been collimated. A beam divergence of 5 degrees or less is preferred. One method is to use a standard condenser 17 and projector 18 lens arrangement, as illustrated in Figure 5. Considering the source of radiation for the collimator to be the spot illuminated inside the ear lobe, this spot is imaged by the condenser lens 17 onto the projector 18 lens aperture, and projected in a beam. The scheme illustrated in Figure 5 has a minimum volume of about 2 cc. Microlens arrays may be used to reduce the volume. For example, an array of microlenses may be configured at a fraction of a cubic centimeter.
Figure 6 portrays a preferred narrow band filter. The narrow band filter separates the wavelengths of radiation transmitted through the tissue at the measurement site and directs the various wavelengths to the sensing array, which is preferably a linear array of elements. The sensors at one end of the array sense only radiation from one end of the spectrum, for example 0.4 microns, while the sensors at the other end of the array sense only radiation from the other end of the spectrum for example 10 microns. Using a linear graded filter, each sensor measures a different color, with color varying linearly with sensor position. A Fabry- Perot narrow band interference filter 19 with a graded dielectric thickness is preferred, where the dielectric film has a graded thickness running from a short wavelength end with a thickness of about 100 nm to a long wavelength end with a thickness of about 2.5 microns. Between the narrow band interference filter and the sensors is a planarizing layer. The spectrophotometer bears sensors which are preferably sensitive to radiation from wavelengths of about 700 nm to about 2500 nm. Figure 6 shows a preferred form of filter, a metal- dielectric-metal sandwich.
The vertical dimension of the dielectric is a quarter wavelength. Additional layers may be used to suppress higher order resonance modes. The filter may be fabricated on a separate substrate and then affixed to the CMOS chip. Since the sensor array may be only one cm long, a separate filter is manageable. The allowable separation between filter and sensor element is determined by the amount of optical cross-talk tolerable between adjacent sensors. For example, if the sensor dimension is approximately 10 microns and the incoming light has a divergence of 5 degrees, then a separation of 25 microns (1 mil) would result in up to 22% cross talk between adjacent elements due to the parallax effects. If a larger separation or lower cross talk is needed, then the incoming light may be better collimated.
Figure 6 shows the narrow band filter integrated directly onto the CMOS chip 12, rather than as a separate substrate. Compared to the example above, filter-to-sensor spacing is very small, and cross talk between adjacent elements due to parallax is less than 10% for the layer thickness' used. With typical semiconductor processing, a planarizing layer may be preferable to accommodate the filter. The first partially transmitting metal layer 22 of the optical filter is then placed on the planarizing layer 23, followed by the dielectric layer 21 and then the top partially transmitting metal layer 20. A wide range of pass band widths may be obtained. Such a filter typically resonates at lA wavelength, corresponding to the dielectric thickness. Hence, typical dielectric thickness is 100 nm at the short wavelength end and 2.5 microns at the long wavelength end, for the preferred spectral range of 0.4 to 10 microns.
Typically, most metals, e.g. gold or aluminum, are partially transmissive at layer thicknesses of 500 to 1000 angstroms. The tapered dielectric layer may be readily fabricated using fixturing (i.e. using a moving aperture) with standard semiconductor equipment. The expected thicknesses and materials may be patterned if desired by standard semiconductor processes.
The sensing array operates over a wide wavelength range of 0.4 to 10 microns. Silicon sensors are sensitive to radiation only over a wavelength range of about 0.4 to 1.1 microns. Beyond 1.1 microns, silicon is generally not useful as a radiation sensor and other methods than direct silicon sensing must be used. Two kinds of arrays are preferably used in the present invention, a direct silicon photo-sensing array and a thermocouple array. Over its range, silicon generates a much stronger signal than other sensing means. The rest of the wavelength range, from 1 to 10 microns, is sensed by the thermocouple array. Both photodiodes and CCDs may be used for direct silicon sensing. The present invention uses CCDs because of their very large dynamic range (more than 1000:1), very low noise capability, easy handling of the small analog signals, inherent CMOS (Complementary Metal Oxide Semiconductor) compatibility, and high quantum efficiency (in the range of 0.5%). Figure 7 illustrates a preferred CCD structure 24 for use in the present invention. The CCD may be viewed as a collection of MOS capacitors that collect photo-induced charges over a controlled integration time, then transfer the collected charges into readout registers 25 (also CCDs) which shift the data serially to an output port 26 where the analog signal is connected to an analog-to-digital converter. Photo-sites 27 are indicated in the figure with radiation impinging on the silicon through transparent polysilicon electrodes. Various clocking schemes (eg. two, three and four phase) may be used, depending on the geometry. Figure 8 illustrates a thermocouple IR sensor cell 28. A variety of devices maybe utilized for sensing over the IR part of the range (1 to 10 microns): extrinsic silicon, pyroelectric sensors (such as LiTaO ), various photoconductors, and thermocouples, for example. The preferred embodiment of the present invention uses thin film thermocouple sensors. D*, the normalized detectivity figure, may be very high in integrated thermocouples, as high as 1016. Thin film thermocouple sensors are very compatible with IC processing and may be patterned using standard photolithographic techniques. The sensitivity to infrared energy is constant over the entire IR range from about 0.7 - 50 microns. The signal levels are good at 63 μv/°C with very low source impedance, since they are metal films, h a preferred embodiment the two metal layers of the thermocouple are nickel - chromium 29 and copper - nickel 30 alloys, as shown, with an additional layer of about 60 μg/cm2 of gold black 31. The thermocouple sensor is thermally isolated from the substrate and exposed to the incident radiation. The cold junctions, not shown, are thermally connected to the substrate as a heat sink and shielded from the light. Additional layers may be used to connect several thermocouples in series to produce larger signals. The thin film thermocouples have a low heat capacity which produces fast response times of about a millisecond. This fast response time allows use of an amplifier tuned to the "chopper" frequency to reduce unwanted background signals, hi an alternative embodiment, 2D thermal imaging maybe used. An array of such elements are placed on the photo sites 27 of Figure 7 and inject charge into the CCD.
A total of 2048 sensor elements are used to read 1024 band width increments similar to those disclosed by Hall and Pollard. Hall J.W. and Pollard A., Near-infrared
Spectrophotometry: A New Dimension in Clinical Chemistry. Clin. Chem. 38, 1623 (1992). See also Hall et. al, U.S. Patent No. 5,361,758, the disclosure of which is hereby incoφorated by reference. The 1024 band increments are spread over the wavelength range of 0.4 - 10 microns. The passband width is expressed as a percentage rather that an absolute wavelength width. Dividing the wavelength range from 0.4 - 10 microns into 1024 equal percent age increments results in a pass band of 0.22% wavelength.
This corresponds to 162 wavelength "slots" for the visible range (0.4 to 1.1 microns) and 862 "slots" for the IR range (1.1 to 10 microns). Using two sensors per "slot" results in 2048 elements (324 for visible and 1724 for IR). Holding the chip size to one centimeter length results in a sensor element length of about 5 microns. A larger sensor length requires a staggered arrangement. The sensing arrays are made as wide as practical, perhaps 100 microns or more, to maximize sensitivity. The wavelength of the incident light is measured along the direction of propagation, not laterally, so that sensors may have lateral dimensions smaller than a wavelength and still sense the radiation. Using absorbing layers like gold black, radiation is absorbed in layers less than a wavelength thick.
The measurement accuracy of the present invention is quite high. Each component shown Figure 3 has a characteristic that is strongly dependent on wavelength. To achieve the desired accuracy (e.g. 10% for glucose) these dependencies must be accounted for. Integrated radiation sources may easily have an emission spectrum that varies by a factor of 10 or more over wavelength range. This variation is partially compensated for by the design of the emitting array. Use of the narrow band filter with constant percentage passband significantly compensates at the IR end of the spectrum. The ear lobe has absorbances that are strongly wavelength dependent and have both skin tissue and blood components. The analyte measurement device of the present invention uses an automatic compensation scheme to account for the varying skin dependencies among individuals, hi one embodiment, a ratiometric technique against a known spectral shape component such as water or albumin yields suitable correction factors. The source optics, collimator optics, narrow band filter and sensor wavelength dependencies are calibrated and thereby taken into account.
Non-invasive glucose monitoring in diabetic patients has shown a more than 50% variation of transmittance in some cases at 900 nm for glucose over the physiological range (2.7 to 27.7 mmol/L). Achieving a glucose measurement accurate to within 10% thus implies a transmittance accuracy of at least 2%. To achieve this accuracy, absorbance measurements accurate or repeatable to 0.1% give a sufficient margin. A 13 bit analog to digital converter is therefore recommended. In a preferred embodiment of the present invention, a 16 bit integrated converter is used. The present invention uses radiation either reflected or transmitted through tissue at the measuring site, including skin, sub-dermal tissue, and blood, so the received signal is a mixture of signals from blood and tissue. One embodiment of the present invention achieves the separation of the blood-related component of the signal from the tissue component of the signal by accepting only the portion of the mixed signal which has a pulse synchronized with the heart pulse. This presumes that the pulsations come from the moving arterial blood or closely related matter and thus allows a signal associated with the blood to be separated from that associated with the tissue. Pulse oximeters, for example, operate using this method. In a preferred embodiment, hematocrit is used to determine the portion of the signal associated with the blood. This technique has two advantages. First, it results in a faster response time because there is no need to wait for heart beats. Second, there is less signal loss due to synchronous signal extraction (the synchronous method removes some blood associated signal unnecessarily).
Figure 9 shows a preliminary schematic diagram for a sensor module. The sensor module is the portion of the analyte measuring device which is positioned on the target tissue and bears the radiation source and sensors, among other things. Everything is integrated onto a single CMOS chip 8 as shown, except the battery 10, radio antenna 9, and one or more capacitors (used, for example, as power filter and charge pump). Figure 9 shows the sensor arrays integrated on the chip as well. Earlier, Figure 3 depicted a separate light source mounted on the other side of the ear for measuring the transmission TR spectra transmitted. The schematic shown in Figure 9 depicts the alternate embodiment, in which the light sources are also integrated onto the chip. While Figure 3 shows transmission and Figure 9 implies a reflection mode, both embodiments are fully encompassed by the present invention. Figure 10 shows a block diagram of functions incoφorated into the CMOS chip and the sensor arrays; one for visible light (e.g. a silicon CCD array), and one for the IR region (e.g. a thermocouple array). Preamplifiers are included for each sensor. The spectral data output from the sensors is digitized by the analog-to-digital converter. A charge pump to stabilize operating voltages and a gated RIP oscillator for the data transmitter are preferably included in the CMOS chip as well. One embodiment also includes integrated light sources. The block diagram shows a microprocessor embedded in the chip. However, a state table design is a viable alternative embodiment.
