Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Jan 12, 2022
Open Peer Review Period: Jan 12, 2022 - Mar 9, 2022
Date Accepted: Apr 29, 2022
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
The assessment of 24-hour physical behavior in adults via wearables: A systematic review of free-living validation studies
ABSTRACT
Background:
Wearable technology is a leading fitness trend with a growing commercial industry and an established method to collect physical behavior data in research studies. High-quality free-living validation studies are required to enable both researchers and consumers to make a guided decision on which study to rely on and which device to use. However, reviews that focus on the quality of free-living studies in adults are missing.
Objective:
The aim of the study is to provide a systematic evaluation of the characteristics and quality of free-living validation studies in adults.
Methods:
Peer-reviewed validation studies from electronic databases as well as back- and forward citation searches (1970 to July 2021) with following required indicators: (a) study protocol must include real-life conditions; (b) validated device outcome must belong to one dimension of the 24-hour PB construct (i.e., intensity, posture/activity type, biological state); (c) the study protocol must include a criterion measure; (d) study results must be published in peer-reviewed English language journals. The risk of bias was evaluated by using the QUADAS-2 tool with nine questions separated into four domains (i.e., patient selection/study design; index measure; criterion measure; flow and time).
Results:
Out of 13,285 unique search results, 223 articles were included and reviewed. Most studies (69.1%) validated an intensity measure outcome such as energy expenditure, but only 21.5 % biological state and 16.1% posture/activity type outcomes. The percentage of meeting the quality criteria ranged from 38.7% to 92.4%. Only, 52 studies were classified as “low risk” or with “some concerns”.
Conclusions:
Overall, free-living validation studies of wearables assessing PB in adults are characterized by low methodological quality, large variability in design, and a focus on intensity. Future research should more strongly aim at biological state and posture/activity outcomes, and strive for standardized protocols embedded in a validation framework. Clinical Trial: CRD42021231033
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