Evidence mapPaperPMID 41592155Full record

SynthesisJMIR mHealth and uHealth2026

Exploiting Unsupervised Free-Living Data for Cardiorespiratory Fitness Estimation: Systematic Review and Meta-Analysis.

Alexios Dosis, Aron Berger Syversen, Mikolaj R Kowal, Daniel Grant, Jim Tiernan, David Wong, David G Jayne

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in JMIR mHealth and uHealth, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Alexios DosisLeeds Institute of Medical Research, University of Leeds, Clinical Sciences Building, St James's University Hospital, Beckett Street, Leeds, LS97LN, United Kingdom, 44 07754226212.ORCID http://orcid.org/0000-0003-1415-6156
Aron Berger SyversenSchool of Computing, University of Leeds, Leeds, England, United Kingdom.ORCID http://orcid.org/0000-0003-0021-8758
Mikolaj R KowalLeeds Institute of Medical Research, University of Leeds, Clinical Sciences Building, St James's University Hospital, Beckett Street, Leeds, LS97LN, United Kingdom, 44 07754226212.ORCID http://orcid.org/0000-0001-5628-4880
Daniel GrantCardiorespiratory Department, Leeds Teaching Hospitals, Leeds, United Kingdom.ORCID http://orcid.org/0009-0001-9046-9253
Jim TiernanAbdominal Medicine and Surgery, Leeds Teaching Hospitals, Leeds, United Kingdom.ORCID http://orcid.org/0000-0002-5582-7748
David Wong5 Leeds Institute of Health Sciences, University of Leeds, Leeds, England, United Kingdom.ORCID http://orcid.org/0000-0001-8117-9193
David G JayneLeeds Institute of Medical Research, University of Leeds, Clinical Sciences Building, St James's University Hospital, Beckett Street, Leeds, LS97LN, United Kingdom, 44 07754226212.ORCID http://orcid.org/0000-0002-8725-3283

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Current methods of cardiorespiratory fitness (CRF) assessment may discriminate against frail individuals who are challenged to perform a maximal cardiopulmonary exercise test. CRF estimations from free-living wearable data, captured over extended time periods, may offer a more representative assessment and increase usability in clinical settings. Objective: This study aimed to review current evidence behind this novel concept and evaluate the performance and quality of models developed to estimate CRF from free-living, unsupervised data. Methods: Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we systematically searched 4 databases (MEDLINE, Embase, Scopus, and arXiv) for studies reporting the development of models to estimate CRF from continuous free-living wearable data. Studies conducted entirely under controlled laboratory conditions were excluded. Performance metrics were combined in a meta-correlation analysis using a random-effects model and Fisher Z transformation. Results: Of 1848 papers screened, 18 met the eligibility criteria, with a total of 31,072 participants. The weighted mean age was 46.9 (SD 1.46) years. Multiple computational techniques were used, with 8 studies employing more advanced machine learning models. The meta-correlation analysis revealed a pooled overall estimate of 0.83 with a 95% CI 0.77-0.88. The I2 test indicated high heterogeneity at 97%. Risk of bias assessment found most concerns in the data analysis domain, with studies often lacking clarity around the data handling process. Conclusions: A promising preliminary agreement between CRF predictions and measured values was noted. However, no definite conclusions can be drawn for clinical implementation due to high heterogeneity among the included studies and lack of external validation. Nonetheless, continuous data streams appear to be a valuable resource that could lead to a step change in how we measure and monitor CRF.

Indexed as

Cardiorespiratory FitnessAdultExercise TestHumansMalecardiorespiratory fitnessfree-living datamachine learningperioperative medicinewearables

Identifiers

PMID41592155
PMCPMC12841865

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.