A "pocket monitor" is provided in a preferred embodiment for displaying analyte measurements in the field. A block diagram for the pocket monitor is shown in Figure 11. For situations that require continuous monitoring, a pocket monitor may be dedicated to a specific individual for data logging and downloading (optional) to a computer at a more convenient time. The pocket monitor contains a radio receiver tuned to a specific sensor transmitter frequency. Data from the sensor module is received and processed for prompt display and storage. The pocket monitor also preferably utilizes an LCD display screen where data may be presented. A graphics mode showing analyte readings for the recent past can also be displayed.
Two preferred embodiments of the pocket monitor are described. The first utilizes existing IRDa hardware available in some personal computers. This embodiment eliminates the need for a separate receiver to be supplied by the personal computer. The second embodiment has a separate receiver that plugs into an existing I/O port in the personal computer. In this embodiment, the receiver accepts the low-power radio frequency transmissions either from the sensor module directly or from the pocket monitor, translates the tramsission into an acceptable I/O format (e.g. RS-232), and then sends the information to the host personal computer via an I O port. These two embodiments may alternately be combined for maximum flexibility.
The software package for the personal computer is based on a user-friendly platform (e.g. Windows 95). The software uses simple GUI (Graphic User Interface, e.g. Visual Basic) that allows for quick and easy results evaluation. The software takes the information received from the I/O port (e.g. an IRDa port or RS-232 port) and imports this information into a database. Algorithms evaluate the spectra data and provide the individual with readily understood information on concentrations of the analytes of interest. These results may be displayed on a "screen" on the personal computer monitor. Preferably, the software enables further analysis and manipulation of the analyte measurement data on the display. An alternative embodiment incoφorates a modem feature that would allow a personal computer to transmit some or all of the information to a main computing center via information transmission means (e.g. a phone line). Data archiving would permit long term trending analysis of analyte concentration levels. Spectrophotometry is an important aspect of the present invention. Currently many spectroscopic methods are in use covering all regions of the electromagnetic spectrum from x-ray to radio wavelengths. For the present invention, the x-ray and UV regions are not preferred because of the greater possibility of damage to the region of the body being tested. Although interesting, the radio region of the spectrum is also not preferred because the physical structures required to generate and sense radio signals differ substantially from those of the preferred embodiments. The preferred spectral regions for use by the analyte measuring device are thus the visible, near-infrared, and infrared regions of the spectrum.
Direct spectroscopic measurements of unmodified body fluids with the more traditional speactral regions (ultraviolet, visible and infrared) generally have limited penetration depths, and are hindered by interfering absoφtion and excessive scattering with inhomogeneous samples. Body fluids and soft tissues, in contrast, are relatively transparent at near-IR wavelengths. Thus, near-IR spectroscopy is preferred with the analyte measuring device of the present invention.
The spectral complexity of typical analytes helps isolate particular species out of the total spectra. For example, β-D-glucopyranose shows absoφtion peaks in the IR fingeφrint region at 1458, 1435, 1365, 1325, 1235, 1205, 1152, 1109, 1080, 1035, and 996 cm'1, and a mere listing of the peaks leaves out a great deal of the complexity of the actual spectra. Very high order polynomials (for example, with hundreds of terms) or tabular methods fitted to individual species spectra are used alongside multivariate analysis techniques or orthogonal function methods to capitalize on this inherent complexity. Effects of interfering compounds and overlapping peaks are part of the analysis and, due to the spectra complexity, tend to be compensated and even separated, if desired. Because blood is a complex mixture, there are various ways of categorizing its many constituents. Table 1, for example, shows the basic separation of blood constituents into solids (formed elements) and liquids (blood plasma). The solids represent about 45% of the blood while liquids (55%) represents the rest. The components of interest for the present invention are contained in the plasma. As seen in Table 1, plasma is about 90% water, with another 8% as plasma proteins, leaving about 2% of the plasma for the analytes of interest. That is, 2% of 55% or roughly 1% of whole blood. Thus, the sensor module is configured to measure spectral amplitude significantly better than 1% (first estimate) in order to obtain data sufficiently accurate to resolve the analytes of interest.
TABLE 1. Blood Constituents
Type Constituent Characteristics/Functions
Erythrocytes anucleate, contain hemoglobin;
(98-99%) O2 & CO transport
Neutrophils granulocytes, polymoφhonuclear;
(60-70%) phagocytosis, wound healing
Eosinophils granulocytes, bilobed nucleus:
(2-4%) phagocytosis
Formed Leukocytes Basophils (0.5- granulocytes, 2-5 lobed nucleus;
Elements (45%) (0.1-0.3%) 1%) release histamine
Lymphocytes agranulocytes, circular nucleus,
(20-25%) T cells, B cells; immune response, antibodies agranulocytes, large kidney-
Monocytes shaped nucleus;
(3-8%) phagocytotic macrophages
Thrombocytes anucleate, megakaryocyte
(platelets) (1- fragments; blood clotting
2%)
Water (90%)
Albumin (54%) maintain osmotic pressure
Globulins (38%) between
Plasma proteins Fibrinogen (7%) blood & tissue
(8%) Others (1%) lipid and metal ion transporters, antibodies clotting factor enzymes, hormones, clotting factors
Figure imgf000025_0001
Cholesterol Membranes & steroid hormones
Urea From breakdown of proteins Creatinine from breakdown of creatine
Waste Products phosphate (from muscles)
Uric acid from breakdown of nucleic acids Bilirubin from breakdown of hemoglobin
Hormones Various
There blood is a complex mixture; only 102 dominant constituents are present with concentrations varying from hemoglobin at about 15 g/dL to constituents such as insulin in the nanogram range and lower. However, this listing by substance is misleading because it does not differentiate between all of the spectroscopically distinct species of a given constituent. For example, glucose has three spectroscopically important species; the open ring, α- and β-pyranose forms. Similarly, hemoglobin has four distinct subunits. The present invention assumes that there are 102 important constituents, but the number is actually higher when considering the effect of various subspecies and subunits with distinct spectral characteristics. For blood analytes with concentrations comparable to or greater than glucose and lactate, Table 2 shows these blood components arranged in order of molar concentration. The components are arranged this way because the spectrum of each, as related by Beers' Law, is typically normalized against molar concentration. Supposing that the relative strength of the spectra correlates with molar concentration (not always true), the table provides an approximate ranking of the components that can be used to decide which ones must be retained for compensation when measuring an analyte (such as glucose). As seen in Table 2, glucose ranks 10th and lactate ranks 16th. The other analyte ranking in Table 2 is by mass concentration. The larger molecules, such as hemoglobin or albumin, may have multiple absorbing sites per molecule. Such multiple absorbing sites distort the molar ranking premise of only one or a small number of absorbing sites. Thus, the top ranked analytes, as ranked by mass concentration, are important as well. For an individual analyte, Beers' Law takes the form A = ε C b, where A is absorbance, ε, is the molecular extinction coefficient, C is the molar concentration, and b is the optical path length. The absorbance, A, is the logarithm of the transmittance. Preferably, the molar extinction coefficient, ε, is a function of wavelength, λ, alone. The molar extinction coefficient ε is measured over a range of wavelengths to form the absoφtion spectrum that would be associated with the particular analyte. The molar extinction coefficient, ε, is measured for each analyte of interest to form a set of spectra, (εj, ε2, ..., ε^) over the wavelength range of interest. When more than one analyte is present, Beers' Law allows simple addition of the absorbance of each one.
Atotai = Aι + A2 +...+ Ar. Ci b εi + C b ε2 +...+ CN b 8N
Presuming that the optical path length , b, is the same for all the analytes, this relation becomes:
Atotai / b = Ci εi + C2 ε + ... + CN εN
Table 2. Proposed Blood Analytes to Compensate. a). Dominant according to mass concentration in the blood,
Minimum Maximum
1. Hemogloblin 12000 18000 mg/dL
2. Albumin 3200 5600 mg/dL
3. Globulins Total 2300 3500 mg/dL
4. Complement Proteins, Total 373 467 mg/dL
5. Fribrinogen 200 400 mg/dL
6. Phospholipids 150 380 mg/dL
7. Cholesterol 150 250 mg/dL
8. Triodothyronine 80 200 mg/dL
9. Triglyceriedes 10 190 mg/dL
10. Glucose 60 100 mg/dL
11. Non-protein Nitrogen 25 50 mg/dL
12. Ceruloplasmin 23 50 mg/dL
13. Protopoφhyrin 15 50 mg/dL
14. Glutathione 24 37 mg/dL
15. Prealbumin 15 36 mg/dL
16. Salicylates 15 30mg/dL
17. Urea Nitrogen 8 23mg/dL
18. Lactate (Lactic Acid) 5 20mg/dL b. Dominant analytes according to molar concentration in the blood.
1. Base, Total 145 160 mmol/L
2. Sodium 136 142 mmol L 3. Chloride 95 103 mmol/L
4. Non-protein Nitrogen 18 36 mmol L
5. Carbon Dioxide 19 30 mmol/L
6. Bicarbonate 21 28 mmol L
7. Lipids, Fatty Acids 9 15 mmol/L 8. Urea Nitrogen 2.9 8.2 mmol/L
9. Cholesterol 3.9 6.5 mmol/L
10. Glucose 3.3 5.6 mmol/L
11. Potassium 3.8 5 mmol/L
12. Alpha Amino Acid Nitrogen 2.6 5 mmol/L 13. Lipids, Phospholipid Phosphorus 2.6 3.6 mmol/L
14. Calcium 2.3 2.7 mmol/L
15. Hemoglobin 1.9 2.5 mmol/L
16. Lactate (Lactic Acid) 0.3 2.2 mmol/L
The total absorbance divided by path length is seen to be a linear supeφosition of spectra, εj, according to the molar concentration of each one, Q. Note that the definition can be shifted to use mass concentration rather than molar concentration, even term-by-term, and Beers' law will still apply. In the application of Beers' Law to an unknown mixture, the set of spectra (εi, ε2, ..., ε>j) is assumed to be known by prior laboratory measurement. The optical path length, b, is also assumed to be known, (hi the lab, bιab can be fixed precisely. But in the embodiment where analytes in the ear lobe are being measured and focusing is used , bea may be a function of λ also.
Rewriting the absorbance relation one more time for composite spectrum (CS):
CS =Atotai / b = Ci εi + C2 ε2 + ... + CN S
In the method of the present invention, the composite spectrum and reference spectra are measured. Thus, the concentration coefficients are determined using Beers' law.
Table 2 lists about 28 primary blood components. A molar extinction coefficient can be determined for each component so that all 28 terms are included. Of course, analytes beyond those listed in Table 2 may also be measured using the present invention. Determination of all 28 molar extenction coefficients, ε, is preferred. Alternately, the calculation may be limited to only the components that are prominent with respect to the analyte of interest. For example, glucose ranks 10th in Table 2 molar concentration. Limiting the calculation to the analytes with 20% or more prominence with respect to glucose will give a model with sufficient accuracy for glucose determination, using perhaps only 25 or 30 terms.
Near IR spectroscopy has been used to extract the concentration of blood analytes such as albumin, glucose, triglycerides and others. Using this method, linear indications of the analyte concentration can be obtained, provided that everything is held constant except the analyte being measured. Usually a "baseline" or reference level must be established through other means. Attempts to measure glucose concentration using near IR spectroscopy have encountered difficulty, primarily from "baseline drift". As other analytes in the blood vary - for example, albumin - the measurement of glucose changes also. The glucose "baseline" shifts because of the albumin change, for example, causing erroneous glucose readings. In fact, a least squares fit of the albumin spectra, using the glucose spectra, yields a non-zero result which adds to the glucose component, hence a variable baseline. Other unknown components such as drugs can also cause shifts in the spectra. The present invention preferably uses self calibration to compensate for the various problems encountered in the near-IR determination of blood analyte concentration. Self calibration relies on the ratio of analyte measurement against a reference material. For analyte measurement in blood, there are two reference materials present in all animals, namely hemoglobin and water. Measuring the concentrations of hemoglobin and water simultaneously with the analyte of interest, an arithmetic ratio may be calculated. This provides a number of advantages. First, the ratio conforms better to commonly accepted definition of concentration, i.e., the amount of analyte per unit of blood. Hemoglobin and water account for about 94% of blood, providing a good basis for the assessing of the amount of blood in the test volume. Second, measurement of hemoglobin and water at the same time as the analyte of interest means that variations that affect the analyte measurement also affects hemoglobin and water. Thus, the ratio should automatically compensate a substantial part of these variations. Third, since hemoglobin occurs only in the blood, it can be used to make a hematocrit determination, based on the proportion of blood by volume made up of erythrocytes, to separate blood and tissue. If the pulsatile method is used to determine a signal associated with the arterial blood movement using the hemoglobin signal, then a ratio of pulsatile hemoglobin to total hemoglobin can be made. Call this ratio the P/B ratio. If the pulsatile component of the analyte of interest is found, the same moving volume is assumed and the P/B ratio used to determine how much of the analyte is in the blood, and how much is in the tissue. For a given analyte, once its fractions are known, the largest signal (usually the tissue signal) can be used to imply blood concentration because the fraction in the blood is not be expected to change very rapidly. The smaller pulsatile signal may then be re-measured over a longer time period, to improve accuracy, with the analyte fraction updated periodically. This method improves accuracy while allowing faster measurements and maintaining self calibration.
