Validity of the Empatica E4 Wristband to Measure Heart Rate Variability (HRV) Parameters: a Comparison to Electrocardiog
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MOBILE & WIRELESS HEALTH
Validity of the Empatica E4 Wristband to Measure Heart Rate Variability (HRV) Parameters: a Comparison to Electrocardiography (ECG) Angela A. T. Schuurmans 1,2 & Peter de Looff 2,3 & Karin S. Nijhof 1,2 & Catarina Rosada 2 & Ron H. J. Scholte 2,4,5 & Arne Popma 6 & Roy Otten 1,2,7 Received: 25 February 2020 / Accepted: 25 August 2020 # The Author(s) 2020
Abstract Wearable monitoring devices are an innovative way to measure heart rate (HR) and heart rate variability (HRV), however, there is still debate about the validity of these wearables. This study aimed to validate the accuracy and predictive value of the Empatica E4 wristband against the VU University Ambulatory Monitoring System (VU-AMS) in a clinical population of traumatized adolescents in residential care. A sample of 345 recordings of both the Empatica E4 wristband and the VU-AMS was derived from a feasibility study that included fifteen participants. They wore both devices during two experimental testing and twelve intervention sessions. We used correlations, cross-correlations, Mann-Whitney tests, difference factors, Bland-Altman plots, and Limits of Agreement to evaluate differences in outcomes between devices. Significant correlations were found between Empatica E4 and VU-AMS recordings for HR, SDNN, RMSSD, and HF recordings. There was a significant difference between the devices for all parameters but HR, although effect sizes were small for SDNN, LF, and HF. For all parameters but RMSSD, testing outcomes of the two devices led to the same conclusions regarding significance. The Empatica E4 wristband provides a new opportunity to measure HRV in an unobtrusive way. Results of this study indicate the potential of the Empatica E4 as a practical and valid tool for research on HR and HRV under non-movement conditions. While more research needs to be conducted, this study could be considered as a first step to support the use of HRV recordings provided by wearables. Keywords Autonomic nervous system . Electrocardiography . Empatica . Heart rate variability . Validation . Wearables
Introduction This article is part of the Topical Collection on Mobile & Wireless Health * Angela A. T. Schuurmans [email protected] 1
Department of Research and Development, Pluryn, P.O. Box 53, 6500, AB Nijmegen, The Netherlands
2
Behavioural Science Institute, Radboud University Nijmegen, P.O. Box 9104, 6500, HE Nijmegen, The Netherlands
3
Wier, Specialized and Forensic Care Fivoor, Den Dolder, Netherlands
4
Praktikon, P.O. Box 6909, 6503, GK Nijmegen, The Netherlands
5
Tranzo, Tilburg University, P. O. Box 90153, 5000 LE Tilburg, The Netherlands
6
Department of Child and Adolescent Psychiatry, VUmc/De Bascule, P.O. Box 303, 1115 ZG, Duivendrecht Amsterdam, The Netherlands
7
ASU REACH Institute, Department of Psychology, Arizona State University, P.O. Box 876005, Tempe, AZ 85287-6005, USA
The past two decades have witnessed an increase in psychophysiological studies that incorporate heart rate (HR) and other autonomic ner
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