Generalizability and performance of methods to detect non-wear with free-living accelerometer recordings.

Wearable physical activity sensors are widely used in research and practice as they provide objective measures of human behavior at a low cost. An important challenge for accurate assessment of physical activity behavior in free-living is the detection non-wear. Traditionally, heuristic algorithms that rely on specific interval lengths have been employed to detect non-wear time; however, machine learned models are emerging. We explore the potential of detecting non-wear using decision trees that combine raw acceleration and skin temperature, and we investigate the generalizability of our models, traditional heuristic algorithms, and recently developed machine learned models by external validation. The Decision tree models were trained using one week of data from thigh- and hip-worn accelerometers from 64 children. External validation was performed using data from wrist-worn accelerometers of 42 adolescents. For non-wear episodes longer than 60 min, the heuristic algorithms performed the best with F1-scores above 0.96. However, regarding episodes shorter than 60 min, the best performing method was the decision tree model including the six most important predictors with F1 scores above 0.74 for all sensor locations. We conclude that for classifying non-wear time, researchers should carefully select an appropriate method and we encourage the use of external validation when reporting on machine learned non-wear models.