{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T03:51:18Z","timestamp":1793850678114,"version":"4.6.1"},"reference-count":56,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Mhealth Uhealth"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Consumer-based wearables are becoming more popular and provide opportunities to track individual\u2019s clinical parameters remotely. However, literature about their criterion and known-groups validity is scarce.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to assess the validity of the Fitbit Charge 4, a wrist-worn consumer-based wearable, to measure clinical parameters (ie, daily step count, resting heart rate [RHR], heart rate variability [HRV], respiratory rate [RR], and oxygen saturation) in patients with chronic obstructive pulmonary disease (COPD) and healthy controls in free-living conditions in Belgium by comparing it with medical-grade devices.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Participants wore the Fitbit Charge 4 along with three medical-grade devices: (1) Dynaport MoveMonitor for 7 days, retrieving daily step count; (2) Polar H10 for 5 days, retrieving RHR, HRV, and RR; and (3) Nonin WristOX\n 2<\/jats:sub>\n 3150 for 4 nights, retrieving oxygen saturation. Criterion validity was assessed by investigating the agreement between day-by-day measures of the Fitbit Charge 4 and the corresponding reference devices. Known-groups validity was assessed by comparing patients with COPD and healthy controls.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Data of 30 patients with COPD and 25 age- and gender-matched healthy controls resulted in good agreement between the Fitbit Charge 4 and the corresponding reference device for measuring daily step count (intraclass correlation coefficient [ICC\n 2,1<\/jats:sub>\n ]=0.79 and ICC\n 2,1<\/jats:sub>\n =0.85, respectively), RHR (ICC\n 2,1<\/jats:sub>\n =0.80 and ICC\n 2,1<\/jats:sub>\n =0.79, respectively), and RR (ICC\n 2,1<\/jats:sub>\n =0.84 and ICC\n 2,1<\/jats:sub>\n =0.77, respectively). The agreement for HRV was moderate (healthy controls: ICC\n 2,1<\/jats:sub>\n =0.69) to strong (COPD: ICC\n 2,1<\/jats:sub>\n =0.87). The agreement in measuring oxygen saturation in patients with COPD was poor (ICC\n 2,1<\/jats:sub>\n =0.32). The Fitbit device overestimated the daily step count and underestimated HRV in both groups. While RHR and RR were overestimated in healthy controls, no difference was observed in patients with COPD. Oxygen saturation was overestimated in patients with COPD. The Fitbit Charge 4 detected significant differences in daily step count, RHR, and RR between patients with COPD and healthy controls, similar to those identified by the reference devices, supporting known-groups validity.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Although the Fitbit Charge 4 shows mainly moderate to good agreement, measures of clinical parameters deviated from the reference devices, indicating that monitoring patients remotely and interpreting parameters requires caution. Differences in clinical parameters between patients with COPD and healthy controls that were measured by the reference devices were all detected by the Fitbit Charge 4.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/56027","type":"journal-article","created":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T14:46:12Z","timestamp":1730904372000},"page":"e56027-e56027","source":"Crossref","is-referenced-by-count":25,"title":["Validity of a Consumer-Based Wearable to Measure Clinical Parameters in Patients With Chronic Obstructive Pulmonary Disease and Healthy Controls: Observational