Study: Consumer wearable devices tend to measure some metrics well (heart rate, cardiorespiratory fitness) but others not so well (energy expenditure, sleep quality)

(Image cred­it: Garmin)

Back in 2010, Gary Wolf, then the edi­tor of Wired mag­a­zine, deliv­ered a TED talk in Cannes called “the quan­ti­fied self”. It was about what he termed a “new fad” among tech enthu­si­asts. These ear­ly adopters were using gad­gets to mon­i­tor every­thing from their phys­i­o­log­i­cal data to their mood, and even the num­ber of nap­pies their chil­dren used.

Wolf acknowl­edged that these peo­ple were out­liers – tech geeks fas­ci­nat­ed by data – but their behav­iour has since per­me­at­ed main­stream culture.

From the smart­watch­es that track our steps and heart rate, to the fit­ness bands that log sleep pat­terns and calo­ries burned, these gad­gets are now ubiq­ui­tous. Their pop­u­lar­i­ty is emblem­at­ic of a mod­ern obses­sion with quan­tifi­ca­tion – the idea that if some­thing isn’t logged, it doesn’t count.

At least half the peo­ple in any giv­en room are like­ly wear­ing a device, such as a fit­ness track­er, that quan­ti­fies some aspect of their lives. Wear­ables are being adopt­ed at a pace rem­i­nis­cent of the mobile phone boom of the late 2000s.

How­ev­er, the quan­ti­fied self move­ment still grap­ples with an impor­tant ques­tion: can wear­able devices tru­ly mea­sure what they claim to?

Our new study and what it shows: the good part

Along with my col­leagues Max­imus Bald­win, Ali­son Keogh, Bri­an Caulfield and Rob Argent, I recent­ly pub­lished an umbrel­la review (a sys­tem­at­ic review of sys­tem­at­ic reviews) exam­in­ing the sci­en­tif­ic lit­er­a­ture on whether con­sumer wear­able devices can accu­rate­ly mea­sure met­rics like heart rate, aer­o­bic capac­i­ty, ener­gy expen­di­ture, sleep and step count.

At a sur­face lev­el, our results were quite pos­i­tive. Accept­ing some error, wear­able devices can mea­sure heart rate with an error rate of plus or minus 3%, depend­ing on fac­tors like skin tone, exer­cise inten­si­ty and activ­i­ty type. They can also accu­rate­ly mea­sure heart rate vari­abil­i­ty and show good sen­si­tiv­i­ty and speci­fici­ty for detect­ing arrhyth­mia, a prob­lem with the rate of a person’s heart beat.

Addi­tion­al­ly, they can accu­rate­ly esti­mate what’s known as car­diores­pi­ra­to­ry fit­ness, which is how the cir­cu­la­to­ry and res­pi­ra­to­ry sys­tems sup­ply oxy­gen to the mus­cles dur­ing phys­i­cal activ­i­ty. This can be quan­ti­fied by some­thing called VO2Max, which is a mea­sure of how much oxy­gen your body uses while exercising.

The abil­i­ty of wear­ables to accu­rate­ly mea­sure this is bet­ter when those pre­dic­tions are gen­er­at­ed dur­ing exer­cise (rather than at rest). In the realm of phys­i­cal activ­i­ty, wear­ables gen­er­al­ly under­es­ti­mate step counts, by about 9%.

Now the challenging part:

How­ev­er, dis­crep­an­cies were larg­er for ener­gy expen­di­ture (the num­ber of calo­ries you burn when exer­cis­ing) with error mar­gins rang­ing from 21.27% to 14.76%, depend­ing on the device used and the activ­i­ty undertaken.

Results weren’t much bet­ter for sleep. Wear­ables tend to over­es­ti­mate total sleep time and sleep effi­cien­cy, typ­i­cal­ly by more than 10%. They also tend to under­es­ti­mate sleep onset laten­cy (a lag in get­ting to sleep) and wake­ful­ness after sleep onset. Errors ranged from 12% to 180%, com­pared to the gold stan­dard mea­sure­ments used in sleep stud­ies, known as polysomnography.

