Article Text

Recommendations for determining the validity of consumer wearable heart rate devices: expert statement and checklist of the INTERLIVE Network
  1. Jan M Mühlen1,
  2. Julie Stang2,
  3. Esben Lykke Skovgaard3,
  4. Pedro B Judice4,5,
  5. Pablo Molina-Garcia6,
  6. William Johnston7,8,
  7. Luís B Sardinha9,
  8. Francisco B Ortega6,10,
  9. Brian Caulfield7,8,
  10. Wilhelm Bloch1,
  11. Sulin Cheng1,11,
  12. Ulf Ekelund2,
  13. Jan Christian Brønd3,
  14. Anders Grøntved3,
  15. Moritz Schumann1,11
  1. 1Institute of Cardiovascular Research and Sports Medicine, Department of Molecular and Cellular Sports Medicine, German Sport University Cologne, Cologne, Germany
  2. 2Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
  3. 3Department of Sports Science and Clinical Biomechanics, Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, University of Southern Denmark, Odense, Denmark
  4. 4Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
  5. 5CIDEFES - Centro de Investigação em Desporto, Educação Física e Exercício e Saúde, Universidade Lusófona, Lisboa, Portugal
  6. 6PROFITH “PROmoting FITness and Health through physical activity” Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
  7. 7SFI Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland
  8. 8School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
  9. 9Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Cruz-Quebrada Dafundo, Portugal
  10. 10Department of Biosciences and Nutrition, Karolinska Institute, Stockholm, Sweden
  11. 11Exercise Translational Medicine Centre, the Key Laboratory of Systems Biomedicine, Ministry of Education, and Exercise, Health and Technology Centre, Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China
  1. Correspondence to Dr Moritz Schumann, Institute of Cardiovascular Research and Sports Medicine, Department of Molecular and Cellular Sports Medicine, German Sport University Cologne, Koln 50858, Germany; m.schumann{at}dshs-koeln.de

Abstract

Assessing vital signs such as heart rate (HR) by wearable devices in a lifestyle-related environment provides widespread opportunities for public health related research and applications. Commonly, consumer wearable devices assessing HR are based on photoplethysmography (PPG), where HR is determined by absorption and reflection of emitted light by the blood. However, methodological differences and shortcomings in the validation process hamper the comparability of the validity of various wearable devices assessing HR. Towards Intelligent Health and Well-Being: Network of Physical Activity Assessment (INTERLIVE) is a joint European initiative of six universities and one industrial partner. The consortium was founded in 2019 and strives towards developing best-practice recommendations for evaluating the validity of consumer wearables and smartphones. This expert statement presents a best-practice validation protocol for consumer wearables assessing HR by PPG. The recommendations were developed through the following multi-stage process: (1) a systematic literature review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, (2) an unstructured review of the wider literature pertaining to factors that may introduce bias during the validation of these devices and (3) evidence-informed expert opinions of the INTERLIVE Network. A total of 44 articles were deemed eligible and retrieved through our systematic literature review. Based on these studies, a wider literature review and our evidence-informed expert opinions, we propose a validation framework with standardised recommendations using six domains: considerations for the target population, criterion measure, index measure, testing conditions, data processing and the statistical analysis. As such, this paper presents recommendations to standardise the validity testing and reporting of PPG-based HR wearables used by consumers. Moreover, checklists are provided to guide the validation protocol development and reporting. This will ensure that manufacturers, consumers, healthcare providers and researchers use wearables safely and to its full potential.

  • public health
  • consensus statement
  • sports medicine
  • sports and exercise medicine
  • cardiology
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Footnotes

  • Twitter @Will_Johns10, @Ulf_Ekelund, @moritz_schumann

  • JMM, JS and ELS contributed equally.

  • Contributors All authors were involved in the development and drafting of the expert statement. All authors have read and approved the content of the manuscript.

  • Funding JMM is partly funded by Private Stiftung Ewald Marquardt für Wissenschaft und Technik, Kunst und Kultur. UE and JS are partly funded by the Research Council of Norway (249932/F20). ELS is supported by TrygFonden (grant number 310081). PBJ is supported by the Portuguese Foundation for Science and Technology (SFRH/BPD/115977/2016). PMG and FBO are supported by grants from the MINECO/FEDER (DEP2016‐79512‐R) and from the University of Granada, Plan Propio de Investigación 2016, Excellence actions: Units of Excellence; Scientific Excellence Unit on Exercise and Health (UCEES); Junta de Andalucía, Consejería de Conocimiento, Investigación y Universidades and European Regional Development Funds (ref. SOMM17/6107/UGR). WJ is partly funded by Science Foundation Ireland (12/RC/2289_P2). AG is supported a European Research Council Grant (grant number 716657). This research was partly funded by Huawei Technologies, Finland.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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