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Cited by 415Physical Activity and HealthContext-Aware Activity Recognition SystemsSleep and related disorders

Using accelerometers to measure physical activity in large-scale epidemiological studies: issues and challenges

Open access
Lee, I-Min, Shiroma, Eric J·2014·British Journal of Sports Medicine
DOI 10.1136/bjsports-2013-093154PMC PMC3947179
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Abstract

Background: The current guidelines for aerobic activity require that adults carry out ≥150 min/week of moderate-intensity physical activity, with a large body of epidemiological evidence showing this level of activity to decrease the incidence of many chronic diseases. Less is known about whether light-intensity activities also have such benefits, and whether sedentary behaviour is an independent predictor of increased risks of these chronic diseases, as imprecise assessments of these behaviours and cross-sectional study designs have limited knowledge to date. Methods: Recent technological advances in assessment methods have made the use of movement sensors, such as the accelerometer, feasible for use in longitudinal, large-scale epidemiological studies. Several such studies are collecting sensor-assessed, objective measures of physical activity with the aim of relating these to the development of clinical endpoints. This is a relatively new area of research; thus, in this article, we use the Women's Health Study (WHS) as a case study to illustrate the challenges related to data collection, data processing and analyses of the vast amount of data collected. Results: The WHS plans to collect 7 days of accelerometer-assessed physical activity and sedentary behaviour in ∼18 000 women aged ≥62 years. Several logistical challenges exist in collecting data; nonetheless, as of 31 August 2013, 11 590 women have already provided some data. In addition, the WHS experience on data reduction and data analyses can help inform other similar large-scale epidemiological studies. Conclusions: Important data on the health effects of light-intensity activity and sedentary behaviour will emerge from large-scale epidemiological studies collecting objective assessments of these behaviours.

AI snapshot

Written from the paper’s full text.

TL;DR

This methods/commentary paper argues that accelerometers can objectively assess light-intensity physical activity and sedentary behavior in large longitudinal epidemiologic studies, addressing gaps left by self-report. It uses the Women’s Health Study (WHS) accelerometer ancillary study as a case study to illustrate logistical, data-reduction, and analytic challenges.

Key findings

  • Current aerobic guidelines recommend ≥150 minutes/week of moderate-intensity activity, but they lack recommendations for light-intensity activity because few data are available, not because existing data show no benefit.
  • In the WHS accelerometer study, as of 31 August 2013, 23,266 women were invited; 19,432 (84%) responded; 15,314 (79% of respondents) agreed to participate; and 11,590 had worn and returned devices. The study projects participation by ~18,000 (~63%) of the remaining 28,680 eligible women.
  • An interim WHS dataset of 8,373 women (mean age 71 years; 20% obese; 4% current smokers) found 95% wore the device for ≥10 hours/day on ≥4 days. The low-frequency extension filter substantially overestimated steps: median ~5,000 steps/day with the normal filter vs ~13,000 steps/day with the LFE filter.
  • Self-reported TV viewing and accelerometer-assessed sedentary time had a correlation of only 0.22, and the paper notes that some self-reported sedentary associations have not been replicated with accelerometry; longitudinal objective studies are needed.

Methods

  • Design: A methods/commentary paper using the Women’s Health Study (WHS) as a case study to discuss issues and challenges in accelerometer use for large-scale epidemiologic research.
  • Data/sample: The WHS was a completed randomized trial (1992–2004) of 39,876 healthy women ≥45 years; 33,681 (89% of those alive) consented to continue observational follow-up. The accelerometer ancillary study began in 2011, asked women to wear an ActiGraph GT3X+ on the hip during all waking hours for 7 days, and aimed to collect data in ~18,000 women aged ≥62 years.
  • Main analysis: Descriptive reporting of WHS recruitment, compliance, data-reduction decisions, and preliminary accelerometer data, including comparison with a comparably aged US national sample; no formal disease-endpoint analysis is presented.

Limitations

  • Stated in the paper: Hip-worn accelerometers primarily measure locomotor activity, miss upper-body movement, cannot account for carried weight, and do not measure posture, so they cannot distinguish sitting from standing still.
  • Stated in the paper: There is no consensus on wear-time algorithms, cutpoints, or best practices for accelerometer data reduction and analysis; cutpoints are often laboratory-derived, may not apply to older populations, and energy-expenditure predictions can under- or overestimate.
  • Evident from the text: The WHS preliminary data are interim and descriptive, with no hard clinical endpoints yet; findings come from a single cohort of older women, limiting generalizability, and the paper is not a systematic review or original prospective outcome study.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1136/bjsports-2013-093154

Cites

50 of 50 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 55 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    As of 31 August 2013, 11,590 women in the Women's Health Study had already provided some accelerometer data.