Study"],"prefix":"10.2196","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7497-4957","authenticated-orcid":false,"given":"Fien","family":"Hermans","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8539-937X","authenticated-orcid":false,"given":"Eva","family":"Arents","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8751-1449","authenticated-orcid":false,"given":"Astrid","family":"Blondeel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1830-2982","authenticated-orcid":false,"given":"Wim","family":"Janssens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6739-1590","authenticated-orcid":false,"given":"Nina","family":"Cardinaels","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6327-8155","authenticated-orcid":false,"given":"Patrick","family":"Calders","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2767-5027","authenticated-orcid":false,"given":"Thierry","family":"Troosters","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1110-4940","authenticated-orcid":false,"given":"Eric","family":"Derom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8925-0564","authenticated-orcid":false,"given":"Heleen","family":"Demeyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2024,11,6]]},"reference":[{"key":"R1","unstructured":"Growing importance of internet-connected devices. Eurostat. URL: https:\/\/ec.europa.eu\/eurostat\/web\/products-eurostat-news\/w\/ddn-20230829-1 [Accessed 25-08-2023]"},{"issue":"2","key":"R2","doi-asserted-by":"publisher","first-page":"282","DOI":"10.3390\/electronics3020282","article-title":"Wearable photoplethysmographic sensors\u2014past and present","volume":"3","author":"Tamura","journal-title":"Electronics (Basel)"},{"issue":"4","key":"R3","doi-asserted-by":"publisher","first-page":"195","DOI":"10.15406\/ijbsbe.2018.04.00125","article-title":"A review on wearable photoplethysmography sensors and their potential future applications in health care","volume":"4","author":"Castaneda","journal-title":"Int J Biosens Bioelectron"},{"key":"R4","unstructured":"Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: 2024 report. Global Initiative for Chronic Obstructive Lung Disease. 2024. URL: https:\/\/goldcopd.org\/2024-gold-report\/ [Accessed 02-08-2023]"},{"issue":"4","key":"R5","doi-asserted-by":"publisher","first-page":"215","DOI":"10.3978\/j.issn.2072-1439.2010.02.04.5","article-title":"Autonomic dysfunction in patients with chronic obstructive pulmonary disease (COPD)","volume":"2","author":"van Gestel","journal-title":"J Thorac Dis"},{"issue":"3","key":"R6","doi-asserted-by":"publisher","first-page":"1239","DOI":"10.1002\/cphy.c150037","article-title":"Overview of the anatomy, physiology, and pharmacology of the autonomic nervous system","volume":"6","author":"Wehrwein","journal-title":"Compr Physiol"},{"issue":"3","key":"R7","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1080\/15412555.2020.1750578","article-title":"COPD patients have a restricted breathing pattern that persists with increased metabolic demands","volume":"17","author":"Yentes","journal-title":"COPD"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S10611","article-title":"Hypoxemia in patients with COPD: cause, effects, and disease progression","volume":"6","author":"Kent","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"issue":"2","key":"R9","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1183\/09031936.00072212","article-title":"Resting heart rate is a predictor of mortality in COPD","volume":"42","author":"Jensen","journal-title":"Eur Respir J"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.1177\/20552076231162989","article-title":"Heart rate and oxygen uptake kinetics obtained from continuous measurements with wearable devices during outdoor walks of patients with COPD","volume":"9","author":"Buekers","journal-title":"Digit Health"},{"key":"R11","unstructured":"Fitbit important safety and product and services information. Fitbit device documentation. URL: https:\/\/www.fitbit.com\/global\/us\/legal\/safety-instructions [Accessed 08-11-2023]"},{"issue":"6","key":"R12","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1136\/hrt.67.6.482","article-title":"Decreased cardiac parasympathetic activity in chronic heart failure and its relation to left ventricular function","volume":"67","author":"Nolan","journal-title":"Br Heart J"},{"issue":"8","key":"R13","doi-asserted-by":"publisher","first-page":"970","DOI":"10.1001\/jamaneurol.2017.1125","article-title":"Association of autonomic dysfunction with disease progression and survival in Parkinson disease","volume":"74","author":"De Pablo-Fernandez","journal-title":"JAMA Neurol"},{"issue":"11","key":"R14","doi-asserted-by":"publisher","first-page":"1323","DOI":"10.1016\/S0002-9149(98)00635-3","article-title":"Prognostic