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Suau Q, Bianchini E, Bellier A, Chardon M, Milane T, Hansen C, Vuillerme N. Current Knowledge about ActiGraph GT9X Link Activity Monitor Accuracy and Validity in Measuring Steps and Energy Expenditure: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2024; 24:825. [PMID: 38339541 PMCID: PMC10857518 DOI: 10.3390/s24030825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/22/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024]
Abstract
Over recent decades, wearable inertial sensors have become popular means to quantify physical activity and mobility. However, research assessing measurement accuracy and precision is required, especially before using device-based measures as outcomes in trials. The GT9X Link is a recent activity monitor available from ActiGraph, recognized as a "gold standard" and previously used as a criterion measure to assess the validity of various consumer-based activity monitors. However, the validity of the ActiGraph GT9X Link is not fully elucidated. A systematic review was undertaken to synthesize the current evidence for the criterion validity of the ActiGraph GT9X Link in measuring steps and energy expenditure. This review followed the PRISMA guidelines and eight studies were included with a combined sample size of 558 participants. We found that (1) the ActiGraph GT9X Link generally underestimates steps; (2) the validity and accuracy of the device in measuring steps seem to be influenced by gait speed, device placement, filtering process, and monitoring conditions; and (3) there is a lack of evidence regarding the accuracy of step counting in free-living conditions and regarding energy expenditure estimation. Given the limited number of included studies and their heterogeneity, the present review emphasizes the need for further validation studies of the ActiGraph GT9X Link in various populations and in both controlled and free-living settings.
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Affiliation(s)
- Quentin Suau
- AGEIS, Université Grenoble Alpes, 38000 Grenoble, France; (Q.S.); (A.B.); (M.C.); (T.M.); (C.H.)
| | - Edoardo Bianchini
- AGEIS, Université Grenoble Alpes, 38000 Grenoble, France; (Q.S.); (A.B.); (M.C.); (T.M.); (C.H.)
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy
| | - Alexandre Bellier
- AGEIS, Université Grenoble Alpes, 38000 Grenoble, France; (Q.S.); (A.B.); (M.C.); (T.M.); (C.H.)
- CHU Grenoble Alpes, Université Grenoble Alpes, Inserm CIC 1406, 38000 Grenoble, France
| | - Matthias Chardon
- AGEIS, Université Grenoble Alpes, 38000 Grenoble, France; (Q.S.); (A.B.); (M.C.); (T.M.); (C.H.)
- UNESP Human Movement Research Laboratory (MOVI-LAB), Department of Physical Education, Bauru Sao Paulo State University, Bauru 17033-360, SP, Brazil
| | - Tracy Milane
- AGEIS, Université Grenoble Alpes, 38000 Grenoble, France; (Q.S.); (A.B.); (M.C.); (T.M.); (C.H.)
| | - Clint Hansen
- AGEIS, Université Grenoble Alpes, 38000 Grenoble, France; (Q.S.); (A.B.); (M.C.); (T.M.); (C.H.)
- Department of Neurology, Kiel University, 24105 Kiel, Germany
| | - Nicolas Vuillerme
- AGEIS, Université Grenoble Alpes, 38000 Grenoble, France; (Q.S.); (A.B.); (M.C.); (T.M.); (C.H.)
- LabCom Telecom4Health, Orange Labs & Université Grenoble Alpes, CNRS, Inria, Grenoble INP-UGA, 38000 Grenoble, France
- Institut Universitaire de France, 75005 Paris, France
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Karine K, Klasnja P, Murphy SA, Marlin BM. Assessing the Impact of Context Inference Error and Partial Observability on RL Methods for Just-In-Time Adaptive Interventions. PROCEEDINGS OF MACHINE LEARNING RESEARCH 2023; 216:1047-1057. [PMID: 37724310 PMCID: PMC10506656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
Just-in-Time Adaptive Interventions (JITAIs) are a class of personalized health interventions developed within the behavioral science community. JITAIs aim to provide the right type and amount of support by iteratively selecting a sequence of intervention options from a pre-defined set of components in response to each individual's time varying state. In this work, we explore the application of reinforcement learning methods to the problem of learning intervention option selection policies. We study the effect of context inference error and partial observability on the ability to learn effective policies. Our results show that the propagation of uncertainty from context inferences is critical to improving intervention efficacy as context uncertainty increases, while policy gradient algorithms can provide remarkable robustness to partially observed behavioral state information.