The method and apparatus of the present invention compensates for individual variation in measurement due to skin and tissue characteristics. Since the spectra of water and hemoglobin are well known, the spectrum of the skin and tissue may be determined simultaneously with the measurement of other analytes. A reference color is chosen corresponding to a prominent absoφtion peak (e.g., of water). For example, if water is the dominant absorber at a particular wavelength, then the rest of the spectrum may be corrected based on the known spectrum of water, at least over the wavelengths down to perhaps 700 nm where water becomes transparent. Similarly, the spectra may be corrected using other dominant absorbers at a particular wavelength. To continue with the water example, below a wavelength of 700 nm hemoglobin becomes the dominant absorber and can be used to extend the correction based on the known spectrum for hemoglobin down to near 450 nm. Correcting factors are thereby used to extract the dominant features of the skin and tissue. As additional analytes are extracted from the skin and tissue spectrum, a large spectrum remains that is associated only with the skin that exhibits a roughly constant absorbance of about 2. This spectral pattern is associated with chemical components not present in the blood. If the original reference wavelength were to produce an appreciable absorbance error, this would show up as a constant error over wavelength. Computing the ratio for the analyte of interest would cause this type of error to disappear since the analyte is affected the same way. The calculation may be corroborated by performing a similar calculation on the pulsatile spectra. Overlapping peaks have previously made computing the concentration of a particular analyte using IR spectroscopy difficult, as it hard to distinguish between the portion of the peak caused by the analyte and that caused by other components present. One technique used to combat this problem is to compute the second derivative of the spectra to shaφen the peaks. This reduces the problem by reducing the amount of overlap, but does not solve it completely, because of the very large ratio between the concentration of interfering analytes and the analytes of interest. This effect is typically the major source of error in attempting to extract a single analyte such as glucose, or any analyte for that matter. The apparatus and method of the present invention preferably uses Linear Regression techniques (including partial least squares methods) and Orthogonal functions to correct for the problem of overlapping peaks and other spectral defects.
The present invention preferably utilizes linear regression or least squares technique. These methods produce an accurate measurement of analytes provided all the interaction terms are included. Hall and Pollard, referenced earlier, includes an excellent discussion of least squares fitting of data and the method of partial least squares for including interactions. The disclosure of this reference is hereby incoφorated. These methods are useful in their own right, and may be used to determine the weighting function, w, described below. A preferred embodiment of the present invention utilizes orthogonal function techniques. Orthogonal functions behave very much like vectors, and an "inner product" may be defined,
< i I w I ε2 > , where:
Figure imgf000030_0001
w = the weighting function (in λ) εi and ε2 are functions defined over λ λ is the common parameter (wavelength)
The two functions εi, and ε2 are said to be orthogonal if < εi | w | ε2 >= 0 for the weighting function w. Thus, the weighting function, w, acts to make the basis functions, or analyte spectra, orthogonal over the wavelength, λ, of interest. The weighting function is positive. Thus, adjustable candidate weighting functions include quadratics. Further, for functions to be orthogonal to one another, at least one of the basis functions must change sign over the interval in order for the defining integral to be zero. The basis functions, or analyte spectra in the present invention, are based upon absoφtion, which is always a positive number. In order to have a sign change, the first or second derivatives of the basis functions, or analyte spectra, may be taken. Alternately, the "ac" component (wherein the average value is subtracted) of the basis function, or analyte spectra, may be used.
To make two functions orthogonal, a single adjustable parameter is needed to find a weighting function. As an example, the water spectrum (which absorbs primarily at long wavelengths) can be made orthogonal to the deoxyhemoglobin spectrum (which absorbs primarily in the 500-600 nm region) if the "ac" method is used and the weighting function (x- a)2 is used. The parameter, a, is adjusted until the defining integral is zero. Further, the four hemoglobin sub-types have sufficient features that they may also be made mutually orthogonal. For 28 basis functions, or analyte spectra, 378 (or 28 x 27 / 2) adjustable parameters are necessary to find a weighting function. Other methods for finding weighting functions may also be used. For example, one weighting function can be found that makes water orthogonal to the other 27 basis functions, which then requires only 27 adjustable parameters. This weighting function may then be used to decompose the water portion of the spectrum. Another weighting function may be found which makes Hb orthogonal to the remaining 26 basis functions (water already being removed). This second weighting function requires only 26 adjustable parameters. And so on for the remaining basis functions. The result is a set of 26 weighting functions rather than just one which accomplishes the same decomposition. Further, because the concentrations of the analytes drop off quickly, another possibility is to remove the analytes in groups. For example, water and the four kinds of hemoglobin may be removed first and the residual spectrum examined thereafter for another group of analytes. There are many sets of orthogonal functions in common use which are defined along these lines. They include Legendre polynomials, Laguerre polynomials, Hermite polynomials, Chebychev polynomials and Ultraspherical polynomials, for example. Sin(n x) and cos(n x) form orthogonal sets also. Each of these sets has the orthogonality property < ε^ I w I 8M >= 0 if N ≠ M. The weighting function depends on the set used. Generally, these sets of orthogonal functions ( εl5 ε ..., ε>j) are used to decompose a more complicated function CS into "components".
CS = Ciει +C2ε2+ + CNεN+
The value of any specific coefficient of interest, for example, the molar concentration of the nth component, CN, is determined by using the orthogonality property. The composite spectrum, CS, is multiplied by the weighting function w and by the basis function, in the present invention the analyte spectra, associated with the coefficient of interest, for example, the molar extinction coefficient of the nth component, εn. The result is integrated over λ, in the present invention, the wavelength of interest. All the terms on the right side of the equation are zero by orthogonality, except the one of interest, the molar extinction coefficient of the nth component, E . wCSε dλ =
Figure imgf000032_0001
And, CN wCSεπdλ = < CS | w\ 8N > IwCSsudλ < 8 I w\ 8 All of the coefficients may be determined this fashion.
IR and near-IR spectra may be analyzed using orthogonal functions as described above. The spectra for the blood analytes are used as basis functions and made orthogonal by proper selection of weighting function w. As explained above, the weighting function or functions are found that make the basis functions orthogonal over the wavelength range of interest. Note that the bulk of the calculations involving reference spectra and weighting functions are performed in the laboratory. The processor of the analyte measuring device can then calculate the result in as little time as a few seconds. The calculations necessary "in the field" consist of only one integration of the spectrum for each analyte. If 28 analytes are being considered, for example, and the integrations take only a millisecond or so (which is within the capacity of available processors), the 28 integrations necessary may be accomplished in under one second.
Because of the complexity of the individual spectra, high order polynomials are needed to fit them. The method and apparatus of the present invention can account for perhaps 100 analytes or more. The number of coefficients needed to determine the weighting function may then be on the order of several thousand. Thus the invention makes use of a matrix that is 1000 x 1000 or larger that must be inverted to determine the weighting function. This may be readily accomplished, as SPICE circuit simulations, for example, routinely invert matrices this size and larger, especially for transient simulations where the typical simulation inverts large matrices thousands of times in a typical run. Polynomial fitting of the spectra for glucose and albumin has also been accomplished using the Microsoft EXCEL matrix inverter. Microsoft EXCEL has built in functions to invert matrices up to 256 x 256 elements, which allows up to 256 data points to fit the spectra.
The use of orthogonal polynomials in this invention provides a distinct advantage over the use of linear regression. Using orthogonal polynomials, once the weighting function is known, < εN | w \ ε > is determined at the lab or factory, and only one integration, < CS | w ] 8 >, is performed at the site "in the field" to determine the concentration of a specific analyte, such as glucose. In contrast, linear regression requires an iterative solution of multiple analytes simultaneously to extract the one of interest. It should be noted that the orthogonal function method also yields a weighted least squares fit of the data. Any of the currently used techniques, such as second derivative peak shaφening, may also be used to improve performance of the invention. Compensating for the 20 or 30 dominant background components eliminates the accuracy and baseline drift issues existing in previous efforts in this area.
The data processing of the present invention resolves numerous other problems as well. For example, overlapping peaks are corrected for by using orthogonal functions. Sample density variations are dealt with by measuring the sample average concentration. Over- fitting of the data may be a statistical problem and should be avoided in determining which εs should be used.
Computational problems may also have a negative impact on accuracy. A significant example of this is large concentration differences. For example, comparing albumin at 5 g/dL and glucose at 100 mg/dL represents a 50:1 concentration ratio. This has implications on the measurement accuracy required. Glucose absorbs at wavelengths where albumin does not, for example, so that the problem in this particular case is abated somewhat. The net numerical effect may be that albumin, measured at its absoφtion peaks, is used to compensate for albumin effects at the glucose peaks. Since ε for albumin is known, the method of orthogonal functions provides a strong advantage because it inherently compensates for the albumin effects at the glucose peak. Obtaining 10% glucose accuracy requires spectral absorbance measurements of 1% or better because of the concentration differences, but as mentioned earlier this is within the capability of the method and apparatus of the present invention.
While the embodiments and applications of this invention have been shown and described in detail, it will be apparent to those skilled in the art that many more modifications than mentioned above are possible without departing from the inventive concepts described herein. The scope of the present invention is thus limited only by the terms of the appended claims.

