The Value of HRMs Tested Against 3 Lead Gold Standard Clinicial ECG Devices

Last Updated on October 1, 2022 by pg@petergamma.org

The second paper of the group of the cardiologist Milind Y. Desai from Cleveland Clinic Ohio is probably one of the best papers, which could serve as a standard protocol for accuracy validation of consumer grade sports sensors:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6732081/

• The term gold standard is not clearly defined scientifically. But in this context where we suppose it means, that it is the most accurate device.

• It uses ECG equipment used for clinical applications.

• We suppose it is one of the most accurate studies, using 3 lead ECG gold standard devices with a vey simple protocol on a threadmill.

• It was assisted by persons trained by a cardiologist which know how to handle with ECG devices. ECG devices are difficult devices, it is a whole science to know about this devices.

• At first sight, the protocol is a bit basic, but it is very well defined. In other studies, they use a plethora of protocol, an the reason to use those is not always clear.

• The protocol can serve to solve issues with ECG studies of consumer grade sports sensors.

• They tested the HRMs only up to about 15 km/h, probably due to ECG movement artifacts at higher speeds.

• The protocol can serve to test new algorithms to remove noise from ECG signals at higher speeds.

• HRMs tested with this protocol and clinical ECG devices could eventually be tested further to approve those for clinical applications. The Polar H10 is not validated for clinical applications, some of the 3 lead gold standard reference ECG devices are clinically approved.

• There were a number of HRMs tested together in this papers. The results can be compared in a table:

The result were:

• Polar H7 was the closest to the gold standard ECG device which had an accuracy of 98 %.

• The Apple Watch III had an accuracy of 96 % compared to the gold standard ECG device

• According to Rob ter Horsts accuracy data, the latest Apple watches are the most accurate devices.

• It is highly desirable to have numerical and statistical data of these newer devices compared to gold standard ECG device with speeds up to 15 km/h.

• It is also be highly desirable to have numerical and statistical data of all devices Rob ter Horst tested.

• As long as there is no 3 lead ECG noise and movement artifact free ECG reference devices are available for activities with speeds which are higher than 15 km/h, and also for activities with strong movements, or also as long as there are now validation papers with cheaper ECG devices like Bitalino or OpenBCI which compare them to clincical devices in high quality journals, which proof the high accuracy of the reference ECG device, a Polar H10 strap can be used as a gold standard reference device in the range of acitivies with strong movments.

• The study of the Swiss Federal Institute of Sporsts in Magglingen about the Polar H10 and a Holter ECG device was partly funded by Polar.
• Rob ter Horst is partly funded by advertising revenues from sports sensor manufacturers.
• Therefore, the Swiss Federal Institute of Sports Magglingen which wrote a paper about the Polar H10, as well as Rob ter Horst which has choosen the Polar H10 as his reference device to test consumer grade HRMS, have a conflict of interest, they are partly funded by Polar.