RAMADAN SERIES

Comparison of Ultrahuman Ring AIR temperature sensing at device and hand level reveals superior overlap with gold standards

Aditi Shanmugam, Prejwal Prabhakaran, Ved Asudani, Akshay Joshi, Amith Suraj, Arun Prasath, Yogansh Namdeo, Apoorv Shankar, Bhuvan Srinivasan, Aditi Bhattacharya
Summary
- Ultrahuman Ring AIR was compared with gold standard (iButton) temperature sensors in two settings.
- Direct device-to-device temperature with iButton displayed a Spearman correlation (ρ of 0.99).
- Finger skin temperature (RingAIR vs iButton) during sleep had superior concordance (ρ = 0.97). 
- Ultrahuman Ring AIR performs at the highest standards in temperature sensing in a variety of scenarios.
Background and Motivation
Body temperature has long been a key indicator of health and disease, recognized since early human history. Elevated temperatures, strongly associated with illness, have been used across civilizations as a diagnostic tool.1 The invention of thermometry enabled accurate core temperature measurements, revolutionizing modern medicine. 2  In parallel, nuances of peripheral and central body temperature variation have emerged which are central to wearable technology-based health insights.3

Peripheral temperature tracking—measured on skin, hands, and feet—offers continuous, non-invasive data. Unlike core temperature, it fluctuates more dynamically due to factors such as skin blood flow, exercise, and environmental conditions.4 This variability makes it a valuable metric for personalized health insights, and is widely utilized in wearable device algorithms. 

The Ultrahuman Ring AIR, equipped with a medical-grade temperature sensor, tracks peripheral skin temperature every 5 minutes, increasing to 30-second intervals during specialized modes. This whitepaper provides its temperature sensing capabilities in two scenarios: (a) device-to-device comparisons within commonly inhabited human temperature ranges, (b) sleep-based on-hand temperature overlaps.
Methods
Ultrahuman Ring AIR Sensor : The Ultrahuman Ring AIR features an advanced temperature sensor designed for continuous peripheral temperature tracking. The device operates at a range of -20°C to 40°C and records data with high precision at a frequency of one reading every 5 minutes.
 
iButton DS1921H Sensor : The iButton sensor is a well-established device for temperature monitoring, widely used in scientific studies for its accuracy and reliability.5,6 It records temperature at user programmable intervals from 1 to 255 minutes and can measure temperatures across the range of  +15°C to +46°C with a resolution of 0.125°C. 

Off body experimental set up-  Ring AIR to iButton Sensor
Experimental Setup : Pairs of Ring AIR and iButton devices were placed in polypropylene tubes to ensure uniform temperature exposure and prevent contamination, with experiments conducted across a wide range of temperatures ranging from 0 to 42  °C. Enhanced sampling was conducted at two discrete temperature ranges (20-25°C and 34-37°C) which represents the most frequent temperature ranges of user data and replicated in a controlled water bath.
Data Collection : The experiment was conducted over a continuous three-day period, with temperature measurements logged at 5-minute intervals by the Ultrahuman Ring AIR and 3-minute intervals by the iButton sensor. Both devices employed time-stamped digital recording to ensure precise synchronization and facilitated robust analytical comparisons.

On body- finger comparison- Ring AIR to iButton Sensor 
Study Participants : 7 healthy adults volunteers (aged 20-50 years, nearly equal male to female ratio) from the Ultrahuman team were included, representing diverse skin tones, and body compositions.
Experimental Setup : Volunteers wore one Ultrahuman Ring AIR on their preferred finger and the iButton secured to the base of the index finger of their non-dominant hand using medical-grade adhesive tape for stable contact to skin throughout the measurement period.
Data Collection : Temperature readings were recorded over 3-5 consecutive nights to capture variations during different sleep stages and environmental conditions. Volunteers maintained their usual sleeping habits and environmental settings to simulate real-world conditions. Both devices recorded temperature data digitally with timestamps to enable accurate synchronization and analysis. Participants ensured proper placement of the iButton and functionality of the Ultrahuman Ring AIR each night to maintain data integrity and prevent loss or corruption.

