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

The DOI matches its Crossref record; 50 of the 55 references it cites were found in a registry or an index; 2 of the 55 sources its claims cite were checked for support.

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

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.

Overview

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.

Verification

Claims the paper makes

36 Not checked yet · 15 Own interpretation · 6 Own result · 6 No basis given · 1 Partly supported · 1 Own method · accuracy not yet measured

Verify all 53 references — free account

Show all 30 claims

  • Probably not a substantial claim. 13
  • It may state two separate claims as one. 27
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

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Citations

Cites

Show all 55 references

Research works printed but not linked: 1

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

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Metadata

Authors
Lee, I.-M., & Shiroma, E. J.
Affiliations
Brigham and Women's Hospital (US)
Corresponding author
Lee, I-Min
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
OpenAlex
W2136019090
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 › Public Health, Environmental and Occupational Health › 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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