role of heart rate variability in patients with a recent acute myocardial infarction","volume":"82","author":"Lanza","journal-title":"Am J Cardiol"},{"issue":"3","key":"R15","doi-asserted-by":"publisher","first-page":"328","DOI":"10.15326\/jcopdf.2023.0410","article-title":"Decreased cardiac autonomic function is associated with higher exacerbation risk and symptom burden in chronic obstructive pulmonary disease","volume":"10","author":"Raju","journal-title":"Chronic Obstr Pulm Dis"},{"issue":"1","key":"R16","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1186\/1471-2466-10-52","article-title":"Domiciliary pulse-oximetry at exacerbation of chronic obstructive pulmonary disease: prospective pilot study","volume":"10","author":"Hurst","journal-title":"BMC Pulm Med"},{"issue":"1","key":"R17","doi-asserted-by":"publisher","DOI":"10.1136\/bmjsem-2015-000013","article-title":"Validity of the Fitbit activity tracker for measuring steps in community-dwelling older adults","volume":"1","author":"Paul","journal-title":"BMJ Open Sport Exerc Med"},{"issue":"9","key":"R18","doi-asserted-by":"publisher","DOI":"10.2196\/18694","article-title":"Reliability and validity of commercially available wearable devices for measuring steps, energy expenditure, and heart rate: systematic review","volume":"8","author":"Fuller","journal-title":"JMIR Mhealth Uhealth"},{"issue":"8","key":"R19","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0236676","article-title":"Accuracy of consumer-based activity trackers as measuring tool and coaching device in patients with COPD and healthy controls","volume":"15","author":"Blondeel","journal-title":"PLoS One"},{"issue":"3","key":"R20","doi-asserted-by":"publisher","DOI":"10.2196\/33635","article-title":"Heart rate measurement accuracy of Fitbit Charge 4 and Samsung Galaxy Watch Active2: device evaluation study","volume":"6","author":"Nissen","journal-title":"JMIR Form Res"},{"issue":"15","key":"R21","doi-asserted-by":"publisher","first-page":"1734","DOI":"10.1080\/02640414.2017.1412235","article-title":"Comparative evaluation of heart rate-based monitors: Apple Watch vs Fitbit Charge HR","volume":"36","author":"Bai","journal-title":"J Sports Sci"},{"issue":"2","key":"R22","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0192691","article-title":"Assessment of the Fitbit Charge 2 for monitoring heart rate","volume":"13","author":"Benedetto","journal-title":"PLoS One"},{"issue":"8","key":"R23","doi-asserted-by":"publisher","first-page":"e70","DOI":"10.1164\/rccm.201908-1590ST","article-title":"Standardization of spirometry 2019 update. An official American Thoracic Society and European Respiratory Society technical statement","volume":"200","author":"Graham","journal-title":"Am J Respir Crit Care Med"},{"issue":"6","key":"R24","doi-asserted-by":"publisher","first-page":"1428","DOI":"10.1183\/09031936.00150314","article-title":"An official European Respiratory Society\/American Thoracic Society technical standard: field walking tests in chronic respiratory disease","volume":"44","author":"Holland","journal-title":"Eur Respir J"},{"issue":"12","key":"R25","doi-asserted-by":"publisher","first-page":"1196","DOI":"10.1016\/j.mayocp.2012.10.013","article-title":"COMPASS 31: a refined and abbreviated Composite Autonomic Symptom Score","volume":"87","author":"Sletten","journal-title":"Mayo Clin Proc"},{"issue":"3","key":"R26","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1378\/chest.93.3.580","article-title":"Evaluation of clinical methods for rating dyspnea","volume":"93","author":"Mahler","journal-title":"Chest"},{"issue":"3","key":"R27","doi-asserted-by":"publisher","first-page":"648","DOI":"10.1183\/09031936.00102509","article-title":"Development and first validation of the COPD assessment test","volume":"34","author":"Jones","journal-title":"Eur Respir J"},{"issue":"6","key":"R28","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0039198","article-title":"Validity of six activity monitors in chronic obstructive pulmonary disease: a comparison with indirect calorimetry","volume":"7","author":"Van Remoortel","journal-title":"PLoS