    “as of 31 August 2013, 11,590 women have already provided some data.”
    Quote in the paperNot a substantial claim
  • Findingown data

    95% of the interim WHS sample wore their device for ≥10 hours each day on ≥4 days, conventionally regarded as valid data.

    “They complied well with instructions: 95% wore their device for ≥10 hours each day on ≥4 days (conventionally regarded as “valid” data[49]).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [49] Tudor-Locke, 2012, A catalog of rules, variables, and definitions applied to accelerometer data in the National Health and Nutrition Examination Survey, 2003-2006, Prev Chronic Dis

      Not checked in the free run.

  • Findingown data

    The rate of accelerometer loss in the WHS is 2.1%.

    “Participants do lose or fail to return their accelerometers; the rate of loss in the WHS is 2.1%.”
    Quote in the paperNot a substantial claim
  • Findingown data

    In the WHS, using logs only to record whether the device was worn or not worn for the day, but not to indicate times, and then applying the Choi algorithm best reflected actual wear-time as assessed by participant detailed logs.

    “Based on preliminary data, we have found that using logs only to record whether the device was “worn” or “not worn” for the day, but not to indicate times (minimizing participant burden and likelihood of missing data), and then applying the Choi algorithm best reflected actual wear-time as assessed by participant detailed logs.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [39] source

      Not checked in the free run.

  • Findingown data

    The LFE filter substantially overestimates steps taken per day in the WHS (median ~5,000 steps/day with normal filter vs ~13,000 steps/day with LFE).

    “Preliminary data in the WHS indicates that the LFE filter substantially overestimates steps taken per day (median of ~5,000 steps per day using the normal filter; ~13,000 steps per day using the LFE filter); thus, we do not recommend this option for assessing steps.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. 13
  • May combine two claims. 27

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    Several logistical challenges exist in collecting accelerometer data in large-scale epidemiologic studies.

    “Several logistical challenges exist in collecting data; nonetheless as of 31 August 2013, 11,590 women have already provided some data.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Of 14,073 WHS women mailed packets, 11,590 wore and returned devices, 725 requested later participation, 1,087 changed their mind, and 671 were not due to return as of 31/8/13.

    “Packets have been mailed to 14,073 women, of whom 11,590 have worn and returned their devices, 725 have requested participation at a later date (we assume some of these will eventually decline), and 1,087 have changed their mind about participation (the remaining 671 women were not due as of 31/8/13 to return their device).”
    Quote in the paperNot a substantial claim
    • The authors state this as an assumption: Some of the 725 WHS women who requested later participation will eventually decline.

  • May combine two claims.

    Findingown data

    As of 31 Aug 2013, of 23,266 WHS women invited to the accelerometer study, 19,432 (84%) responded, 15,314 (79% of respondents) agreed to participate, 16% declined, and 5% were not eligible because they cannot walk outside without assistance.

    “As of 31 August 2013, 23,266 women have been invited; 19,432 (84%) have responded, of whom 15,314 (79% of respondents) have agreed to participate (16% declined and 5% were not eligible because they cannot walk outside without assistance).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    In the WHS main study, response to first mailing of questionnaires is typically ~80%, second ~10%, third ~5%, total ~95%.

    “Typically, in the main study, we obtain ~80% response to the first mailing of study questionnaires, another ~10% to the second, and a further ~5% to the third, for a total response of ~95%.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given

    When the WHS trial ended, 89% (33,681) of those alive consented to continue in an observational study, reporting health habits and medical history annually on questionnaires.

    “Of those alive, 89% or 33,681 women consented, reporting on their health habits and medical history annually on questionnaires.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingreasoning

    The 2.1% accelerometer loss rate in the WHS translates to 420 units at substantial cost, based on the ~20,000 women anticipated to be sent accelerometers.

    “While this seems negligible, 2.1% of the ~20,000 whom we anticipate sending accelerometers translates to 420 units, at substantial cost.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    The interim WHS sample had mean age 71 years, 20% were obese, and 4% were current smokers.

    “Women were of mean age 71 years, 20% were obese, and 4% were current smokers.[30]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [30] Shiroma EJ Freedson PS Trost SG . Patterns of accelerometer-assessed sedentary behavior in older women. JAMA; in press [published Online First].

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Self-reports of physical activity are more reliable and valid for moderate-to-vigorous intensity activities than for light-intensity activities, which tend to be poorly reported.

