Methods and systems are provided for deriving and analyzing shape metrics, including skewness metrics, from physiological signals and their derivatives to determine measurement quality, patient status and operating conditions of a physiological measurement device. Such determinations may be used for any number of functions, including indicating to a patient or care provider that the measurement quality is low or unacceptable, alerting a patient or care provider to a change in patient status, triggering or delaying a recalibration of a monitoring device, and adjusting the operating parameters of a monitoring system.