Claims

What is claim is:
1. An apparatus for the non-invasive measurement of the concentration of one or more blood analytes in the blood of a portion of tissue comprising: a radiation source for generating a spectrum of radiation and transmitting the spectrum of radiation to the portion of tissue; one or more sensors for detecting radiation from the portion of tissue over a broad spectrum and generating an output regarding the detected radiation; and a processor for receiving the output from the sensors, the processor being configured for performing an algorithm to determine the concentration of one or more blood analytes in the blood of the portion of tissue.
2. The apparatus of claim 1, wherein the portion of tissue is an ear lobe.
3. The apparatus of claim 1, wherein the portion of tissue is a finger.
4. The apparatus of claim 1, further including a mounting device for positioning the radiation source and the one or more sensors in position for the radiation source to approximately adjacent the portion of tissue.
5. The apparatus of claim 4, wherein the portion of tissue has a first side and a second side, the mounting device positioning the radiation source and the one or more sensors approximately adjacent the first side.
6. The apparatus of claim 4, wherein the portion of tissue has a first side and a second side, the mounting device positioning the radiation source approximately adjacent the first side and the one or more sensors approximately adjacent the second side.
7. The apparatus of claim 1, wherein the one or more sensors are configured for detecting radiation reflected from the portion of tissue.
8. The apparatus of claim 1, wherein the one or more sensors are configured for detecting radiation transmitted through the portion of tissue.
9. The apparatus of claim 1, wherein the radiation source comprises a series of incandescent elements integrated onto a silicon chip.
10. The apparatus of claim 1, wherein the radiation source comprises a thermal radiator.
11. The apparatus of claim 10, wherein the thermal radiator comprises a metal positioned over a reflective heat shield.
12. The apparatus of claim 11 , wherein the metal is tungsten.
13. The apparatus of claim 11 , wherein the metal is tantalum
14. The apparatus of claim 1, further including a focusing device for focusing the radiation from the radiation source onto a measurement point on the portion of tissue.
15. The apparatus of claim 14, wherein the focusing device is a fresnel lens.
16. The apparatus of claim 1, further including a collimator.
17. The apparatus of claim 16, wherein the collimator is configured for collimation of 5 degrees or less.
18. The apparatus of claim 1, wherein the one or more sensors comprise a spectrometer capable of detecting near infrared radiation.
19. The apparatus of claim 18, wherein the one or more sensors are capable of detecting near infrared regions of wavelengths of about 700 nm to about 2500 nm.
20. The apparatus of claim 1, wherein the apparatus is adapted to detect blood glucose with accuracy within 10% of the actual level of blood glucose.
21. The apparatus of claim 1, wherein the apparatus is adapted to detect blood lactate with accuracy within 10% of the actual level of blood lactate.
22. The apparatus of claim 1, wherein the sensors comprise direct silicon sensors sensitive to radiation of a wavelength range from about 0.4 to 1.1 microns and infrared sensors sensitive to radiation of a wavelength range from 1 to 10 microns.
23. The apparatus of claim 22, wherein the sensors further comprise an array of approximately 1024 elements.
24. The apparatus of claim 22, wherein the direct silicon sensors comprise photodiodes.
25. The apparatus of claim 22, wherein the direct silicon sensors comprise charge coupled device arrays.
26. The apparatus of claim 25, wherein the charge coupled device arrays further comprise a plurality of elements sensitive to differing portions of a wavelength range of about 0.4 to
1.1 microns.
27. The apparatus of claim 22, wherein the infrared sensors are selected from the group consisting of extrinsic silicon, pyroelectric, photoconductor, and thermocouple sensors.
28. . The apparatus of claim 22, wherein the infrared sensors are thermocouples comprising two layers of metal and a layer of gold black.
29. The apparatus of claim 28, wherein one of the metal layers is a nickel-chromium alloy.
30. The apparatus of claim 28, wherein one of the metal layers is a nickel-copper alloy.
31. The apparatus of claim 1, further including a filter for separating radiation from the portion of tissue into various wavelengths, the filter being positioned such that the radiation from the tissue passes through the filter prior to detection by the one or more sensors.
32. The apparatus of claim 31, wherein the filter is an optical narrow-band filter having a passband of about 0.22 percent of its center wavelength or frequency.
33. The apparatus of claim 31 , wherein the filter is a Fabry-Perot narrow band interference filter comprising a dielectric film between two metal films.
34. The apparatus of claim 31, wherein the dielectric fihn has a graded thickness.
35. The apparatus of claim 34, wherein the dielectric film has a short wavelength end with a thickness of about 100 nm and a long wavelength end with a thickness of about 2.5 microns.
36. The apparatus of claim 35 further comprising a planarizing layer positioned between the narrow band interference filter and the one or more sensors.
37. The apparatus of claim 1, wherein the processor is configured for wirelessly receiving the output from the sensors
38. The apparatus of claim 37, further including an RF transmitter for communicating the output from the sensors to the processor.
39. The apparatus of claim 1, wherein the processor is a CMOS microprocessor.
40. The apparatus of claim 39, wherein the CMOS microprocessor uses a Boolean algorithm for processing the output.
41. The apparatus of claim 1 , further including a display for displaying the concentration of the one or more blood analytes.
42. The apparatus of claim 41, wherein the display is a liquid crystal display.
43. The apparatus of claim 1, wherein the blood analytes are selected from the group consisting of lactate, glucose, insulin, ethanol, triglycerides, albumin, proteins, hemoglobin, immunoglobulins, cholesterol, and urea.
44. A system for the continuous, non-invasive measurement of the concentration of one or more blood analytes in a perambulatory human, comprising: a sensor module including a radiation source and one or more sensors, the radiation source being configured for generating radiation to the portion of tissue, and the one or more sensors being adapted for sensing radiation from the tissue as analyte spectra, and a transmitter for transmitting the analyte spectra to a processor, the sensor module being compact; a processor for receiving the analyte spectra from the sensor module, the processor being adapted for processing the analyte spectra to determine the concentration of one or more blood analytes; and a lightweight monitor for displaying the concentration of the one or more blood analytes.
45. The system of claim 44, wherein the processor is integral with the sensor module.
46. The system of claim 44, wherein the sensor module comprises two chips, the radiation source being positioned on one of the chips and the one ore more sensors being positioned on the other chip.
47. The system of claim 44, wherein the portion of tissue has a first side and a second side, one chip being configured for positioning approximately adjacent the first side, the other chip being configured for positioning approximately adjacent the second side.
48. The system of claim 44, wherein the one or more sensors are adapted for sensing radiation transmitted through the portion of tissue.
49. The system of claim 44, wherein the sensor module comprises one chip, the radiation source and the one or more sensors being positioned on the chip.
50. The system of claim 49, wherein the portion of tissue has a first side and a second side, the chip being configured for positioning approximately adjacent either side.
51. The system of claim 49, wherein the one or more sensors are configured for sensing radiation reflected from the portion of tissue.
52. An apparatus capable of attachment to an ear lobe for the non-invasive measurement of the concentration of one or more blood analytes comprising: a radiation source for generating a spectrum of radiation and transmitting the spectrum of radiation to the portion of tissue; a focusing device for focusing the radiation from the radiation source onto a measurement point on the portion of tissue; a collimator for refocusing the radiation from the measurement point; a filter for separating the radiation into separate wavelengths; one or more sensors for detecting radiation from the measurement point and generating an output regarding the detected radiation; a processor for receiving the output from the sensors, the processor being configured for performing an algorithm to determine the concentration of one or more blood analytes in the blood of the portion of tissue; and a monitor for displaying the concentration of the one or more blood analytes.
53. The apparatus of claim 52, further including a radio antenna coil for transmitting a signal corresponding to the concentration of one or more blood analytes.
54. A method of measuring the concentration of one or more blood analytes in a portion of tissue with a non-invasive measuring apparatus comprising the steps of: positioning a portion of tissue approximately adjacent one or more sensors and a radiation source; exposing the tissue to radiation from the radiation source; detecting radiation from the tissue with the one or more sensors; generating a signal from the one or more sensors in response to the detected radiation and communicating that signal to a processor, the signal including spectra of the one or more blood analytes; and using an algorithm to inteφret the signal communicated to the processor to determine the concentration of one or more blood analytes.
55. The method of claim 54, further including the step of displaying the concentration of one or more blood analytes.
56. The method of claim 54, wherein the step of exposing the tissue to radiation from the radiation source includes focusing the radiation from the radiation source onto a spot on the tissue.
57. The method of claim 54, further including the step of filtering the radiation from the tissue into a plurality of wavelengths.
58. The method of claim 54, wherein the step of detecting radiation from the tissue with the one or more sensors comprises detecting radiation that has transmitted through the tissue.
59. The method of claim 54, wherein the step of detecting radiation from the tissue with the one or more sensors comprises detecting radiation that has been reflected from the tissue.
60. The method of claim 54, wherein the portion of tissue is an earlobe.
61. The method of claim 54, wherein the portion of tissue is a finger.
62. The method of claim 54, wherein the blood analytes are selected from the group consisting of lactate, glucose, insulin, ethanol, triglycerides, albumin, proteins, hemoglobin, immunoglobulins, cholesterol, and urea.
63. The method of claim 54, wherein the algorithm used to inteφret the signal is a form of linear regression.
64. The method of claim 54, wherein the algorithm used to inteφret the signal uses an orthogonal function technique.
65. The method of claim 64, wherein the algorithm further applies orthogonal function to Beer's law wherein the spectra of the blood analytes is modified by at least one weighting function to make the spectra orthogonal.
66. The method of claim 64, wherein the first derivative of the spectra are taken for use in the orthogonal function.
67. The method of claim 64, wherein the second derivative of the spectra are taken for use in the orthogonal function.
68. The method of claim 64, wherein a matrix of about 1000 x 1000 or more is inverted to determine the weighted function in the orthogonal function technique.
69. The method of claim 54, further including the step of self-calibrating the signal.
70. The method of claim 69, wherein the step of self-calibrating the signal is done using a ratio of analyte measurement against a reference material. .
71. The method of claim 70, wherein the reference material is water.
72. The method of claim 70, wherein the reference material is hemoglobin.
73. The method of claim 69, wherein the step of self-calibrating the signal is done using a ratio of pulsatile hemoglobin to total hemoglobin.
74. The method of claim 54, wherein the step of positioning the portion of tissue is carried out such that the one or more sensors and the radiation source have minimal or no contact with the portion of tissue.
75. The method of claim 54 wherein the concentration of blood analytes is determined in less than 5 seconds.
PCT/US2003/008084 2002-03-21 2003-03-18 A non-invasive blood analyte measuring system and method utilizing optical absorption WO2003079892A2 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU2003220328A AU2003220328A1 (en) 2002-03-21 2003-03-18 A non-invasive blood analyte measuring system and method utilizing optical absorption