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O’Brien MW, Pellerine LP, Shivgulam ME, Kimmerly DS. Disagreements in physical activity monitor validation study guidelines create challenges in conducting validity studies. Front Digit Health 2023; 4:1063324. [PMID: 36703940 PMCID: PMC9871762 DOI: 10.3389/fdgth.2022.1063324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 12/28/2022] [Indexed: 01/11/2023] Open
Affiliation(s)
- Myles W. O’Brien
- School of Physiotherapy (Faculty of Health) & Division of Geriatric Medicine (Faculty of Medicine), Dalhousie University, Halifax, NS, Canada,Geriatric Medicine Research, Dalhousie University & Nova Scotia Health, Halifax, NS, Canada,Correspondence: Myles W. O'Brien
| | - Liam P. Pellerine
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Madeline E. Shivgulam
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Derek S. Kimmerly
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS, Canada
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Giurgiu M, Timm I, Becker M, Schmidt S, Wunsch K, Nissen R, Davidovski D, Bussmann JBJ, Nigg CR, Reichert M, Ebner-Priemer UW, Woll A, von Haaren-Mack B. Quality Evaluation of Free-living Validation Studies for the Assessment of 24-Hour Physical Behavior in Adults via Wearables: Systematic Review. JMIR Mhealth Uhealth 2022; 10:e36377. [PMID: 35679106 PMCID: PMC9227659 DOI: 10.2196/36377] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/27/2022] [Accepted: 04/29/2022] [Indexed: 12/13/2022] Open
Abstract
Background Wearable technology is a leading fitness trend in the growing commercial industry and an established method for collecting 24-hour physical behavior data in research studies. High-quality free-living validation studies are required to enable both researchers and consumers to make guided decisions on which study to rely on and which device to use. However, reviews focusing on the quality of free-living validation studies in adults are lacking. Objective This study aimed to raise researchers’ and consumers’ attention to the quality of published validation protocols while aiming to identify and compare specific consistencies or inconsistencies between protocols. We aimed to provide a comprehensive and historical overview of which wearable devices have been validated for which purpose and whether they show promise for use in further studies. Methods Peer-reviewed validation studies from electronic databases, as well as backward and forward citation searches (1970 to July 2021), with the following, required indicators were included: protocol must include real-life conditions, outcome must belong to one dimension of the 24-hour physical behavior construct (intensity, posture or activity type, and biological state), the protocol must include a criterion measure, and study results must be published in English-language journals. The risk of bias was evaluated using the Quality Assessment of Diagnostic Accuracy Studies-2 tool with 9 questions separated into 4 domains (patient selection or study design, index measure, criterion measure, and flow and time). Results Of the 13,285 unique search results, 222 (1.67%) articles were included. Most studies (153/237, 64.6%) validated an intensity measure outcome such as energy expenditure. However, only 19.8% (47/237) validated biological state and 15.6% (37/237) validated posture or activity-type outcomes. Across all studies, 163 different wearables were identified. Of these, 58.9% (96/163) were validated only once. ActiGraph GT3X/GT3X+ (36/163, 22.1%), Fitbit Flex (20/163, 12.3%), and ActivPAL (12/163, 7.4%) were used most often in the included studies. The percentage of participants meeting the quality criteria ranged from 38.8% (92/237) to 92.4% (219/237). On the basis of our classification tree to evaluate the overall study quality, 4.6% (11/237) of studies were classified as low risk. Furthermore, 16% (38/237) of studies were classified as having some concerns, and 72.9% (173/237) of studies were classified as high risk. Conclusions Overall, free-living validation studies of wearables are characterized by low methodological quality, large variability in design, and focus on intensity. Future research should strongly aim at biological state and posture or activity outcomes and strive for standardized protocols embedded in a validation framework. Standardized protocols for free-living validation embedded in a framework are urgently needed to inform and guide stakeholders (eg, manufacturers, scientists, and consumers) in selecting wearables for self-tracking purposes, applying wearables in health studies, and fostering innovation to achieve improved validity.
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Affiliation(s)
- Marco Giurgiu
- Department of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany.,Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Irina Timm
- Department of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Marlissa Becker
- Unit Physiotherapy, Department of Orthopedics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Steffen Schmidt
- Department of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Kathrin Wunsch
- Department of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Rebecca Nissen
- Department of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Denis Davidovski
- Department of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Johannes B J Bussmann
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Claudio R Nigg
- Health Science Department, Institute of Sport Science, University of Bern, Bern, Switzerland
| | - Markus Reichert
- Department of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany.,Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Department of eHealth and Sports Analytics, Faculty of Sport Science, Ruhr-University Bochum, Bochum, Germany
| | - Ulrich W Ebner-Priemer
- Department of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany.,Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Alexander Woll
- Department of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Birte von Haaren-Mack
- Department of Health and Social Psychology, Institute of Psychology, German Sport University, Cologne, Germany
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Ertin E, Sugavanam N, Holtyn AF, Preston KL, Bertz JW, Marsch LA, McLeman B, Shmueli-Blumberg D, Collins J, King JS, McCormack J, Ghitza UE. An Examination of the Feasibility of Detecting Cocaine Use Using Smartwatches. Front Psychiatry 2021; 12:674691. [PMID: 34248712 PMCID: PMC8264124 DOI: 10.3389/fpsyt.2021.674691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/14/2021] [Indexed: 12/18/2022] Open
Abstract
As digital technology increasingly informs clinical trials, novel ways to collect study data in the natural field setting have the potential to enhance the richness of research data. Cocaine use in clinical trials is usually collected via self-report and/or urine drug screen results, both of which have limitations. This article examines the feasibility of developing a wrist-worn device that can detect sufficient physiological data (i.e., heart rate and heart rate variability) to detect cocaine use. This study aimed to develop a wrist-worn device that can be used in the natural field setting among people who use cocaine to collect reliable data (determined by data yield, device wearability, and data quality) that is less obtrusive than chest-based devices used in prior research. The study also aimed to further develop a cocaine use detection algorithm used in previous research with an electrocardiogram on a chestband by adapting it to a photoplethysmography sensor on the wrist-worn device which is more prone to motion artifacts. Results indicate that wrist-based heart rate data collection is feasible and can provide higher data yield than chest-based sensors, as wrist-based devices were also more comfortable and affected participants' daily lives less often than chest-based sensors. When properly worn, wrist-based sensors produced similar quality of heart rate and heart rate variability features to chest-based sensors and matched their performance in automated detection of cocaine use events. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT02915341.
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Affiliation(s)
- Emre Ertin
- Dreese Lab, Department of Electrical and Computer Engineering, Ohio State University, Columbus, OH, United States
| | - Nithin Sugavanam
- Dreese Lab, Department of Electrical and Computer Engineering, Ohio State University, Columbus, OH, United States
| | - August F Holtyn
- Center for Learning and Health, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Kenzie L Preston
- National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD, United States
| | - Jeremiah W Bertz
- National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD, United States
| | - Lisa A Marsch
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - Bethany McLeman
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | | | | | | | | | - Udi E Ghitza
- Center for the Clinical Trials Network, National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, United States
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