Background and Aim The consumer ‘wearables’ market has grown considerably over the past few years, and wrist-worn devices are becoming an increasingly popular means of monitoring physical activity, supporting people to modify and increase their physical activity levels. However the evidence regarding the accuracy of wrist-worn devices that measure heart rate (HR) has not been summarised. The aim was to conduct a systematic review to examine and summarise the literature reporting on the accuracy of wrist-worn wearable devices that measure HR.
Method A systematic search of the literature was performed using a specific search strategy in the following databases; PubMed, CINAHL, the Cochrane Library, and SPORTDiscus. Articles published in English, including human participants, between January 2008 and up to the date the searches were performed (1 May 2018) were included. This review considered any peer reviewed original articles that evaluated the accuracy of HR measures/signals from any consumer, research or medical-grade wrist-worn activity tracker device. The methodological quality of the studies included was assessed using an adapted version of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) framework. Data extracted from each study included the following: characteristics of the study participants, study setting, devices used, study protocol and the criterion measure.
Results Thirty studies examining the validity of 24 different devices were included in this systematic review. Overall the methodological quality of the studies examined was high, with 22 of the included studies scoring ≥7. The Fitbit Charge HR was the most frequently studied device (evaluated in nine studies) closely followed by the Apple Watch (series 1 and 2) which was examined in eight studies. The identified studies included both healthy participants as well as patients with a range of clinical conditions.
Conclusions The Apple Watch and Fitbit Charge HR devices appear to be relatively accurate in measuring HR, with no substantial under- or over-estimation. A meta-analysis will be performed to derive more definitive conclusions.
This project has been funded by the EU’s INTERREG VA programme, managed by the Special EU Programmes Body (SEUPB).
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