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US10/104,782 US6898451B2 (en) 2001-03-21 2002-03-21 Non-invasive blood analyte measuring system and method utilizing optical absorption
US10/104,782 2002-03-21

Publications (2)

Publication Number Publication Date
WO2003079892A2 true WO2003079892A2 (en) 2003-10-02
WO2003079892A3 WO2003079892A3 (en) 2004-10-28

Family

ID=28452389

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2003/008084 WO2003079892A2 (en) 2002-03-21 2003-03-18 A non-invasive blood analyte measuring system and method utilizing optical absorption

Country Status (3)

Country Link
US (2) US6898451B2 (en)
AU (1) AU2003220328A1 (en)
WO (1) WO2003079892A2 (en)

Families Citing this family (200)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6018673A (en) 1996-10-10 2000-01-25 Nellcor Puritan Bennett Incorporated Motion compatible sensor for non-invasive optical blood analysis
US9042952B2 (en) 1997-01-27 2015-05-26 Lawrence A. Lynn System and method for automatic detection of a plurality of SPO2 time series pattern types
US20060161071A1 (en) 1997-01-27 2006-07-20 Lynn Lawrence A Time series objectification system and method
US8932227B2 (en) 2000-07-28 2015-01-13 Lawrence A. Lynn System and method for CO2 and oximetry integration
US9521971B2 (en) 1997-07-14 2016-12-20 Lawrence A. Lynn System and method for automatic detection of a plurality of SPO2 time series pattern types
US20070191697A1 (en) 2006-02-10 2007-08-16 Lynn Lawrence A System and method for SPO2 instability detection and quantification
DE19952215C2 (en) * 1999-10-29 2001-10-31 Roche Diagnostics Gmbh Test element analysis system
US9053222B2 (en) 2002-05-17 2015-06-09 Lawrence A. Lynn Patient safety processor
US20060195041A1 (en) 2002-05-17 2006-08-31 Lynn Lawrence A Centralized hospital monitoring system for automatically detecting upper airway instability and for preventing and aborting adverse drug reactions
US7657292B2 (en) * 2001-03-16 2010-02-02 Nellcor Puritan Bennett Llc Method for evaluating extracellular water concentration in tissue
US8135448B2 (en) * 2001-03-16 2012-03-13 Nellcor Puritan Bennett Llc Systems and methods to assess one or more body fluid metrics
US6591122B2 (en) * 2001-03-16 2003-07-08 Nellcor Puritan Bennett Incorporated Device and method for monitoring body fluid and electrolyte disorders
US7239902B2 (en) 2001-03-16 2007-07-03 Nellor Puritan Bennett Incorporated Device and method for monitoring body fluid and electrolyte disorders
US6898451B2 (en) * 2001-03-21 2005-05-24 Minformed, L.L.C. Non-invasive blood analyte measuring system and method utilizing optical absorption
US7711403B2 (en) * 2001-04-05 2010-05-04 Rhode Island Hospital Non-invasive determination of blood components
US8581697B2 (en) * 2001-04-11 2013-11-12 Trutouch Technologies Inc. Apparatuses for noninvasive determination of in vivo alcohol concentration using raman spectroscopy
US8174394B2 (en) * 2001-04-11 2012-05-08 Trutouch Technologies, Inc. System for noninvasive determination of analytes in tissue
US6754516B2 (en) * 2001-07-19 2004-06-22 Nellcor Puritan Bennett Incorporated Nuisance alarm reductions in a physiological monitor
DK1494579T3 (en) * 2002-04-02 2011-11-14 Yeda Res & Dev Characterization of moving objects in a stationary background
US20160354016A1 (en) * 2002-04-09 2016-12-08 Aliphcom Microchip spectrophotometer
US20080200775A1 (en) * 2007-02-20 2008-08-21 Lynn Lawrence A Maneuver-based plethysmographic pulse variation detection system and method
US8512276B2 (en) * 2002-07-24 2013-08-20 Medtronic Minimed, Inc. System for providing blood glucose measurements to an infusion device
SE523545C2 (en) * 2002-09-19 2004-04-27 Foss Tecator Ab Method, a portable device and a measuring instrument for standardizing a satellite measuring instrument to a corresponding main measuring instrument
US7993108B2 (en) 2002-10-09 2011-08-09 Abbott Diabetes Care Inc. Variable volume, shape memory actuated insulin dispensing pump
US7727181B2 (en) * 2002-10-09 2010-06-01 Abbott Diabetes Care Inc. Fluid delivery device with autocalibration
DE60336834D1 (en) 2002-10-09 2011-06-01 Abbott Diabetes Care Inc FUEL FEEDING DEVICE, SYSTEM AND METHOD
EP1558134B1 (en) * 2002-11-06 2012-08-29 Itamar Medical Ltd Detecting medical conditions with noninvasive body probes
US7006856B2 (en) * 2003-01-10 2006-02-28 Nellcor Puritan Bennett Incorporated Signal quality metrics design for qualifying data for a physiological monitor
US7016715B2 (en) 2003-01-13 2006-03-21 Nellcorpuritan Bennett Incorporated Selection of preset filter parameters based on signal quality
US7679407B2 (en) 2003-04-28 2010-03-16 Abbott Diabetes Care Inc. Method and apparatus for providing peak detection circuitry for data communication systems
EP1634061A4 (en) * 2003-04-30 2007-11-21 Univ Mcgill Method and system for measuring lactate levels in vivo
US7039448B2 (en) * 2003-05-02 2006-05-02 Diramed, Llc Zero corrected optical blood analyte detector
DE10333075B4 (en) * 2003-07-21 2011-06-16 Siemens Ag Method and device for training adjustment in sports, especially in running
US20070123762A1 (en) * 2004-01-30 2007-05-31 Crawford Gregory P Non-invasive spectroscopy of mammalian tissues
DE102004008685A1 (en) * 2004-02-21 2005-09-29 Roche Diagnostics Gmbh Transmission spectrometer for the examination of a liquid sample
US7120479B2 (en) * 2004-02-25 2006-10-10 Nellcor Puritan Bennett Inc. Switch-mode oximeter LED drive with a single inductor
US7190985B2 (en) * 2004-02-25 2007-03-13 Nellcor Puritan Bennett Inc. Oximeter ambient light cancellation
US7534212B2 (en) * 2004-03-08 2009-05-19 Nellcor Puritan Bennett Llc Pulse oximeter with alternate heart-rate determination
US8611977B2 (en) * 2004-03-08 2013-12-17 Covidien Lp Method and apparatus for optical detection of mixed venous and arterial blood pulsation in tissue
US7194293B2 (en) 2004-03-08 2007-03-20 Nellcor Puritan Bennett Incorporated Selection of ensemble averaging weights for a pulse oximeter based on signal quality metrics
US8515506B2 (en) * 2004-05-24 2013-08-20 Trutouch Technologies, Inc. Methods for noninvasive determination of in vivo alcohol concentration using Raman spectroscopy
US20080319286A1 (en) * 2004-05-24 2008-12-25 Trent Ridder Optical Probes for Non-Invasive Analyte Measurements
US8730047B2 (en) 2004-05-24 2014-05-20 Trutouch Technologies, Inc. System for noninvasive determination of analytes in tissue
US20110178420A1 (en) * 2010-01-18 2011-07-21 Trent Ridder Methods and apparatuses for improving breath alcohol testing
US7344500B2 (en) 2004-07-27 2008-03-18 Medtronic Minimed, Inc. Sensing system with auxiliary display
US8249698B2 (en) * 2004-08-31 2012-08-21 The University Of Akron General diagnostic and real-time applications of discrete hermite functions to digital data
EP1830695B1 (en) * 2004-12-14 2011-11-30 Koninklijke Philips Electronics N.V. Integrated pulse oximetry sensor
US7460895B2 (en) * 2005-01-24 2008-12-02 University Of Iowa Research Foundation Method for generating a net analyte signal calibration model and uses thereof
US7392075B2 (en) 2005-03-03 2008-06-24 Nellcor Puritan Bennett Incorporated Method for enhancing pulse oximetry calculations in the presence of correlated artifacts
CA2601441A1 (en) 2005-03-21 2006-09-28 Abbott Diabetes Care Inc. Method and system for providing integrated medication infusion and analyte monitoring system
US8172763B2 (en) * 2005-05-06 2012-05-08 Yeda Research And Development Co., Ltd. Imaging and analysis of movement of erythrocytes in blood vessels in relation to the cardiac cycle
US7768408B2 (en) 2005-05-17 2010-08-03 Abbott Diabetes Care Inc. Method and system for providing data management in data monitoring system
US7620437B2 (en) 2005-06-03 2009-11-17 Abbott Diabetes Care Inc. Method and apparatus for providing rechargeable power in data monitoring and management systems
KR20070034169A (en) * 2005-09-23 2007-03-28 삼성전자주식회사 Apparatus and method for measuring blood component concentration using terahertz wave
US7725146B2 (en) 2005-09-29 2010-05-25 Nellcor Puritan Bennett Llc System and method for pre-processing waveforms
US7725147B2 (en) 2005-09-29 2010-05-25 Nellcor Puritan Bennett Llc System and method for removing artifacts from waveforms
US20070106126A1 (en) 2005-09-30 2007-05-10 Mannheimer Paul D Patient monitoring alarm escalation system and method
US7756561B2 (en) 2005-09-30 2010-07-13 Abbott Diabetes Care Inc. Method and apparatus for providing rechargeable power in data monitoring and management systems
WO2007047279A1 (en) * 2005-10-18 2007-04-26 Richards Cynthia C Dispenser having a first pump for insulin and a second pump for glucose or glucagon