    “Self-reports of physical activity are more reliable and valid for activities of moderate-to-vigorous intensity than light-intensity activities, which tend to be poorly reported.[9 10]”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [9 10]

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    A large body of epidemiologic evidence shows that physically active individuals have a better cardio-metabolic risk profile, lower rates of major non-communicable diseases, better physical and mental function, and live longer than inactive individuals.

    “A large body of epidemiologic literature, accumulated over more than 60 years, shows that individuals who are physically active have a better cardio-metabolic risk profile, lower rates of major non-communicable diseases, better physical and mental function, and live longer, compared with those inactive.[1-3]”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [1] U.S. Department of Health & Human Services. 2008 Physical Activity Guidelines Advisory Committee report. Secondary 2008 Physical Activity Guidelines Advisory Committee report. http://www.health.gov/paguidelines/

      Not checked in the free run.

    • cites [2] source

      Not checked in the free run.

    • cites [3] World Health Organization. Global recommendations on physical activity for health. Geneva, Switzerland: WHO Press, 2010.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The high prevalence of insufficient physical activity has been estimated to cause as many deaths worldwide each year as smoking.

    “Indeed, this high prevalence of insufficient activity has been estimated to cause as many deaths worldwide each year as smoking:[5]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [5] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Current guidelines require adults to carry out at least 150 minutes per week of moderate-intensity physical activity, or 75 minutes per week of vigorous-intensity activity, or an equivalent combination of both.

    “With regard to aerobic activities, the guidelines require that adults carry out at least 150 minutes per week of moderate-intensity physical activity (e.g., brisk walking, whether for leisure or commuting), or 75 minutes per week of vigorous-intensity activity (e.g., jogging), or some combination of activities from both intensities that expend an equivalent amount of energy.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [8] U.S. Department of Health and Human Services. 2008 Physical Activity Guidelines for Americans. Secondary 2008 Physical Activity Guidelines for Americans. http://www.health.gov/paguidelines/

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Approximately one-third of the world's population does not get sufficient physical activity to meet current recommendations.

    “It is therefore unfortunate that approximately one-third of the world’s population does not get sufficient physical activity to meet current recommendations.[4]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4] source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Current recommendations have no provision for light-intensity physical activity because few data are available, not because existing data indicate no benefit.

    “As a consequence, current recommendations have no provision for light-intensity physical activity because few data are available, and not because existing data indicate no benefit.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [8] U.S. Department of Health and Human Services. 2008 Physical Activity Guidelines for Americans. Secondary 2008 Physical Activity Guidelines for Americans. http://www.health.gov/paguidelines/

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Accelerometers do not inform on body posture; they cannot distinguish between sitting and standing still.

    “Accelerometers do not inform on body posture; thus, they cannot distinguish between sitting and standing still.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The expert panel did consider data from studies of physical activity in relation to cardio-metabolic risk factors, but these data were considered supporting information.

    “The expert panel did consider data from studies of physical activity in relation to cardio-metabolic risk factors (e.g., blood pressure, lipid parameters, measures of glucose and insulin processing); however, these data were considered supporting information.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [1] U.S. Department of Health & Human Services. 2008 Physical Activity Guidelines Advisory Committee report. Secondary 2008 Physical Activity Guidelines Advisory Committee report. http://www.health.gov/paguidelines/

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In a nationally representative sample of adults from the Health Survey for England, cross-sectional analyses showed consistent deleterious associations of self-reported sitting time with a panel of cardio-metabolic risk factors; however, when accelerometer measures of sedentary behaviour were analysed, little relation was observed.

    “in a nationally representative sample of adults from the Health Survey for England, cross-sectional analyses showed consistent deleterious associations of self-reported sitting time with a panel of cardio-metabolic risk factors; however, when accelerometer measures of sedentary behaviour were analysed, little relation was observed.[23]”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [23] source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The WHS was a completed randomized trial (1992-2004) testing aspirin and vitamin E for preventing cardiovascular disease and cancer among 39,876 healthy women, ≥45 years, living throughout the US.

    “The WHS is a completed randomized trial (1992-2004) testing aspirin and vitamin E for preventing cardiovascular disease and cancer among 39,876 healthy women, ≥45 years, living throughout the US.[32-34]”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [32] source

      Not checked in the free run.

    • cites [33] source

      Not checked in the free run.

    • cites [34] source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    The accelerometer studies of sedentary behavior are predominantly cross-sectional, so the direction of association cannot be ascertained.

