ArticlePloS one2025
Validity of heart rate measurements in wrist-based monitors across skin tones during exercise.
Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Consumer-oriented (wearable) sleep technology: a systematic SWOT analysis and recommendations for athletes and fitness enthusiasts.Frontiers in sports and active living · 2026Pooled it
- The Representation of Different Populations in Studies Assessing the Validity of Consumer Wearable Photoplethysmography-Based Measurements: Scoping Review.JMIR mHealth and uHealth · 2026Article
- Orthometria: Metric Fixation in Digital Health and a Framework for Responsible Use in High-Performance Sport.Sports medicine - open · 2026Article
- HEART-Watch: A multimodal physiological dataset from a Google Pixel Watch across different physical states.PLOS digital health · 2026Article
- Consumer Smartwatch Technology in Health and Performance Research: Validity, Limitations, and Real-World Applications.Sensors (Basel, Switzerland) · 2026Review
- Comparison of heart rate measurement accuracy among commercially available photoplethysmography-based wearable devices across exercise intensities.Physical activity and nutrition · 2026Article
- PPG-Based Heart Rate Accuracy in Hispanic Adults with Fitzpatrick III-V Skin Tones: An Evaluation of Body Composition and Skin-Tone Effects.Sensors (Basel, Switzerland) · 2026Article
- Accuracy of Optical Heart Rate Measurements for 10 Commercial Wearables in Different Climate Conditions and Activities: Instrument Validation Study.JMIR formative research · 2026Article
- Influence of skin pigmentation on the accuracy and data quality of photoplethysmographic heart rate measurement during exercise.European journal of applied physiology · 2026Article
- Wearable technology for athletes: material innovations, performance monitoring, and emerging paradigms.Mikrochimica acta · 2026Review
- Advancement in wrist worn physical activity trackers: technological developments and measurement accuracy: a systematic review.Frontiers in digital health · 2026Review
- Advancing health equity in proactive health management: from data underrepresentation and algorithmic bias to a closed-loop governance framework.Frontiers in public health · 2026Review
- Reducing bias and enhancing equity in AI-enabled precision nutrition: addressing measurement error across wearables, multiomics, and dietary data.Frontiers in digital health · 2026Review
- Finger pulse monitoring is a reliable and valid tool for measuring heart rate during exercise among adolescents in lab and school settings.BMC sports science, medicine & rehabilitation · 2025Article
- The Effect of Tattoos on Heart Rate Validity in the Polar Verity Sense Commercial Wearable Device.Sensors (Basel, Switzerland) · 2025Article
- Photoplethysmography in Diverse Skin Tones: Evaluating Bias in Smartwatch Health Monitoring.Cureus · 2025Review
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo evaluate the accuracy of a wrist-based heart rate (HR) monitor at different exercise intensities across different skin tones.
methodsUsing a cross-sectional design, we compared HR measures from the wrist-based photoplethysmography Fitbit Charge 5 to the Polar H10 chest strap at rest and during the YMCA Protocol using a recumbent cycle ergometer. Participant were grouped into three skin tone categories: light (Fitzpatrick Scale Skin Types 1+2), medium (Types 3+4), and darker skin tone (Types 5+6). HR measures using the Polar chest strap during the exercise test were categorized as <40%, 40-60%, or >60% HR reserve (HRR). Absolute error in beats per minute (bpm) between the two devices was calculated for each measure. A linear mixed effects model was used to assess interaction effects between skin tone and exercise intensity, with participants as the random effect. Bland-Altman plots were used for visual analyses.
resultsTwenty-five participants [mean (SD): 25.8 (1.9) years old; 64% female] were included with 495 observations of simultaneous Fitbit and Polar HR recordings collected during exercise. During exercise, we observed a statistically significant interaction effect between skin tone and exercise intensity. Compared with light skin tone at <40% HRR, mean error was greater for medium skin tone at >60% HRR [mean error (95%CI): 11.8 (5.6-17.9) bpm, p<0.001] and darker skin tone at 40-60% HRR [7.6 (1.7-13.5) bpm, p = 0.011] and >60% HRR [11.7 (5.3-18.0) bpm, p<0.001].
conclusionHR measurement error using a wrist-based device was greater with increasing exercise intensity for people with darker skin tones.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.