US20070100220A1 (en) * 2005-10-28 2007-05-03 Baker Clark R Jr Adjusting parameters used in pulse oximetry analysis
US7583190B2 (en) 2005-10-31 2009-09-01 Abbott Diabetes Care Inc. Method and apparatus for providing data communication in data monitoring and management systems
WO2007056971A2 (en) * 2005-11-15 2007-05-24 Weinmann Geräte für Medizin GmbH & Co. KG Device for determining physiological variables
US8344966B2 (en) 2006-01-31 2013-01-01 Abbott Diabetes Care Inc. Method and system for providing a fault tolerant display unit in an electronic device
US7668579B2 (en) 2006-02-10 2010-02-23 Lynn Lawrence A System and method for the detection of physiologic response to stimulation
US20070208259A1 (en) * 2006-03-06 2007-09-06 Mannheimer Paul D Patient monitoring alarm escalation system and method
US8702606B2 (en) * 2006-03-21 2014-04-22 Covidien Lp Patient monitoring help video system and method
EP2030210A4 (en) 2006-04-12 2010-04-14 Proteus Biomedical Inc Void-free implantable hermetically sealed structures
US8380271B2 (en) 2006-06-15 2013-02-19 Covidien Lp System and method for generating customizable audible beep tones and alarms
US7582869B2 (en) * 2006-07-20 2009-09-01 Sas Photonics, Llc System and method for optical analysis
US8116852B2 (en) * 2006-09-29 2012-02-14 Nellcor Puritan Bennett Llc System and method for detection of skin wounds and compartment syndromes
US8728059B2 (en) * 2006-09-29 2014-05-20 Covidien Lp System and method for assuring validity of monitoring parameter in combination with a therapeutic device
US7848891B2 (en) * 2006-09-29 2010-12-07 Nellcor Puritan Bennett Llc Modulation ratio determination with accommodation of uncertainty
US8579853B2 (en) 2006-10-31 2013-11-12 Abbott Diabetes Care Inc. Infusion devices and methods
US20080200819A1 (en) * 2007-02-20 2008-08-21 Lynn Lawrence A Orthostasis detection system and method
US8346327B2 (en) * 2007-03-09 2013-01-01 Covidien Lp Method for identification of sensor site by local skin spectrum data
US8690864B2 (en) 2007-03-09 2014-04-08 Covidien Lp System and method for controlling tissue treatment
US20080221411A1 (en) * 2007-03-09 2008-09-11 Nellcor Puritan Bennett Llc System and method for tissue hydration estimation
US8175665B2 (en) * 2007-03-09 2012-05-08 Nellcor Puritan Bennett Llc Method and apparatus for spectroscopic tissue analyte measurement
US20080221416A1 (en) * 2007-03-09 2008-09-11 Nellcor Puritan Bennett Llc System and method for detection of macular degeneration using spectrophotometry
US8280469B2 (en) 2007-03-09 2012-10-02 Nellcor Puritan Bennett Llc Method for detection of aberrant tissue spectra
JP5028143B2 (en) * 2007-05-23 2012-09-19 ローレル精機株式会社 Safety management system
JP4974761B2 (en) * 2007-05-25 2012-07-11 ローレル精機株式会社 Safety management system
EP2156348B1 (en) 2007-05-30 2018-08-01 Ascensia Diabetes Care Holdings AG System and method for managing health data
US20090018416A1 (en) * 2007-07-13 2009-01-15 Walker Stephen D Analyte Concentration Measurement Device
US8818477B2 (en) * 2007-07-13 2014-08-26 University Of Massachusetts Physical performance monitoring and monitors
US20090047177A1 (en) * 2007-08-17 2009-02-19 Walker Stephen D Lactate concentration measurement device
JP4569615B2 (en) * 2007-09-25 2010-10-27 ブラザー工業株式会社 Printing device
US8204567B2 (en) 2007-12-13 2012-06-19 Nellcor Puritan Bennett Llc Signal demodulation
US8403862B2 (en) 2007-12-20 2013-03-26 Yeda Research And Development Co. Ltd. Time-based imaging
US20090171167A1 (en) * 2007-12-27 2009-07-02 Nellcor Puritan Bennett Llc System And Method For Monitor Alarm Management
US20090171170A1 (en) * 2007-12-28 2009-07-02 Nellcor Puritan Bennett Llc Medical Monitoring With Portable Electronic Device System And Method
US20090171175A1 (en) * 2007-12-31 2009-07-02 Nellcor Puritan Bennett Llc Personalized Medical Monitoring: Auto-Configuration Using Patient Record Information
US8092993B2 (en) 2007-12-31 2012-01-10 Nellcor Puritan Bennett Llc Hydrogel thin film for use as a biosensor
US20090216096A1 (en) * 2007-12-31 2009-08-27 Nellcor Puritan Bennett Llc Method and apparatus to determine skin sterol levels
JP5033652B2 (en) * 2008-01-18 2012-09-26 ローレル機械株式会社 Health condition management device and health condition management system
US8750953B2 (en) 2008-02-19 2014-06-10 Covidien Lp Methods and systems for alerting practitioners to physiological conditions
US8275553B2 (en) 2008-02-19 2012-09-25 Nellcor Puritan Bennett Llc System and method for evaluating physiological parameter data
US20090247851A1 (en) * 2008-03-26 2009-10-01 Nellcor Puritan Bennett Llc Graphical User Interface For Monitor Alarm Management
US8140272B2 (en) * 2008-03-27 2012-03-20 Nellcor Puritan Bennett Llc System and method for unmixing spectroscopic observations with nonnegative matrix factorization
US8437822B2 (en) 2008-03-28 2013-05-07 Covidien Lp System and method for estimating blood analyte concentration
US8292809B2 (en) 2008-03-31 2012-10-23 Nellcor Puritan Bennett Llc Detecting chemical components from spectroscopic observations
US8364224B2 (en) 2008-03-31 2013-01-29 Covidien Lp System and method for facilitating sensor and monitor communication
EP2283443A1 (en) 2008-05-07 2011-02-16 Lynn, Lawrence A. Medical failure pattern search engine
US8306594B2 (en) 2008-06-12 2012-11-06 Paseman Sabrina K Transmission fluorometer
USD626561S1 (en) 2008-06-30 2010-11-02 Nellcor Puritan Bennett Llc Circular satseconds indicator and triangular saturation pattern detection indicator for a patient monitor display panel
US8827917B2 (en) * 2008-06-30 2014-09-09 Nelleor Puritan Bennett Ireland Systems and methods for artifact detection in signals
US9895068B2 (en) * 2008-06-30 2018-02-20 Covidien Lp Pulse oximeter with wait-time indication
US8295567B2 (en) * 2008-06-30 2012-10-23 Nellcor Puritan Bennett Ireland Systems and methods for ridge selection in scalograms of signals
USD626562S1 (en) 2008-06-30 2010-11-02 Nellcor Puritan Bennett Llc Triangular saturation pattern detection indicator for a patient monitor display panel
US8077297B2 (en) 2008-06-30 2011-12-13 Nellcor Puritan Bennett Ireland Methods and systems for discriminating bands in scalograms
US8260556B2 (en) * 2008-08-21 2012-09-04 Bio-Rad Laboratories, Inc. Calibration surface method for determination on of analyte ratios
US8417309B2 (en) 2008-09-30 2013-04-09 Covidien Lp Medical sensor
US8433382B2 (en) * 2008-09-30 2013-04-30 Covidien Lp Transmission mode photon density wave system and method
US8968193B2 (en) 2008-09-30 2015-03-03 Covidien Lp System and method for enabling a research mode on physiological monitors
US8386000B2 (en) * 2008-09-30 2013-02-26 Covidien Lp System and method for photon density wave pulse oximetry and pulse hemometry
AU2009308780B2 (en) * 2008-10-31 2013-10-17 Covidien Lp System and method for facilitating observation of monitored physiologic data
WO2010051479A1 (en) 2008-10-31 2010-05-06 Nellcor Puritan Bennett Llc System and method for facilitating observation of monitored physiologic data
US8560082B2 (en) 2009-01-30 2013-10-15 Abbott Diabetes Care Inc. Computerized determination of insulin pump therapy parameters using real time and retrospective data processing
EP3127476A1 (en) 2009-02-25 2017-02-08 Valencell, Inc. Light-guiding devices and monitoring devices incorporating same
US8788002B2 (en) 2009-02-25 2014-07-22 Valencell, Inc. Light-guiding devices and monitoring devices incorporating same
WO2010129375A1 (en) 2009-04-28 2010-11-11 Abbott Diabetes Care Inc. Closed loop blood glucose control algorithm analysis
EP2425209A4 (en) 2009-04-29 2013-01-09 Abbott Diabetes Care Inc Method and system for providing real time analyte sensor calibration with retrospective backfill
US8509869B2 (en) 2009-05-15 2013-08-13 Covidien Lp Method and apparatus for detecting and analyzing variations in a physiologic parameter
WO2010151592A1 (en) 2009-06-23 2010-12-29 Bayer Healthcare Llc System and apparatus for determining temperatures in a fluid analyte system
EP2456351B1 (en) 2009-07-23 2016-10-12 Abbott Diabetes Care, Inc. Real time management of data relating to physiological control of glucose levels
US8494786B2 (en) 2009-07-30 2013-07-23 Covidien Lp Exponential sampling of red and infrared signals
US20110029865A1 (en) * 2009-07-31 2011-02-03 Nellcor Puritan Bennett Llc Control Interface For A Medical Monitor
US8494606B2 (en) * 2009-08-19 2013-07-23 Covidien Lp Photoplethysmography with controlled application of sensor pressure
WO2011084120A1 (en) * 2009-09-18 2011-07-14 Northwestern University Bimetallic integrated on-chip thermocouple array
US8788001B2 (en) * 2009-09-21 2014-07-22 Covidien Lp Time-division multiplexing in a multi-wavelength photon density wave system
