Stressing the accuracy: Wrist‐worn wearable sensor validation over different conditions
Abstract
Wearable sensors are promising instruments for conducting both laboratory and ambulatory research in psychophysiology. However, scholars should be aware of their measurement error and the conditions in which accuracy is achieved. This study aimed to assess the accuracy of a wearable sensor designed for research purposes, the E4 wristband (Empatica, Milan, Italy), in measuring heart rate (HR), heart rate variability (HRV), and skin conductance (SC) over five laboratory conditions widely used in stress reactivity research (seated rest, paced breathing, orthostatic, Stroop, speech task) and two ecological conditions (slow walking, keyboard typing). Forty healthy participants concurrently wore the wristband and two gold standard measurement systems (i.e., electrocardiography and finger SC sensor). The wristband accuracy was determined by evaluating the signal quality and the correlations with and the Bland‐Altman plots against gold standard‐derived measurements. Moreover, exploratory analyses were performed to assess predictors of measurement error. Mean HR measures showed the best accuracy over all conditions. HRV measures showed satisfactory accuracy in seated rest, paced breathing, and recovery conditions but not in dynamic conditions, including speaking. Accuracy was diminished by wrist movements, cognitive and emotional stress, nonstationarity, and larger wrist circumferences. Wrist SC measures showed neither correlation nor visual resemblance with finger SC signal, suggesting that the two sites may reflect different phenomena. Future studies are needed to assess the responsivity of wrist SC to emotional and cognitive stress. Limitations and implications for laboratory and ambulatory research are discussed.
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Greater wearable movement is associated with decreased photoplethysmography accuracy.
“which may be due to the fact that greater wearable movement is associated with decreased PPG accuracy as discussed below62.”
From Guidelines for wrist-worn consumer wearable assessment of heart rate in biobehavioral research (2020) · cites this paper as [62]
Higher body mass index, which likely covaries with larger wrist circumference, has been shown to be associated with reduced heart rate accuracy, although these outcomes have not been found in all studies.
“Higher body mass index, which likely covaries with larger wrist circumference as described above, has been shown to be associated with reduced HR accuracy42,62, although again these outcomes have not been found in all studies44,46.”
From Guidelines for wrist-worn consumer wearable assessment of heart rate in biobehavioral research (2020) · cites this paper as [62]
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- Authors
- Menghini, L., Gianfranchi, E., Cellini, N., Patron, E., Tagliabue, M., & Sarlo, M.
- Affiliations
- University of Padua (IT)
- Corresponding author
- Menghini, Luca
- ORCID
- Venue
- Psychophysiology
- Publisher
- Wiley
- Published
- 2019-07-23
- Volume
- 56
- Issue
- 11
- Pages
- e13441-e13441
- ISSN
- 0048-5772 (ISSN-L)
- 1469-8986
- OpenAlex
- W2963323264
- Semantic Scholar
- f1dd89b0b7d12e2161e726e52868bf5477e078c8
- Cited by
- 157
- References
- 48
- Citations by year
- 2026: 9 · 2025: 28 · 2024: 22 · 2023: 31 · 2022: 28 · 2021: 25 · 2020: 13 · 2019: 1
- FWCI
- 12.06
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychophysiology (publishedVersion)
- PubMed (publishedVersion)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
- Iris (University of Trento) (submittedVersion)
- CINECA IRIS Institutional Research information system (University of Urbino) (submittedVersion)
- Padua Research Archive (University of Padova) (submittedVersion)
- Funders
- Università degli Studi di Padova
- U.S. Food and Drug Administration
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Emotion and Mood Recognition
- Keywords
- wearable sensors, measurement accuracy, heart rate, heart rate variability, skin conductance, stress reactivity, ambulatory measurement, wrist kinematics, cognitive stress, emotional stress, non-stationarity, sensor validation, gold standard comparison
- MeSH terms
- Wearable Electronic Devices, Adolescent, Adult, Electrocardiography, Female, Fingers, Galvanic Skin Response, Heart Rate, Humans, Male, Middle Aged, Motor Activity, Psychomotor Performance, Stress, Psychological, Wrist, Monitoring, Ambulatory, Young Adult
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