Why do we not have a generally accepted highly accurate optical heart rate sensor for clinical and research applications?

The first optical heart rate monitors we used where MIO devices. Then the Garmin Forerunner 235. These had three green sensor lights. After that, we used the Polar OH1 with 6 green sensor lights. Then surprisingly, the Polar Verity came, but not with a higher accuracy, but with a longer battery life than the Polar …