Comparison of SpO2 and heart rate values on Apple Watch and conventional commercial oximeters devices in patients with lung disease
Open accessAbstract
Lung diseases have high mortality and morbidity, with an important impact on quality of life. Hypoxemic patients are advised to use oxygen therapy to prolong their survival, but high oxygen saturation (SpO 2) levels can also have negative effects. Pulse oximeters are the most common way to assess oxygen levels and guide medical treatment. This study aims to assess whether wearable devices can provide precise SpO 2 measurements when compared to commercial pulse oximeters. This is a cross-section study with 100 patients with chronic obstructive pulmonary disease and interstitial lung disease from an outpatient pneumology clinic. SpO 2 and heart rate data were collected with an Apple Watch Series 6 (Apple) and compared to two commercial pulse oximeters. The Bland–Altman method and interclass correlation coefficient were used to compare their values. We observed strong positive correlations between the Apple Watch device and commercial oximeters when evaluating heart rate measurements (r = 0.995, p < 0.001) and oximetry measurements (r = 0.81, p < 0.001). There was no statistical difference in the evaluation of skin color, wrist circumference, presence of wrist hair, and enamel nail for SpO 2 and heart rate measurements in Apple Watch or commercial oximeter devices (p > 0.05). Apple Watch 6 is a reliable way to obtain heart rate and SpO 2 in patients with lung diseases in a controlled environment.
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The few existing studies do not investigate the effects of individual characteristics such as skin tone, compare across multiple devices, thoroughly examine performance in low ranges, or explore patterns of error and bias or missingness.
“The few studies that do exist do not investigate the effects of individual characteristics (e.g., skin tone), compare across multiple devices or thoroughly examine performance in low ranges, or explore patterns of error and bias (e.g., consistent over- or underestimation of measurements) or missingness [10–13].”
From Investigating the accuracy of blood oxygen saturation measurements in common consumer smartwatches (2023) · cites this paper as [12]
The Methods (Data collection; no page supplied) say the study recorded skin color and measured SpO2 with an Apple Watch and two commercial oximeters. The Methods (Statistical analysis) and Results also report an analysis of measurement bias. These passages contradict the claim that this study did not examine individual characteristics, compare multiple devices, or explore bias; they do not establish whether it thoroughly examined low ranges or missingness. (LLM, conf=0.90)
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- Authors
- Pipek, L. Z., Nascimento, R. F. V., Acencio, M. M. P., & Teixeira, L. R.
- Affiliations
- Universidade de São Paulo (BR)
- Faculdade de Medicina do ABC (BR)
- Corresponding author
- Pipek, Leonardo Zumerkorn
- ORCID
- Venue
- Scientific Reports
- Published
- 2021-09-23
- Volume
- 11
- Issue
- 1
- Pages
- 18901-18901
- ISSN
- 2045-2322 (ISSN-L)
- PMC
- PMC8460792
- OpenAlex
- W3200444947
- Cited by
- 87
- References
- 34
- Citations by year
- 2026: 5 · 2025: 15 · 2024: 17 · 2023: 31 · 2022: 19
- FWCI
- 5.09
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Scientific Reports (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Faculdade de Medicina da Universidade de São Paulo
- Topics
- Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
- Keywords
- Apple Watch, wearable devices, pulse oximetry, SpO2 measurement, heart rate monitoring, chronic obstructive pulmonary disease, interstitial lung disease, lung disease, device agreement, hypoxemia
- MeSH terms
- Wearable Electronic Devices, Oxygen Saturation, Aged, Cross-Sectional Studies, Female, Heart Rate, Humans, Male, Middle Aged, Oximetry, Wrist, Reproducibility of Results, Lung Diseases, Interstitial, Pulmonary Disease, Chronic Obstructive, Healthy Volunteers
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