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To the Editor In a study in a recent issue of JAMA Internal Medicine, Murakami et al1 evaluated the performance of 12 wearable devices at measuring total energy expenditure (TEE) against 2 separate reference standards—metabolic chamber and doubly labeled water method. With both methods, they found all 12 wearables underestimated TEE with wide variability.1 Although variability in accuracy could be attributed to many factors (ie, use of best possible reference standards, use of healthy subjects for evaluation, placement of wearables [waist vs wrist], inherent inconsistencies during test days, varying metabolic rates, and lapses in device use from charging or performing activities restricting usage) some limitations of this evaluation include a very small sample size (n = 13) and a choice of populations studied. Regardless, the study is well designed and presents interesting findings.1
Pai NP, Budd D. Remaining Questions Concerning Wearable Devices. JAMA Intern Med. 2016;176(9):1408-1409. doi:10.1001/jamainternmed.2016.4756