Establishing a Global Standard for Wearable Devices in Sport and Fitness: Perspectives from the New England Chapter of the American College of Sports Medicine Members.

The recent explosion of wearable technology and the associated concerns prompted the International Federation of Sports Medicine (FIMS) to create a quality assurance standard for wearable devices, which provides commissioned testing of marketing claims and endorsement of commercial wearables that test favorably. An open forum as announced in the conference advertising was held at the Annual Meeting of the New England Regional Chapter of the American College of Sports Medicine (NEACSM) November 7 to 8, 2019, in Providence, Rhode Island, USA for attending NEACSM members to voice their input on the process. Herein, we report the proceedings. The round table participants perceived the quality assurance standard to be important, but identified some practical process challenges that included the broad scope and complexity of the device universe, the need for a multiphase testing pathway, and the associated fees for product evaluation. The participants also supported the evaluation of device data analysis, behavioral influences, and user experience in the overall evaluation. Looking forward, the FIMS quality assurance standard faces the challenge of balancing these broader perspectives with practical constraints of budget, facilities, time, and human resources.

Antidoping Science: Important Lessons From the Medical Sciences.

The ineffectiveness of antidoping programs in elite sport, largely due to human and political factors, is leading to a new resolve and greater transparency of antidoping authorities and those stakeholders interested in drug-free sport. The perception by the public, athletes, and the World Anti-Doping Agency (WADA) of antidoping science and current drug testing programs in elite sport varies widely from "ineffective" to "robust and reliable." Here, we discuss why a careful and considered reevaluation of the underlying premise of antidoping science is needed to bring this unique application of predictive/diagnostic science more in line with other areas of medicine. We show how the validity of doping tests are neither "stand-alone figures" generated under ideal laboratory conditions, nor figures that can be used in isolation to support the efficacy of the current drug testing program. Given the consequences of a failed doping test for the athlete, the sport, and multiple stakeholders (e.g., the sponsors), there is a need for transparent decision making to ensure those affected are well informed. We identify in this perspective the minimal essential data on drug testing that should be reported by antidoping laboratories to draw meaningful conclusions about the effectiveness of specific drug testing methods to support antidoping. In the absence of information on the validity of a doping test, it is not possible to plan or conduct "intelligent testing." It is imperative that the prevalence of doping and the likelihood of false-positive doping tests be regularly updated and made available for the wider antidoping research community to explore new approaches that could improve the validity of antidoping tests. True confirmatory testing which requires the use of different analytical technology and ideally an independent sample taken from an athlete with a positive test to transcend the present-day analysis of the B-sample. Indirect biomarkers of doping derived from new "omics"-based approaches may significantly improve the testing strategy. Biomarker molecular signatures are flexible enough to develop "normal ranges" optimized for either test sensitivity or specificity to detect a plethora of doping substances and methods.

Inaugural HealthAccord Conference (SportAccord Convention, Bangkok, Thailand): The Power of Sport - The Power to Change.

SportAccord organized the inaugural HealthAccord conference on April 19, 2018, in Bangkok, Thailand. The goal of HealthAccord is for the International Sport Federations (IF) and sport industry leaders to address high-priority issues facing sport through a serious commitment to innovation to protect athlete health, to enhance athlete performance, and to stimulate action to improve global health through the promotion of physical activity. The first HeathAccord conference was organized by drawing on the knowledge and experience of experts from global health programs focused on athletes and global citizens, respectively. The first session, "The Power of Sport," addressed the application of "state of the art" sport science and sport medicine for the protection of athlete health and to enhance sport performance. "The Power of Sport" session concentrated on enabling athletes to perform spectacular feats that are "higher, stronger, faster" intended to engage and thrill global audiences without resorting to prohibited substances and methods, to enable athletes to remain active in sport for a longer career, and to increase the attraction of sport for sponsors. In the second session, "The Power to Change," sport was viewed as having an important role in promoting physical activity within their respective federations, community, and internationally. The Olympic movement, IF, and other sport stakeholders are urgently needed to become the social drivers to correct the mismatch between physical activity for health development and draw toward sedentary lifestyles of the modern world. Key outcomes of this first HealthAccord conference were the agreement among participants to develop an innovative and high-impact collaboration between IF and related stakeholders; to use sport as a social movement platform to measurably improve health, both for athletes and for global citizens.

Establishing a Global Standard for Wearable Devices in Sport and Exercise Medicine: Perspectives from Academic and Industry Stakeholders.

Millions of consumer sport and fitness wearables (CSFWs) are used worldwide, and millions of datapoints are generated by each device. Moreover, these numbers are rapidly growing, and they contain a heterogeneity of devices, data types, and contexts for data collection. Companies and consumers would benefit from guiding standards on device quality and data formats. To address this growing need, we convened a virtual panel of industry and academic stakeholders, and this manuscript summarizes the outcomes of the discussion. Our objectives were to identify (1) key facilitators of and barriers to participation by CSFW manufacturers in guiding standards and (2) stakeholder priorities. The venues were the Yale Center for Biomedical Data Science Digital Health Monthly Seminar Series (62 participants) and the New England Chapter of the American College of Sports Medicine Annual Meeting (59 participants). In the discussion, stakeholders outlined both facilitators of (e.g., commercial return on investment in device quality, lucrative research partnerships, and transparent and multilevel evaluation of device quality) and barriers (e.g., competitive advantage conflict, lack of flexibility in previously developed devices) to participation in guiding standards. There was general agreement to adopt Keadle et al.'s standard pathway for testing devices (i.e., benchtop, laboratory, field-based, implementation) without consensus on the prioritization of these steps. Overall, there was enthusiasm not to add prescriptive or regulatory steps, but instead create a networking hub that connects companies to consumers and researchers for flexible guidance navigating the heterogeneity, multi-tiered development, dynamicity, and nebulousness of the CSFW field.