Statistical Analysis: 
To ensure data accuracy, consecutive data points within a 5-minute interval were selected, minimizing the impact of measurement errors and unexpected deviations. Key statistical metrics were calculated to evaluate the performance and agreement between the devices at individual data point levels. The mean difference (bias) assessed the average deviation between paired temperature measurements, while the upper and lower limits of agreement (LOA) evaluated the range within which most differences fell. Group variance (MLM) quantified variability across participant groups to account for individual differences. Subsequent to normality testing, Spearman correlation was used to measure the strength and direction of the monotonic relationship between the devices, and the p-value determined the statistical significance of the observed correlations. Data was analyzed using scikit-learn, an open source statistical and machine learning library in Python. Since this was an internal volunteer study, two separate data analysts independently analyzed the results. 
Results
Off-Body Ring AIR vs iButton comparison demonstrated a strong positive correlation between the Ultrahuman Ring AIR and iButton temperature readings, with an R-Squared of 0.987, Spearman Correlation of 0.965, and negligible mean temperature difference (bias) of ~0.4 °C (Figure 1A, Table 1). The narrow LOA range of +0.3 °C to -0.6 °C highlights strong agreement in typical conditions, particularly between 25 °C and 40 °C, while sparse data at temperature extremes indicates consistent performance with minimal deviations. The narrow group variation of 0.032 further underscores the reliability of the Ultrahuman Ring AIR in purely device-level comparisons.

On-Body Ring AIR vs iButton comparison was only done during sleep sessions to avoid movement and activity related confounds. Here again, we found a strong positive correlation between the two devices, with an R-Squared of 0.975, Spearman Correlation of 0.965, and hardly any mean temperature difference (bias). A narrow LOA range of 1.2 °C (Upper LOA: +0.8 °C, Lower LOA: -0.4 °C) highlighted the sensors’ reliability in typical on-body conditions, particularly within the high-density temperature range of 32 °C to 37 °C (Figure 1B, Table 1). We found sparse data points outside this range (~0.36% of all data points) suggesting occasional deviations, potentially due to movement or environment related factors as the volunteers slept.
Figure 1 : Graphical representation of overlap percentage between Ultrahuman Ring AIR and iButton in A) Off-Body and B) On-Body comparison. N = 2401 datapoints for Off-Body and N = 1435 datapoints for On-Body.
Table 1 : Statistical comparison of all Off-body and On-body experiments.
Discussion
The study evaluated the Ultrahuman Ring AIR’s performance under real-world conditions and its relation to core body temperature measurements, providing a rigorous framework of operation along with its accuracy in diverse use cases.6,7 Temperature tracking is not only important for determining early signals of illness (infectious diseases or inflammation related) but also forms the bed-rock of cycle tracking analytics that rely on changes in basal body temperature equivalents across the menstrual cycle.6,8 In extreme environment professions, such as firefighting, oil rig activities, ground staff at airports or high altitude activities, peripheral temperature requires monitoring to provide critical information on thermoregulatory strain.9

In usual human habitation and functioning conditions (20-40°C), as expected there were wide variations in skin temperature of fingers to thorax or abdomen. This was primarily due to the range of materials and conditions that a human hand is exposed to, rather than actual device fluctuations. Another contributing factor is the higher surface-to-volume ratio of fingers, which accelerates heat exchange with the surrounding environment, leading to greater variability in measured temperatures, and extremities being more susceptible to environmental variations and transient changes in temperature regulation.

Controlled water-bath and ambient room temperature (off-body) experiments corroborated this assertion given the high agreement noted between the Ultrahuman Ring AIR and the iButton sensors, consistently across different experimental days. The same iButton sensors, when worn just below the ring,  by volunteers while sleeping, demonstrated best-in-class overlap. There were expected deviations in extreme temperature ranges (cold or hot) for which algorithmic refinement is underway for specific use cases. 

Body temperature has its own circadian rhythm as well, which in the future may see wider application in wellness and disease diagnosis and tracking. Wearables are an excellent stream of continuous data, which will be increasingly leveraged for remote surveillance in healthcare settings. 
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