US8704666B2 (en) * 2009-09-21 2014-04-22 Covidien Lp Medical device interface customization systems and methods
US8494604B2 (en) * 2009-09-21 2013-07-23 Covidien Lp Wavelength-division multiplexing in a multi-wavelength photon density wave system
US8571621B2 (en) 2009-09-24 2013-10-29 Covidien Lp Minimax filtering for pulse oximetry
WO2011037699A2 (en) * 2009-09-24 2011-03-31 Nellcor Puritan Bennett Llc Determination of a physiological parameter
US8798704B2 (en) 2009-09-24 2014-08-05 Covidien Lp Photoacoustic spectroscopy method and system to discern sepsis from shock
US8923945B2 (en) * 2009-09-24 2014-12-30 Covidien Lp Determination of a physiological parameter
US9066660B2 (en) 2009-09-29 2015-06-30 Nellcor Puritan Bennett Ireland Systems and methods for high-pass filtering a photoplethysmograph signal
US8515511B2 (en) 2009-09-29 2013-08-20 Covidien Lp Sensor with an optical coupling material to improve plethysmographic measurements and method of using the same
US9554739B2 (en) 2009-09-29 2017-01-31 Covidien Lp Smart cable for coupling a medical sensor to an electronic patient monitor
US8376955B2 (en) * 2009-09-29 2013-02-19 Covidien Lp Spectroscopic method and system for assessing tissue temperature
US20110077470A1 (en) * 2009-09-30 2011-03-31 Nellcor Puritan Bennett Llc Patient Monitor Symmetry Control
US8401608B2 (en) * 2009-09-30 2013-03-19 Covidien Lp Method of analyzing photon density waves in a medical monitor
US20110074342A1 (en) * 2009-09-30 2011-03-31 Nellcor Puritan Bennett Llc Wireless electricity for electronic devices
US20110082711A1 (en) 2009-10-06 2011-04-07 Masimo Laboratories, Inc. Personal digital assistant or organizer for monitoring glucose levels
US8391943B2 (en) 2010-03-31 2013-03-05 Covidien Lp Multi-wavelength photon density wave system using an optical switch
US8498683B2 (en) 2010-04-30 2013-07-30 Covidien LLP Method for respiration rate and blood pressure alarm management
US7884933B1 (en) 2010-05-05 2011-02-08 Revolutionary Business Concepts, Inc. Apparatus and method for determining analyte concentrations
US8930145B2 (en) 2010-07-28 2015-01-06 Covidien Lp Light focusing continuous wave photoacoustic spectroscopy and its applications to patient monitoring
US9380982B2 (en) 2010-07-28 2016-07-05 Covidien Lp Adaptive alarm system and method
US9522396B2 (en) 2010-12-29 2016-12-20 S.D. Sight Diagnostics Ltd. Apparatus and method for automatic detection of pathogens
US8610769B2 (en) 2011-02-28 2013-12-17 Covidien Lp Medical monitor data collection system and method
JP6134729B2 (en) 2011-11-24 2017-05-24 イタマール メディカル リミテッド Device for monitoring arterial pulse waves in diagnosing various medical conditions
CN106840812B (en) 2011-12-29 2019-12-17 思迪赛特诊断有限公司 Methods and systems for detecting pathogens in biological samples
CN104168828A (en) 2012-01-16 2014-11-26 瓦伦赛尔公司 Physiological metric estimation rise and fall limiting
JP6116017B2 (en) 2012-01-16 2017-04-19 ヴァレンセル,インコーポレイテッドValencell, Inc. Reduction of physiological measurement error by inertia rhythm
US10219709B2 (en) * 2012-03-28 2019-03-05 Wayne State University Sensor and method for continuous health monitoring
WO2013148753A1 (en) * 2012-03-28 2013-10-03 Wayne State University Sensor and method for continuous health monitoring
US9833146B2 (en) 2012-04-17 2017-12-05 Covidien Lp Surgical system and method of use of the same
ITRM20120212A1 (en) * 2012-05-14 2012-08-13 Biochemical Systems Internat S R L MULTIPARAMETER SKIN SCANNER FOR NON-INVASIVE MEASUREMENTS OF CONCENTRATIONS OF BILIRUBINE HEMOGLOBIN AND GLUCOSE IN BLOOD
JP5988690B2 (en) * 2012-05-18 2016-09-07 浜松ホトニクス株式会社 Spectroscopic sensor
TWI481385B (en) * 2012-10-02 2015-04-21 Univ Lunghwa Sci & Technology Non - invasive blood glucose measurement circuit module
US10067054B2 (en) 2012-10-16 2018-09-04 K Sciences Gp, Llc Simple sugar concentration sensor and method
US9949675B2 (en) * 2012-10-19 2018-04-24 Convergence Biometrics, LLC Noninvasive blood measurement platform
EP3184038B1 (en) 2012-12-31 2019-02-20 Omni MedSci, Inc. Mouth guard with short-wave infrared super-continuum lasers for early detection of dental caries
US9164032B2 (en) 2012-12-31 2015-10-20 Omni Medsci, Inc. Short-wave infrared super-continuum lasers for detecting counterfeit or illicit drugs and pharmaceutical process control
US10660526B2 (en) 2012-12-31 2020-05-26 Omni Medsci, Inc. Near-infrared time-of-flight imaging using laser diodes with Bragg reflectors
WO2014143276A2 (en) 2012-12-31 2014-09-18 Omni Medsci, Inc. Short-wave infrared super-continuum lasers for natural gas leak detection, exploration, and other active remote sensing applications
EP2938259A4 (en) 2012-12-31 2016-08-17 Omni Medsci Inc Near-infrared lasers for non-invasive monitoring of glucose, ketones, hba1c, and other blood constituents
EP3869257A1 (en) 2013-05-23 2021-08-25 S.D. Sight Diagnostics Ltd. Method and system for imaging a cell sample
IL227276A0 (en) 2013-07-01 2014-03-06 Parasight Ltd A method and system for preparing a monolayer of cells, particularly suitable for diagnosis
EP3039477B1 (en) 2013-08-26 2021-10-20 S.D. Sight Diagnostics Ltd. Digital microscopy systems, methods and computer program products
CN103690176B (en) * 2013-12-26 2015-10-28 苏州大学 A kind of Noninvasive Blood Glucose Detection Methods
EP3013217B1 (en) * 2014-01-07 2017-02-22 Opsolution GmbH Device and method for determining a concentration in a sample
EP3186778B1 (en) 2014-08-27 2023-01-11 S.D. Sight Diagnostics Ltd. System and method for calculating focus variation for a digital microscope
CN104224193B (en) * 2014-09-12 2016-05-18 北京玉峰生物技术有限公司 A kind of non-invasive blood-sugar detecting instrument
WO2016041073A1 (en) * 2014-09-17 2016-03-24 2352409 Ontario Inc. Device and method for monitoring fat balance
US10383579B2 (en) 2014-10-16 2019-08-20 Covidien Lp System and method for monitoring autoregulation
US10219705B2 (en) 2015-05-08 2019-03-05 Covidien Lp System and method for identifying autoregulation zones
US10194870B2 (en) 2015-05-27 2019-02-05 Covidien Lp Systems and methods for optimizing autoregulation measurements
US10932724B2 (en) 2015-06-17 2021-03-02 Covidien Lp Systems and methods for monitoring autoregulation using a confidence level
US10271779B2 (en) 2015-06-30 2019-04-30 Covidien Lp System and method of monitoring autoregulation
US10292663B2 (en) 2015-06-30 2019-05-21 Covidien Lp System and method of monitoring autoregulation
JP6952683B2 (en) 2015-09-17 2021-10-20 エス.ディー.サイト ダイアグノスティクス リミテッド Methods and devices for detecting entities in body samples
KR102443262B1 (en) * 2015-09-23 2022-09-13 삼성전자주식회사 Method and apparatus for predicting analyte concentration
WO2017062458A1 (en) 2015-10-06 2017-04-13 Covidien Lp System and method for monitoring autoregulation utilizing normalized regional oxygen saturation values
WO2017066515A1 (en) 2015-10-16 2017-04-20 Covidien Lp System and method for identifying autoregulation zones
EP3352656B1 (en) 2015-10-19 2021-02-17 Covidien LP System and method for providing blood pressure safe zone indication during autoregulation monitoring
US11426100B1 (en) * 2015-12-08 2022-08-30 Socrates Health Solutions, Inc. Blood glucose trend meter
US11733150B2 (en) 2016-03-30 2023-08-22 S.D. Sight Diagnostics Ltd. Distinguishing between blood sample components
US11307196B2 (en) 2016-05-11 2022-04-19 S.D. Sight Diagnostics Ltd. Sample carrier for optical measurements
BR112018072627A2 (en) 2016-05-11 2019-02-19 S D Sight Diagnostics Ltd performing optical measurements on a sample
US10736578B2 (en) 2016-07-14 2020-08-11 Covidien Lp Systems and methods of monitoring autoregulation
US11419506B2 (en) 2016-08-22 2022-08-23 Covidien Lp System and method for identifying blood pressure zones during autoregulation monitoring
CA3081669A1 (en) 2017-11-14 2019-05-23 S.D. Sight Diagnostics Ltd Sample carrier for optical measurements
US10804562B2 (en) * 2017-12-06 2020-10-13 Tesla Motors Canada ULC Method and system for determining concentration of electrolyte components for lithium-ion cells
US10966655B2 (en) 2018-04-27 2021-04-06 Hyrostasis, Inc. Tissue hydration monitor
US20210244365A1 (en) * 2018-05-11 2021-08-12 Spectronix Inc. Non-invasive epidermal health-monitoring sensor, patch system and method, and epidemiological monitoring and tracking system related thereto
US20210059585A1 (en) * 2019-08-26 2021-03-04 nanoLambda Korea On-chip integrated multi-wavelengths biological sensing device
CN111297374B (en) * 2020-02-24 2022-05-27 京东方科技集团股份有限公司 Physical sign parameter detection equipment and physical sign parameter detection method
RU2770566C1 (en) * 2021-01-15 2022-04-18 ООО "НПП Волга" Method for non-invasive determination of the content of lipids in a person

Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5361758A (en) 1988-06-09 1994-11-08 Cme Telemetrix Inc. Method and device for measuring concentration levels of blood constituents non-invasively

Family Cites Families (36)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3596057A (en) * 1969-05-08 1971-07-27 Dominion Electric Corp Electric heating device
US3983751A (en) * 1974-07-17 1976-10-05 Atlantic Richfield Company Method of measuring the level of elevated temperature particulate material
US4271358A (en) * 1979-11-13 1981-06-02 Frank Schwarz Selective infrared detector
JPS60130274A (en) * 1983-12-19 1985-07-11 Toshiba Corp Solid-state image pickup device
JPS62250320A (en) * 1986-04-23 1987-10-31 New Japan Radio Co Ltd Thermopile
US5069214A (en) * 1988-12-14 1991-12-03 Gms Engineering Corporation Flash reflectance oximeter
US5197470A (en) * 1990-07-16 1993-03-30 Eastman Kodak Company Near infrared diagnostic method and instrument
US5784507A (en) * 1991-04-05 1998-07-21 Holm-Kennedy; James W. Integrated optical wavelength discrimination devices and methods for fabricating same
DE4128458C2 (en) * 1991-08-28 1994-02-10 Siemens Ag Method and device for determining the concentration of a component, in particular glucose, a liquid optically active substance, in particular the body fluid of a patient, by polarimetry
US5792050A (en) * 1992-07-06 1998-08-11 Alam; Mary K. Near-infrared noninvasive spectroscopic determination of pH
US5355880A (en) * 1992-07-06 1994-10-18 Sandia Corporation Reliable noninvasive measurement of blood gases
US5424545A (en) * 1992-07-15 1995-06-13 Myron J. Block Non-invasive non-spectrophotometric infrared measurement of blood analyte concentrations
US5434412A (en) * 1992-07-15 1995-07-18 Myron J. Block Non-spectrophotometric measurement of analyte concentrations and optical properties of objects
US5348003A (en) * 1992-09-03 1994-09-20 Sirraya, Inc. Method and apparatus for chemical analysis
US5398681A (en) * 1992-12-10 1995-03-21 Sunshine Medical Instruments, Inc. Pocket-type instrument for non-invasive measurement of blood glucose concentration
DE4242232C2 (en) * 1992-12-15 1998-12-10 Burkhard Kuhls Device and method for the non-invasive determination of the concentration of polarizing substances in the human body
US5615672A (en) * 1993-01-28 1997-04-01 Optiscan, Inc. Self-emission noninvasive infrared spectrophotometer with body temperature compensation
US5515847A (en) * 1993-01-28 1996-05-14 Optiscan, Inc. Self-emission noninvasive infrared spectrophotometer
US5383452A (en) * 1993-07-01 1995-01-24 Buchert; Janusz Method, apparatus and procedure for non-invasive monitoring blood glucose by measuring the polarization ratio of blood luminescence
DK88893D0 (en) * 1993-07-30 1993-07-30 Radiometer As A METHOD AND APPARATUS FOR DETERMINING THE CONTENT OF A CONSTITUENT OF BLOOD OF AN INDIVIDUAL
US5553615A (en) * 1994-01-31 1996-09-10 Minnesota Mining And Manufacturing Company Method and apparatus for noninvasive prediction of hematocrit
US5529755A (en) * 1994-02-22 1996-06-25 Minolta Co., Ltd. Apparatus for measuring a glucose concentration
US5660181A (en) * 1994-12-12 1997-08-26 Physical Optics Corporation Hybrid neural network and multiple fiber probe for in-depth 3-D mapping
EP0762109A3 (en) * 1995-08-30 1997-09-17 Kyoto Daiichi Kagaku Kk Method of and apparatus for measuring lactic acid in organism
US5666956A (en) * 1996-05-20 1997-09-16 Buchert; Janusz Michal Instrument and method for non-invasive monitoring of human tissue analyte by measuring the body's infrared radiation
US6119031A (en) * 1996-11-21 2000-09-12 Boston Scientific Corporation Miniature spectrometer
US5900632A (en) * 1997-03-12 1999-05-04 Optiscan Biomedical Corporation Subsurface thermal gradient spectrometry
CN1242693A (en) * 1997-08-26 2000-01-26 精工爱普生株式会社 Measuring, sensing and diagnosing apparatus and method relating to wave pulse, cardiac function, and motion intensity
US6039697A (en) * 1998-03-20 2000-03-21 Datex-Ohmeda, Inc. Fiber optic based multicomponent infrared respiratory gas analyzer
AU763570B2 (en) * 1998-08-14 2003-07-24 Spectro Scientific, Inc. On-site analyzer
US6215403B1 (en) * 1999-01-27 2001-04-10 International Business Machines Corporation Wireless monitoring system
US6341257B1 (en) * 1999-03-04 2002-01-22 Sandia Corporation Hybrid least squares multivariate spectral analysis methods
US6198949B1 (en) * 1999-03-10 2001-03-06 Optiscan Biomedical Corporation Solid-state non-invasive infrared absorption spectrometer for the generation and capture of thermal gradient spectra from living tissue
US6175750B1 (en) * 1999-03-19 2001-01-16 Cytometrics, Inc. System and method for calibrating a reflection imaging spectrophotometer
AU2001238400A1 (en) * 2000-02-18 2001-08-27 Argose, Inc. Multivariate analysis of green to ultraviolet spectra of cell and tissue samples
US6898451B2 (en) * 2001-03-21 2005-05-24 Minformed, L.L.C. Non-invasive blood analyte measuring system and method utilizing optical absorption

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5361758A (en) 1988-06-09 1994-11-08 Cme Telemetrix Inc. Method and device for measuring concentration levels of blood constituents non-invasively

Also Published As

Publication number Publication date
US20030050541A1 (en) 2003-03-13
US20050192493A1 (en) 2005-09-01
AU2003220328A1 (en) 2003-10-08
WO2003079892A3 (en) 2004-10-28
US6898451B2 (en) 2005-05-24

Similar Documents

Publication Publication Date Title
US6898451B2 (en) Non-invasive blood analyte measuring system and method utilizing optical absorption
JP3242346U (en) Devices and systems for non-invasive monitoring of physiological measurements
US7343185B2 (en) Measurement of body compounds
US8786838B2 (en) Analyte monitoring systems and methods
JP4071113B2 (en) Noninvasive measurement of glucose by optical properties of tissue
US6771993B2 (en) Sample adapter
EP0948284B1 (en) Monitoring of tissue analytes by infrared radiation
US7061593B2 (en) Device and method for in vitro determination of analyte concentrations within body fluids
US20040132167A1 (en) Cartridge lance
WO2006092050A1 (en) Method and apparatus for determining blood analytes
US20090198113A1 (en) Dedicated spectral illumination spectroscopy
JPH09113439A (en) Method and apparatus for measuring organic component
Priyoti et al. Non-invasive blood glucose measurement using near infra-red spectroscopy
EP1528890A1 (en) Device and method for in vitro determination of analyte concentrations within body fluids
Basri et al. PLS Predictive Model for In-Vivo Non-Invasive Finger Touch Blood Glucose NIR Spectrosensor
Céelleri et al. Non-Invasive Blood Sugar Measurement System
Sequeira et al. Prediction of Alanine Using Neural Network Model
Shih et al. Introduction to spectroscopy for noninvasive glucose sensing
Davies-Shaw et al. New light upon non-invasive blood glucose monitoring
Carlson-Newberry et al. Noninvasive Measurement of Plasma Metabolites Using Near-Infrared Spectroscopy

Legal Events

Date Code Title Description
AK Designated states

Kind code of ref document: A2

Designated state(s): AE AG AL AM AT AU AZ BA BB BG BR BY BZ CA CH CN CO CR CU CZ DE DK DM DZ EC EE ES FI GB GD GE GH GM HR HU ID IL IN IS JP KE KG KP KR KZ LC LK LR LS LT LU LV MA MD MG MK MN MW MX MZ NO NZ OM PH PL PT RO RU SC SD SE SG SK SL TJ TM TN TR TT TZ UA UG UZ VC VN YU ZA ZM ZW

AL Designated countries for regional patents

Kind code of ref document: A2

Designated state(s): GH GM KE LS MW MZ SD SL SZ TZ UG ZM ZW AM AZ BY KG KZ MD RU TJ TM AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HU IE IT LU MC NL PT RO SE SI SK TR BF BJ CF CG CI CM GA GN GQ GW ML MR NE SN TD TG

121 Ep: the epo has been informed by wipo that ep was designated in this application
DFPE Request for preliminary examination filed prior to expiration of 19th month from priority date (pct application filed before 20040101)
122 Ep: pct application non-entry in european phase
NENP Non-entry into the national phase

Ref country code: JP

WWW Wipo information: withdrawn in national office

Country of ref document: JP