Accuracy of Fitbit Charge 4, Garmin Vivosmart 4, and WHOOP Versus Polysomnography: Systematic Review.

Background: Despite being the gold-standard method for objectively assessing sleep, polysomnography (PSG) faces several limitations as it is expensive, time-consuming, and labor-intensive; requires various equipment and technical expertise; and is impractical for long-term or in-home use. Consumer wrist-worn wearables are able to monitor sleep parameters and thus could be used as an alternative for PSG. Consequently, wearables gained immense popularity over the past few years, but their accuracy has been a major concern. Objective: A systematic review of the literature was conducted to appraise the performance of 3 recent-generation wearable devices (Fitbit Charge 4, Garmin Vivosmart 4, and WHOOP) in determining sleep parameters and sleep stages. Methods: Per the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement, a comprehensive search was conducted using the PubMed, Web of Science, Google Scholar, Scopus, and Embase databases. Eligible publications were those that (1) involved the validity of sleep data of any marketed model of the candidate wearables and (2) used PSG or an ambulatory electroencephalogram monitor as a reference sleep monitoring device. Exclusion criteria were as follows: (1) incorporated a sleep diary or survey method as a reference, (2) review paper, (3) children as participants, and (4) duplicate publication of the same data and findings. Results: The search yielded 504 candidate articles. After eliminating duplicates and applying the eligibility criteria, 8 articles were included. WHOOP showed the least disagreement relative to PSG and Sleep Profiler for total sleep time (-1.4 min), light sleep (-9.6 min), and deep sleep (-9.3 min) but showed the largest disagreement for rapid eye movement (REM) sleep (21.0 min). Fitbit Charge 4 and Garmin Vivosmart 4 both showed moderate accuracy in assessing sleep stages and total sleep time compared to PSG. Fitbit Charge 4 showed the least disagreement for REM sleep (4.0 min) relative to PSG. Additionally, Fitbit Charge 4 showed higher sensitivities to deep sleep (75%) and REM sleep (86.5%) compared to Garmin Vivosmart 4 and WHOOP. Conclusions: The findings of this systematic literature review indicate that the devices with higher relative agreement and sensitivities to multistate sleep (ie, Fitbit Charge 4 and WHOOP) seem appropriate for deriving suitable estimates of sleep parameters. However, analyses regarding the multistate categorization of sleep indicate that all devices can benefit from further improvement in the assessment of specific sleep stages. Although providers are continuously developing new versions and variants of wearables, the scientific research on these wearables remains considerably limited. This scarcity in literature not only reduces our ability to draw definitive conclusions but also highlights the need for more targeted research in this domain. Additionally, future research endeavors should strive for standardized protocols including larger sample sizes to enhance the comparability and power of the results across studies.

Autism-friendly public bus transport: A personal experience-based perspective.

LAY ABSTRACT: Transportation plays an essential role in daily life, allowing people to participate in the community and form social relationships. Many autistic people rely on public transportation to meet their mobility needs. However, research shows that it is not always easy for them to use it. The exact issues autistic individuals face when traveling with public transportation and how public transportation can be made more autism-friendly have yet to be researched. The current study allowed autistic individuals to express themselves regarding issues they face while traveling by public bus transportation, to raise awareness for making public transportation more autism-friendly. We interviewed 17 autistic individuals about their experiences riding the bus. Three main themes emerged from the results: creating predictability, limiting stimuli, and open and accessible communication. If transport companies take initiatives related to these themes, autistic people traveling by bus can have a more pleasant experience. Participants also described coping strategies for stressful or uncomfortable situations while using public bus transportation, such as using noise-cancelling headphones or digital applications for real-time route tracking, etc. These findings may lead to a more autism-friendly public transportation.

Post-trip safety interventions: State-of-the-art, challenges, and practical implications.

INTRODUCTION: Currently, risky driving behaviour is a major contributor to road crashes and as a result, wide array of tools have been developed in order to record and improve driving behaviour. Within that group of tools, interventions have been indicated to significantly enhance driving behaviour and road safety. This study critically reviews monitoring technologies that provide post-trip interventions, such as retrospective visual feedback, gamification, rewards or penalties, in order to inform an appropriate driver mentoring strategy delivered after each trip. METHOD: The work presented here is part of the European Commission H2020 i-DREAMS project. The reviewed platform characteristics were obtained through commercially available solutions as well as a comprehensive literature search in popular scientific databases, such as Scopus and Google Scholar. Focus was given on state-of-the-art-technologies for post-trip interventions utilized in four different transport modes (i.e. car, truck, bus and rail) associated with risk prevention and mitigation. RESULTS: The synthesized results revealed that smartphone applications and web-based platforms are the most accepted, frequently and easiest to use tools in cars, buses and trucks across all papers considered, while limited evidence of post-trip interventions in -rail was found. The majority of smartphone applications detected mobile phone use and harsh events and provided individual performance scores, while in-vehicle systems provided delayed visual reports through a web-based platform. CONCLUSIONS: Gamification and appropriate rewards appeared to be effective solutions, as it was found that they keep drivers motivated in improving their driving skills, but it was clear that these cannot be performed in isolation and a combination with other strategies (i.e. driver coaching and support) might be beneficial. Nevertheless, as there is no holistic and cross-modal post-trip intervention solution developed in real-world environments, challenges associated with post-trip feedback provision and suggestions on practical implementation are also provided.