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Observational Study
. 2020 Dec 16;8(12):e20214.
doi: 10.2196/20214.

Wearability Testing of Ambulatory Vital Sign Monitoring Devices: Prospective Observational Cohort Study

Carlos Areia #  1   2 , Louise Young #  1   2 , Sarah Vollam  1   2 , Jody Ede  1   2 , Mauro Santos  2   3 , Lionel Tarassenko  2   3 , Peter Watkinson  1   2
Affiliations
Observational Study

Wearability Testing of Ambulatory Vital Sign Monitoring Devices: Prospective Observational Cohort Study

Carlos Areia et al. JMIR Mhealth Uhealth. .

Abstract

Background: Timely recognition of patient deterioration remains challenging. Ambulatory monitoring systems (AMSs) may provide support to current monitoring practices; however, they need to be thoroughly tested before implementation in the clinical environment for early detection of deterioration.

Objective: The objective of this study was to assess the wearability of a selection of commercially available AMSs to inform a future prospective study of ambulatory vital sign monitors in an acute hospital ward.

Methods: Five pulse oximeters (4 with finger probes and 1 wrist-worn only, collecting pulse rates and oxygen saturation) and 2 chest patches (collecting heart rates and respiratory rates) were selected to be part of this study: The 2 chest-worn patches were VitalPatch (VitalConnect) and Peerbridge Cor (Peerbridge); the 4 wrist-worn devices with finger probe were Nonin WristOx2 3150 (Nonin), Checkme O2+ (Viatom Technology), PC-68B, and AP-20 (both from Creative Medical); and the 1 solely wrist-worn device was Wavelet (Wavelet Health). Adult participants wore each device for up to 72 hours while performing usual "activities of daily living" and were asked to score the perceived exertion and perception of pain or discomfort by using the Borg CR-10 scale; thoughts and feelings caused by the AMS using the Comfort Rating Scale (CRS); and to provide general free text feedback. Median and IQRs were reported and nonparametric tests were used to assess differences between the devices' CRS scores.

Results: Quantitative scores and feedback were collected in 70 completed questionnaires from 20 healthy volunteers, with each device tested approximately 10 times. The Wavelet seemed to be the most wearable device (P<.001) with an overall median (IQR) CRS score of 1.00 (0.88). There were no statistically significant differences in wearability between the chest patches in the CRS total score; however, the VitalPatch was superior in the Attachment section (P=.04) with a median (IQR) score of 3.00 (1.00). General pain and discomfort scores and total percentage of time worn are also reflective of this.

Conclusions: Our results suggest that adult participants prefer to wear wrist-worn pulse oximeters without a probe compressing the fingertip and they prefer to wear a smaller chest patch. A compromise between wearability, reliability, and accuracy should be made for successful and practical integration of AMSs within the hospital environment.

Keywords: ambulatory monitoring; chest patch; pulse oximeter; vital signs; wearability; wearables.

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Conflict of interest statement

Conflicts of Interest: PW and LT report significant grants from the NIHR, UK, and the NIHR Biomedical Research Centre, Oxford, during the conduct of the study. PW and LT report modest grants and personal fees from Sensyne Health, outside the submitted work. LT works part-time for Sensyne Health and has share options in the company. PW holds shares in the company. All other authors have no conflicts to declare.

Figures

Figure 1
Figure 1
Devices included in this study.
Figure 2
Figure 2
The study participant flowchart. AMD: ambulatory monitoring device.
Figure 3
Figure 3
Comfort Rating Scale scores for each pulse oximeter. Green represents the percentage of positive outcomes and red represents the percentage of negative outcomes from the Comfort Rating Scale scores (Multimedia Appendix 2).
Figure 4
Figure 4
Comfort Rating Scale scores for each chest patch device. Green represents the percentage of positive outcomes and red represents the percentage of negative outcome from the Comfort Rating Scale scores (Multimedia Appendix 2).
See this image and copyright information in PMC

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