One"},{"issue":"5","key":"R29","doi-asserted-by":"publisher","first-page":"1205","DOI":"10.1183\/09031936.00134312","article-title":"Validity of physical activity monitors during daily life in patients with COPD","volume":"42","author":"Rabinovich","journal-title":"Eur Respir J"},{"issue":"4","key":"R30","doi-asserted-by":"publisher","first-page":"528","DOI":"10.15326\/jcopdf.2021.0213","article-title":"Objectively measured physical activity in patients with COPD: recommendations from an international task force on physical activity","volume":"8","author":"Demeyer","journal-title":"Chronic Obstr Pulm Dis"},{"issue":"7","key":"R31","doi-asserted-by":"publisher","first-page":"1525","DOI":"10.1007\/s00421-019-04142-5","article-title":"RR interval signal quality of a heart rate monitor and an ECG Holter at rest and during exercise","volume":"119","author":"Gilgen-Ammann","journal-title":"Eur J Appl Physiol"},{"issue":"1","key":"R32","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1016\/j.cmpb.2013.07.024","article-title":"Kubios HRV--heart rate variability analysis software","volume":"113","author":"Tarvainen","journal-title":"Comput Methods Programs Biomed"},{"issue":"6","key":"R33","doi-asserted-by":"publisher","DOI":"10.2196\/12866","article-title":"Wearable finger pulse oximetry for continuous oxygen saturation measurements during daily home routines of patients with chronic obstructive pulmonary disease (COPD) over one week: observational study","volume":"7","author":"Buekers","journal-title":"JMIR Mhealth Uhealth"},{"issue":"2","key":"R34","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1016\/j.jcm.2016.02.012","article-title":"A guideline of selecting and reporting intraclass correlation coefficients for reliability research","volume":"15","author":"Koo","journal-title":"J Chiropr Med"},{"issue":"3","key":"R35","first-page":"69","volume":"24","author":"Mukaka","journal-title":"Malawi Med J"},{"issue":"6","key":"R36","doi-asserted-by":"publisher","DOI":"10.2196\/13084","article-title":"Validity evaluation of the Fitbit Charge2 and the Garmin vivosmart HR+ in free-living environments in an older adult cohort","volume":"7","author":"Tedesco","journal-title":"JMIR Mhealth Uhealth"},{"issue":"1","key":"R37","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1123\/japa.2016-0344","article-title":"The validity of consumer-level activity monitors in healthy older adults in free-living conditions","volume":"26","author":"Farina","journal-title":"J Aging Phys Act"},{"issue":"10","key":"R38","doi-asserted-by":"publisher","first-page":"596","DOI":"10.1007\/s00520-023-08061-2","article-title":"Accuracy of consumer-based activity trackers as measuring tool and coaching device in breast and colorectal cancer survivors","volume":"31","author":"De Groef","journal-title":"Support Care Cancer"},{"issue":"8","key":"R39","doi-asserted-by":"publisher","DOI":"10.3390\/s23084156","article-title":"Validation of commercial activity trackers in everyday life of people with Parkinson\u2019s disease","volume":"23","author":"Ginis","journal-title":"Sensors (Basel)"},{"key":"R40","doi-asserted-by":"publisher","DOI":"10.1016\/j.physbeh.2016.03.006","article-title":"Measures of sleep and cardiac functioning during sleep using a multi-sensory commercially-available wristband in adolescents","volume":"158","author":"de Zambotti","journal-title":"Physiol Behav"},{"issue":"7","key":"R41","doi-asserted-by":"publisher","first-page":"927","DOI":"10.1080\/07420528.2019.1596947","article-title":"Accuracy of PurePulse photoplethysmography technology of Fitbit Charge 2 for assessment of heart rate during sleep","volume":"36","author":"Haghayegh","journal-title":"Chronobiol Int"},{"issue":"16","key":"R42","doi-asserted-by":"publisher","DOI":"10.3390\/s22166317","article-title":"A validation of six wearable devices for estimating sleep, heart rate and heart rate variability in healthy adults","volume":"22","author":"Miller","journal-title":"Sensors (Basel)"},{"issue":"2","key":"R43","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-020162","article-title":"Reliability of wireless monitoring using a wearable patch sensor in high-risk surgical patients at a step-down unit in the Netherlands: a clinical validation