PPG-Based Heart Rate Accuracy in Diverse Populations: Investigating Inequities Across Body Composition and Skin Tones
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arXiv
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| Format: | Preprint |
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2026
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| _version_ | 1866908799032360960 |
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| author | Kostrna Jason Oparina Ekaterina Palacios Cristina Rodriguez J, Andres Pei JunZhu Ajmal Ajmal Ramella-Roman C, Jessica |
| author_facet | Kostrna Jason Oparina Ekaterina Palacios Cristina Rodriguez J, Andres Pei JunZhu Ajmal Ajmal Ramella-Roman C, Jessica |
| contents | Wearable devices are widely used for heart rate (HR) monitoring, yet their accuracy across diverse body compositions and skin tones remains uncertain. This study evaluated four wrist worn devices (Apple, Fitbit, Samsung, Garmin) in 58 Hispanic adults with Fitzpatrick skin types III to V during a cycling protocol alternating moderate (0.64 to 0.76 HRmax) and vigorous (0.77 to 0.95 HRmax) intensities. Criterion HR was obtained using a Polar H10 ECG, and accuracy was assessed using mean absolute error, mean absolute percentage error (MAPE), bias, and intraclass correlation coefficients. All devices showed significant deviation from criterion measures. Apple and Garmin demonstrated the lowest error, whereas Fitbit and Samsung exhibited greater inaccuracies. Higher BMI and darker skin tones were associated with increased MAPE. These biases disproportionately affect higher risk populations, underscoring the need for improved algorithms to ensure equitable health monitoring. |
| format | Preprint |
| id |
arxiv_https___arxiv_org_abs_2601_22377 |
| institution | arXiv |
| publishDate | 2026 |
| record_format | arxiv |
| spellingShingle | PPG-Based Heart Rate Accuracy in Diverse Populations: Investigating Inequities Across Body Composition and Skin Tones Kostrna Jason Oparina Ekaterina Palacios Cristina Rodriguez J, Andres Pei JunZhu Ajmal Ajmal Ramella-Roman C, Jessica Medical Physics Optics Physics and Society Wearable devices are widely used for heart rate (HR) monitoring, yet their accuracy across diverse body compositions and skin tones remains uncertain. This study evaluated four wrist worn devices (Apple, Fitbit, Samsung, Garmin) in 58 Hispanic adults with Fitzpatrick skin types III to V during a cycling protocol alternating moderate (0.64 to 0.76 HRmax) and vigorous (0.77 to 0.95 HRmax) intensities. Criterion HR was obtained using a Polar H10 ECG, and accuracy was assessed using mean absolute error, mean absolute percentage error (MAPE), bias, and intraclass correlation coefficients. All devices showed significant deviation from criterion measures. Apple and Garmin demonstrated the lowest error, whereas Fitbit and Samsung exhibited greater inaccuracies. Higher BMI and darker skin tones were associated with increased MAPE. These biases disproportionately affect higher risk populations, underscoring the need for improved algorithms to ensure equitable health monitoring. |
| title | PPG-Based Heart Rate Accuracy in Diverse Populations: Investigating Inequities Across Body Composition and Skin Tones |
| topic | Medical Physics Optics Physics and Society |
| url | https://arxiv.org/abs/2601.22377 |