    “However, these studies are predominantly cross-sectional in design; thus, one cannot ascertain the direction of association (i.e., does being sedentary result in poor health? Or, does being in poor health predispose one towards being sedentary?).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Important data on the health effects of light-intensity activity and sedentary behaviour will emerge from large-scale epidemiologic studies collecting objective assessments of these behaviours.

    “Important data on the health effects of light-intensity activity and sedentary behaviour will emerge from large-scale epidemiologic studies collecting objective assessments of these behaviours.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    In the Look AHEAD trial, the intensive lifestyle intervention clearly improved cardio-metabolic risk factors, but there was no difference in rates of cardiovascular events between groups after a median follow-up of 9.6 years, when the trial was stopped for futility.

    “In recently published results, the intensive intervention clearly improved cardio-metabolic risk factors; however, there was no difference in rates of cardiovascular events between groups after a median follow-up of 9.6 years, when the trial was stopped for futility.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [27] source

      Not checked in the free run.

  • May combine two claims.

    Premisenone given

    The accelerometer is capable of measuring light-intensity physical activity and sedentary behaviour objectively.

    “One movement sensor capable of measuring light-intensity physical activity and sedentary behaviour objectively is the accelerometer.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    Technological advances have made the accelerometer smaller, lighter, and less expensive, so it has become feasible for use in large-scale epidemiologic studies.

    “Recent technological advances in assessment methods have made the use of movement sensors, such as the accelerometer, feasible for use in longitudinal, large-scale epidemiologic studies.”
    • Also stated in: § Using Accelerometers in Large-Scale Epidemiologic Studies · plain
      “Thus, the accelerometer has now become feasible for use in large-scale studies, such as the examples shown in Table 1.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationnone given

    Accelerometers worn over the hip primarily measure locomotor activity and miss upper body movement.

    “They primarily measure locomotor activity when worn over the hip (typical placement position), and so miss upper body movement.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisereasoning

    Large observational epidemiologic studies typically require thousands or hundreds of thousands of subjects for sufficient statistical power, and self-report is a cost-effective method of assessment.

    “This has occurred because such studies typically require thousands, and even hundreds of thousands, of subjects to possess sufficient statistical power for investigating associations of physical activity with the incidence of hard clinical endpoints (e.g., major non-communicable diseases), and self-report is a cost-effective method of assessment.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    The expert panel emphasized data from studies examining the relation between physical activity and the risks of developing hard clinical endpoints, reviewing individual studies in detail.

    “This panel emphasized data from studies that examined the relation between physical activity and the risks of developing hard clinical endpoints, such as all-cause mortality, cardiovascular disease, type 2 diabetes, and cancer, reviewing the data from individual studies in detail.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [1] U.S. Department of Health & Human Services. 2008 Physical Activity Guidelines Advisory Committee report. Secondary 2008 Physical Activity Guidelines Advisory Committee report. http://www.health.gov/paguidelines/

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationnone given

    The Women's Health Study experience on data reduction and data analyses can help inform other similar large-scale epidemiologic studies.

    “Additionally, the WHS experience on data reduction and data analyses can help inform other similar large-scale epidemiologic studies.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The Women’s Health Study is sufficiently similar to other large-scale epidemiologic studies that its data-reduction and analysis experience can inform them.

  • May combine two claims.

    Interpretationown data

    Of ~30,000 total WHS women, 1,320 (4.4%) are expected to be non-eligible, and participation is projected for ~18,000 (~63%) of the remaining 28,680.

    “Of the ~30,000 total women, we expect 1320 (4.4%) to be non-eligible, and project participation by ~18,000 (~63%) of the remaining 28,680.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    Recent technological advances have made the use of movement sensors, such as the accelerometer, feasible for use in longitudinal, large-scale epidemiologic studies.

    “However, recent technological advances have made the use of movement sensors, such as the accelerometer, feasible for use in longitudinal, large-scale epidemiologic studies.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    The authors decided a priori to create an interim, closed dataset comprising all women who returned their accelerometer by 31 March 2013 (n=8,373; approximately half the total anticipated sample of ~18,000).

    “Thus, we decided a priori to create an interim, closed dataset that comprised all women who returned their accelerometer by 31 March 2013 (n = 8,373; approximately half the total anticipated sample of ~18,000).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    There is no consensus on what the correct cutpoints might be, with several proposed in the literature based on calibration studies primarily carried out under laboratory settings and not in free-living conditions.