study","volume":"8","author":"Breteler","journal-title":"BMJ Open"},{"key":"R44","doi-asserted-by":"publisher","DOI":"10.2490\/prm.20220016","article-title":"Accuracy of heart rate and respiratory rate measurements using two types of wearable devices","volume":"7","author":"Takahashi","journal-title":"Prog Rehabil Med"},{"issue":"1","key":"R45","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-98453-3","article-title":"Comparison of SpO and heart rate values on Apple Watch and conventional commercial oximeters devices in patients with lung disease","volume":"11","author":"Pipek","journal-title":"Sci Rep"},{"issue":"1","key":"R46","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1007\/s11845-023-03456-w","article-title":"Accuracy of the Apple Watch in measuring oxygen saturation: comparison with pulse oximetry and ABG","volume":"193","author":"Arslan","journal-title":"Ir J Med Sci"},{"issue":"1","key":"R47","doi-asserted-by":"publisher","first-page":"42","DOI":"10.3357\/AMHP.6078.2023","article-title":"Measuring arterial oxygen saturation using wearable devices under varying conditions","volume":"94","author":"Hearn","journal-title":"Aerosp Med Hum Perform"},{"issue":"14","key":"R48","doi-asserted-by":"publisher","first-page":"1268","DOI":"10.1055\/a-1337-2790","article-title":"Accuracy and reliability of pulse O2 saturation measured by a wrist-worn oximeter","volume":"42","author":"Hermand","journal-title":"Int J Sports Med"},{"issue":"19","key":"R49","doi-asserted-by":"publisher","DOI":"10.3390\/s21196363","article-title":"Validity of peripheral oxygen saturation measurements with the Garmin F\u0113nix 5X Plus wearable device at 4559 m","volume":"21","author":"Schiefer","journal-title":"Sensors (Basel)"},{"key":"R50","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S15099","article-title":"Fractal correlation property of heart rate variability in chronic obstructive pulmonary disease","volume":"6","author":"Carvalho","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"issue":"6","key":"R51","doi-asserted-by":"publisher","first-page":"704","DOI":"10.1136\/bjo.82.6.704","article-title":"Systemic corticosteroid therapy--side effects and their management","volume":"82","author":"Stanbury","journal-title":"Br J Ophthalmol"},{"issue":"7","key":"R52","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1136\/thoraxjnl-2011-200949","article-title":"Systemic elastin degradation in chronic obstructive pulmonary disease","volume":"67","author":"Maclay","journal-title":"Thorax"},{"issue":"4","key":"R53","doi-asserted-by":"publisher","DOI":"10.3390\/bios11040126","article-title":"Sources of inaccuracy in photoplethysmography for continuous cardiovascular monitoring","volume":"11","author":"Fine","journal-title":"Biosensors (Basel)"},{"issue":"6","key":"R54","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-057510","article-title":"Treatment and prescribing trends of antihypertensive drugs in 2.7 million UK primary care patients over 31 years: a population-based cohort study","volume":"12","author":"Rouette","journal-title":"BMJ Open"},{"issue":"1","key":"R55","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-020-09929-2","article-title":"Daily step count and incident diabetes in community-dwelling 70-year-olds: a prospective cohort study","volume":"20","author":"Ballin","journal-title":"BMC Public Health"},{"issue":"15","key":"R56","doi-asserted-by":"publisher","first-page":"E442","DOI":"10.1503\/cmaj.150462","article-title":"Resting heart rate, heart rate variability and functional decline in old age","volume":"187","author":"Ogliari","journal-title":"CMAJ"}],"container-title":["JMIR mHealth and uHealth"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/mhealth.jmir.org\/2024\/1\/e56027","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:44:38Z","timestamp":1782841478000},"score":1,"resource":{"primary":{"URL":"https:\/\/mhealth.jmir.org\/2024\/1\/e56027"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,6]]},"references-count":56,"URL":"https:\/\/doi.org\/10.2196\/56027","relation":{},"ISSN":["2291-5222"],"issn-type":[{"value":"2291-5222","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,6]]},"article-number":"v12i2e56027"}}