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      Reliability and Validity of Commercially Available Wearable Devices for Measuring Steps, Energy Expenditure, and Heart Rate: Systematic Review

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          Abstract

          Background

          Consumer-wearable activity trackers are small electronic devices that record fitness and health-related measures.

          Objective

          The purpose of this systematic review was to examine the validity and reliability of commercial wearables in measuring step count, heart rate, and energy expenditure.

          Methods

          We identified devices to be included in the review. Database searches were conducted in PubMed, Embase, and SPORTDiscus, and only articles published in the English language up to May 2019 were considered. Studies were excluded if they did not identify the device used and if they did not examine the validity or reliability of the device. Studies involving the general population and all special populations were included. We operationalized validity as criterion validity (as compared with other measures) and construct validity (degree to which the device is measuring what it claims). Reliability measures focused on intradevice and interdevice reliability.

          Results

          We included 158 publications examining nine different commercial wearable device brands. Fitbit was by far the most studied brand. In laboratory-based settings, Fitbit, Apple Watch, and Samsung appeared to measure steps accurately. Heart rate measurement was more variable, with Apple Watch and Garmin being the most accurate and Fitbit tending toward underestimation. For energy expenditure, no brand was accurate. We also examined validity between devices within a specific brand.

          Conclusions

          Commercial wearable devices are accurate for measuring steps and heart rate in laboratory-based settings, but this varies by the manufacturer and device type. Devices are constantly being upgraded and redesigned to new models, suggesting the need for more current reviews and research.

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          Most cited references183

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          Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement

          Systematic reviews should build on a protocol that describes the rationale, hypothesis, and planned methods of the review; few reviews report whether a protocol exists. Detailed, well-described protocols can facilitate the understanding and appraisal of the review methods, as well as the detection of modifications to methods and selective reporting in completed reviews. We describe the development of a reporting guideline, the Preferred Reporting Items for Systematic reviews and Meta-Analyses for Protocols 2015 (PRISMA-P 2015). PRISMA-P consists of a 17-item checklist intended to facilitate the preparation and reporting of a robust protocol for the systematic review. Funders and those commissioning reviews might consider mandating the use of the checklist to facilitate the submission of relevant protocol information in funding applications. Similarly, peer reviewers and editors can use the guidance to gauge the completeness and transparency of a systematic review protocol submitted for publication in a journal or other medium.
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            PRESS Peer Review of Electronic Search Strategies: 2015 Guideline Statement.

            To develop an evidence-based guideline for Peer Review of Electronic Search Strategies (PRESS) for systematic reviews (SRs), health technology assessments, and other evidence syntheses.
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              The effect of English-language restriction on systematic review-based meta-analyses: a systematic review of empirical studies.

              The English language is generally perceived to be the universal language of science. However, the exclusive reliance on English-language studies may not represent all of the evidence. Excluding languages other than English (LOE) may introduce a language bias and lead to erroneous conclusions. We conducted a comprehensive literature search using bibliographic databases and grey literature sources. Studies were eligible for inclusion if they measured the effect of excluding randomized controlled trials (RCTs) reported in LOE from systematic review-based meta-analyses (SR/MA) for one or more outcomes. None of the included studies found major differences between summary treatment effects in English-language restricted meta-analyses and LOE-inclusive meta-analyses. Findings differed about the methodological and reporting quality of trials reported in LOE. The precision of pooled estimates improved with the inclusion of LOE trials. Overall, we found no evidence of a systematic bias from the use of language restrictions in systematic review-based meta-analyses in conventional medicine. Further research is needed to determine the impact of language restriction on systematic reviews in particular fields of medicine.
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                Author and article information

                Contributors
                Journal
                JMIR Mhealth Uhealth
                JMIR Mhealth Uhealth
                JMU
                JMIR mHealth and uHealth
                JMIR Publications (Toronto, Canada )
                2291-5222
                September 2020
                8 September 2020
                : 8
                : 9
                : e18694
                Affiliations
                [1 ] School of Human Kinetics and Recreation Memorial University St. John's, NL Canada
                [2 ] Department of Computer Science Memorial University St. John's, NL Canada
                [3 ] Division of Community Health and Humanities Faculty of Medicine Memorial University St. John's, NL Canada
                [4 ] Faculty of Medicine Memorial University St. John's, NL Canada
                [5 ] Faculty of Engineering Memorial University St. John's, NL Canada
                [6 ] Department of Geography University of Oregon Eugene, OR United States
                [7 ] School of Health Administration Dalhousie University Halifax, NS Canada
                Author notes
                Corresponding Author: Daniel Fuller dfuller@ 123456mun.ca
                Author information
                https://orcid.org/0000-0002-2015-2955
                https://orcid.org/0000-0002-1045-6234
                https://orcid.org/0000-0002-1964-6237
                https://orcid.org/0000-0002-1355-8842
                https://orcid.org/0000-0002-4128-4690
                https://orcid.org/0000-0003-3695-2815
                https://orcid.org/0000-0001-7981-7854
                https://orcid.org/0000-0001-8994-8428
                https://orcid.org/0000-0001-9884-8509
                https://orcid.org/0000-0002-7904-9151
                https://orcid.org/0000-0003-2641-4124
                https://orcid.org/0000-0001-6478-8165
                Article
                v8i9e18694
                10.2196/18694
                7509623
                32897239
                8a51c01a-ebed-4c42-a985-0332cd0bc31a
                ©Daniel Fuller, Emily Colwell, Jonathan Low, Kassia Orychock, Melissa Ann Tobin, Bo Simango, Richard Buote, Desiree Van Heerden, Hui Luan, Kimberley Cullen, Logan Slade, Nathan G A Taylor. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 08.09.2020.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mHealth and uHealth, is properly cited. The complete bibliographic information, a link to the original publication on http://mhealth.jmir.org/, as well as this copyright and license information must be included.

                History
                : 30 March 2020
                : 12 June 2020
                : 22 June 2020
                : 25 June 2020
                Categories
                Review
                Review

                commercial wearable devices,systematic review,heart rate,energy expenditure,step count,fitbit,apple watch,garmin,polar

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