The upshot is that, despite the promis­ing capa­bil­i­ties of wear­ables, we found con­duct­ing and syn­the­sis­ing research in this field to be very chal­leng­ing. One hur­dle we encoun­tered was the incon­sis­tent method­olo­gies employed by dif­fer­ent research groups when val­i­dat­ing a giv­en device.

This lack of stan­dard­i­s­a­tion leads to con­flict­ing results and makes it dif­fi­cult to draw defin­i­tive con­clu­sions about a device’s accu­ra­cy. A clas­sic exam­ple from our research: one study might assess heart rate accu­ra­cy dur­ing high-inten­si­ty inter­val train­ing, while anoth­er focus­es on seden­tary activ­i­ties, lead­ing to dis­crep­an­cies that can’t be eas­i­ly reconciled.

Oth­er issues include vary­ing sam­ple sizes, par­tic­i­pant demo­graph­ics, and exper­i­men­tal con­di­tions – all of which add lay­ers of com­plex­i­ty to the inter­pre­ta­tion of our findings.

What our findings mean for users, research and industry:

Per­haps most impor­tant­ly, the rapid pace at which new wear­able devices are released exac­er­bates these issues. With most com­pa­nies fol­low­ing a year­ly release cycle, we and oth­er researchers find it chal­leng­ing to keep up. The time­line for plan­ning a study, obtain­ing eth­i­cal approval, recruit­ing and test­ing par­tic­i­pants, analysing results, and pub­lish­ing can often exceed 12 months.

By the time a study is pub­lished, the device under inves­ti­ga­tion is like­ly to already be obso­lete, replaced by a new­er mod­el with poten­tial­ly dif­fer­ent spec­i­fi­ca­tions and per­for­mance char­ac­ter­is­tics. This is demon­strat­ed by our find­ing that less than 5% of the con­sumer wear­ables that have been released to date have been val­i­dat­ed for the range of phys­i­o­log­i­cal sig­nals they pur­port to measure.

What do our results mean for you? As wear­able tech­nolo­gies con­tin­ue to per­me­ate var­i­ous facets of health and lifestyle, it is impor­tant to approach man­u­fac­tur­ers’ claims with a healthy dose of scep­ti­cism. Gaps in research, incon­sis­tent method­olo­gies and the rapid pace of new device releas­es under­score the need for a more for­malised and stan­dard­ised approach to val­i­da­tion of devices.

The goal here would be to fos­ter col­lab­o­ra­tive syn­er­gies between for­mal cer­ti­fi­ca­tion bod­ies, aca­d­e­m­ic research con­sor­tia, pop­u­lar media influ­encers, and the indus­try, so that we can aug­ment the depth and reach of wear­able tech­nol­o­gy evaluation.

Efforts are already under­way to estab­lish a col­lab­o­ra­tive net­work that can fos­ter a rich­er, mul­ti­fac­eted dia­logue that res­onates with a broad spec­trum of stake­hold­ers – ensur­ing that wear­ables are not just inno­v­a­tive gad­gets, but reli­able tools for health and wellness.

Cailb­he Doher­ty is an Assis­tant Pro­fes­sor in the School of Pub­lic Health, Phys­io­ther­a­py and Sports Sci­ence at Uni­ver­si­ty Col­lege Dublin, focused on the poten­tial for con­sumer wear­able tech­nolo­gies to rev­o­lu­tionise pub­lic health. This arti­cle was orig­i­nal­ly pub­lished on The Con­ver­sa­tion.

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About SharpBrains

SHARPBRAINS is an independent think-tank and consulting firm providing services at the frontier of applied neuroscience, health, leadership and innovation.
SHARPBRAINS es un think-tank y consultoría independiente proporcionando servicios para la neurociencia aplicada, salud, liderazgo e innovación.

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