Irwin Crista, Gary Rebecca
Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA.
Transl J Am Coll Sports Med. 2022 Fall;7(4):1-7. doi: 10.1249/tjx.0000000000000215. Epub 2022 Oct 12.
There are research-grade devices that have been validated to measure either heart rate (HR) by electrocardiography (ECG) with a Polar chest strap, or step count with ACTiGraph accelerometer. However, wearable activity trackers that measure HR and steps concurrently have been tested against research-grade accelerometers and HR monitors with conflicting results. This review examines validation studies of the Fitbit Charge 2 (FBC2) for accuracy in measuring HR and step count and evaluates the device's reliability for use by researchers and clinicians.
This registered review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The robvis (risk-of-bias visualization) tool was used to assess the strength of each considered article.
Eligible articles published between 2018 and 2019 were identified using PubMed, CINHAL, Embase, Cochran, and World of Science databases and hand-searches. All articles were HR and/or step count validation studies for the FBC2 in adult ambulatory populations.
Eight articles were examined in accordance with the eligibility criteria alignment and agreement among the authors and research librarian.
Concordance correlation coefficients (CCC) were used to measure agreement between the tracker and criterion devices. Mean absolute percent error (MAPE) was used to average the individual absolute percent errors.
Studies that measured CCC found agreement between the FBC2 and criterion devices ranged between 26% and 92% for HR monitoring, decreasing in accuracy as exercise intensity increased. Inversely, CCC increased from 38% to 99% for step count when exercise intensity increased. HR error between MAPE was 9.21% to 68% and showed more error as exercise intensity increased. Step measurement error MAPE was 12% for healthy persons aged 24-72 years but was reported at 46% in an older population with heart failure.
Relative agreement with criterion and low-to-moderate MAPE were consistent in most studies reviewed and support validation of the FBC2 to accurately measure HR at low or moderate exercise intensities. However, more investigation controlling testing and measurement congruency is needed to validate step capabilities. The literature supports the validity of the FBC2 to accurately monitor HR, but for step count is inconclusive so the device may not be suitable for recommended use in all populations.
有一些经过验证的研究级设备，可通过 Polar 胸带式心电图（ECG）测量心率（HR），或使用 ACTiGraph 加速度计测量步数。然而，同时测量心率和步数的可穿戴活动追踪器，与研究级加速度计和心率监测器进行对比测试时，结果存在冲突。本综述考察了 Fitbit Charge 2（FBC2）在测量心率和步数准确性方面的验证研究，并评估了该设备供研究人员和临床医生使用时的可靠性。
本注册综述采用系统评价与 Meta 分析的首选报告项目（PRISMA）指南进行。使用 robvis（偏倚风险可视化）工具评估每篇纳入文章的强度。
通过 PubMed、CINHAL、Embase、Cochran 和科学世界数据库以及手工检索，确定 2018 年至 2019 年期间发表的符合条件的文章。所有文章均为针对成年非卧床人群中 FBC2 的心率和/或步数验证研究。
根据纳入标准，作者和研究馆员共同审查了八篇文章。
一致性相关系数（CCC）用于衡量追踪器与标准设备之间的一致性。平均绝对百分比误差（MAPE）用于计算个体绝对百分比误差的平均值。
测量 CCC 的研究发现，FBC2 与标准设备在心率监测方面的一致性在 26%至 92%之间，随着运动强度增加，准确性降低。相反，随着运动强度增加，步数的 CCC 从 38%增至 99%。MAPE 测量的心率误差为 9.21%至 68%，且随着运动强度增加误差更大。24 至 72 岁健康人群的步数测量误差 MAPE 为 12%，但在老年心力衰竭人群中报告为 46%。
在大多数综述研究中，与标准的相对一致性以及低至中度的 MAPE 是一致的，这支持 FBC2 在低或中度运动强度下准确测量心率的验证。然而，需要更多控制测试和测量一致性的研究来验证步数测量能力。文献支持 FBC2 准确监测心率的有效性，但对于步数测量尚无定论，因此该设备可能不适用于推荐所有人群使用。
