ArticleSensors (Basel, Switzerland)2026
Multi-Tier Validation of a Single-Lead Wearable ECG Signal-Processing Pipeline: Clinical Comparison and Algorithmic Benchmarking on Public Expert-Annotated Databases.
Article in Sensors (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Wearable single-lead electrocardiogram (ECG) devices are increasingly used for out-of-clinic rhythm monitoring, but the rigour with which their signal-processing pipelines are validated varies widely across the literature, with most published reports relying on either a single clinical comparison or a single algorithmic benchmark. We propose and apply a multi-tier validation methodology-combining clinical reference comparison, expert-annotated database benchmarking, and a deliberate morphological stress-test-and demonstrate it on the SmartGuard single-lead wearable ECG device and its signal-processing pipeline. The three tiers comprise (i) a within-subject clinical comparison in 31 healthy adult volunteers against a Bionet Cardio 7 limb-lead Lead I reference with cardiologist-confirmed measurements (a two-electrode limb configuration approximating Lead I, not a full diagnostic 12-lead ECG), (ii) algorithmic benchmarking on the Lobachevsky University ECG Database (LUDB, 200 records, expert annotations), and (iii) a robustness stress-test on the QT Database (QTDB, 103 records, hybrid expert annotations). The pipeline integrates discrete wavelet transform-based PQRST delineation with a derivative-based QRS-width refinement, a tangent-method T-wave end estimator, and median-absolute-deviation robust averaging. In the clinical tier, mean within-subject biases were negligible for heart rate, QT, QTc and RR (all
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