    “However, there is no consensus on what the “correct” cutpoints might be, with several proposed in the literature based on calibration studies primarily carried out under laboratory settings and not in free-living conditions.[40 41]”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [40 41]

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Efforts are ongoing to use pattern recognition or machine learning data analytic approaches to identify specific activities from accelerometer data.

    “Efforts are ongoing to better take advantage of the rich data, such as pattern recognition or machine learning data analytic approaches to identify specific activities carried out.[47 48]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [47 48]

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Recent work indicates a strong correlation between counts from the vertical axis and counts combined from all three axes using vector magnitude; thus, vector magnitude data may not provide much additional information beyond vertical axis counts.

    “Recent work indicates a strong correlation between counts from the vertical axis and counts combined from all three axes using vector magnitude; thus, the vector magnitude data may not provide much additional information beyond vertical axis counts.[46]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [46] source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    While best practices and standards for accelerometer data reduction have been proposed, no consensus has been reached.

    “Further, while best practices and standards have been proposed,[35-37] no consensus has been reached.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [35] source

      Not checked in the free run.

    • cites [36] source

      Not checked in the free run.

    • cites [37] source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Automated algorithms for wear-time determination (Troiano and Choi) were developed for protocols where participants received the device directly from investigators, so mail noise is not applicable.

    “Automated algorithms are available (e.g., the commonly used Troiano[38] and Choi[39] algorithms) for wear-time determination; however, these were developed for protocols where participants received the device directly from investigators (thus, “mail noise” is not applicable).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [38] source

      Not checked in the free run.

    • cites [39] source

      Not checked in the free run.

  • May combine two claims.

    Interpretationnone given

    Imprecise assessments of light-intensity activities and sedentary behaviour and cross-sectional study designs have limited our knowledge.

    “Imprecise assessments of these behaviours and cross-sectional study designs have limited our knowledge.”
    Quote in the paperSubstantial claim
35 of 35

  • The paper relies on this without support.

    The Women’s Health Study is sufficiently similar to other large-scale epidemiologic studies that its data-reduction and analysis experience can inform them.

    “Additionally, the WHS experience on data reduction and data analyses can help inform other similar large-scale epidemiologic studies.”

  • The paper relies on this without support.

    In the WHS older women, walking is the most common physical activity.

    “for example, in the WHS below that includes older women, walking is the most common physical activity.”

  • The authors state this as an assumption.

    Some of the 725 WHS women who requested later participation will eventually decline.

    “725 have requested participation at a later date (we assume some of these will eventually decline)”
3 of 3

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

  • REGARDS device-return percentage is misstated

    Minor

    The stated counts give 10,863 ÷ 22,195 × 100 = 48.94%, which rounds to 49%, not 48%.

    Reported 48 · recomputed 48.943456

1 of 1

Cites

Flagged first, then by citations

5 of the 55 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. World Health Organization. Global recommendations on physical activity for health. Geneva, Switzerland: WHO Press, 2010.

Cited by

Sorted by citations

Related

Authors
Lee, I.-M., & Shiroma, E. J.
Affiliations
Brigham and Women's Hospital (US)
Corresponding author
Lee, I-Min
ORCID
Venue
British Journal of Sports Medicine
Publisher
BMJ
Published
2013-12-02
Volume
48
Issue
3
Pages
197-201
ISSN
  • 0306-3674 (ISSN-L)
  • 1473-0480
DOI
10.1136/bjsports-2013-093154
PMC
PMC3947179
OpenAlex
W2136019090
Semantic Scholar
4f904384be8d865260d8f27dfd7a14dccefcee46
Cited by
415
References
55
Citations by year
2026: 10 · 2025: 23 · 2024: 29 · 2023: 27 · 2022: 31 · 2021: 62 · 2020: 41 · 2019: 32 · 2018: 39 · 2017: 46 · 2016: 33 · 2015: 26 · 2014: 16
FWCI
17.41
Type
journal article
Language
en
Open access
Locations
  • British Journal of Sports Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • HighWire Press Open Archive (submittedVersion)
Funders
  • National Institutes of Health (5r01hl043851-10)
  • National Heart, Lung, and Blood Institute (R01HL080467, R01‐HL043851)
  • National Cancer Institute (CA154647, R01CA154647, R01CA047988)
Topics
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Context-Aware Activity Recognition Systems
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Keywords
accelerometer, physical activity measurement, sedentary behavior, light physical activity, Women's Health Study, data collection challenges, data processing and analysis, chronic disease risk, older women
MeSH terms
Data Collection, Female, Humans, Risk Factors, Exercise, Epidemiologic Studies, Women's Health, Practice Guidelines as Topic, Sedentary Behavior, Accelerometry

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