Agreement Between Wearable-based Vital-sign Monitoring and Standard Bedside Monitoring in Patients After Knee Arthroscopy

Min Wang; Pan Zhang; Wenhui Ma; Jing Hu-Yan; Erfei Zhang

doi:doi:10.11648/j.cmr.20261504.12

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Agreement Between Wearable-based Vital-sign Monitoring and Standard Bedside Monitoring in Patients After Knee Arthroscopy

Min Wang, Pan Zhang, Wenhui Ma, Jing Hu-Yan, Erfei Zhang^*

Published in Clinical Medicine Research (Volume 15, Issue 4)

Received: 13 September 2026 Accepted: 8 October 2026 Published: 28 October 2026

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Abstract

Postoperative vital sign monitoring is essential for early detection of inpatient hemodynamic and respiratory complications. Although conventional bedside monitors serve as the clinical gold standard, their fixed design limits patient mobility and continuous ambulatory monitoring, which hinders early rehabilitation after orthopedic surgery. Wearable monitoring devices have shown great potential for postoperative vital sign surveillance due to their mobility and continuous data collection capabilities, yet real-world validation data in orthopedic postoperative patients remain insufficient, and wearable blood pressure measurement accuracy remains controversial. This study aimed to evaluate the agreement between a wearable monitor and a standard bedside monitor for heart rate, respiratory rate, systolic blood pressure, diastolic blood pressure, and peripheral oxygen saturation (SpO₂) in patients undergoing knee arthroscopy. A total of 100 elective knee arthroscopy patients were prospectively enrolled. Paired vital sign data were collected simultaneously via the two devices at four daily time points over two postoperative days. Intra-class correlation coefficient (ICC), Lin’s concordance correlation coefficient, Bland-Altman analysis, temporal trend analysis, and clinical acceptability evaluation were performed for statistical assessment. After excluding five missing values, 3995 paired observations were analyzed. The wearable device showed excellent agreement for heart rate (ICC = 0.994, bias = −0.63 bpm, 95% LoA: −2.97 to 1.70 bpm), good agreement for respiratory rate (ICC = 0.940, bias = −0.51 breaths/min, 95% LoA: −2.71 to 1.68 breaths/min), and moderate-to-good agreement for SpO2 (ICC = 0.872, bias = −0.85%, 95% LoA: −3.50 to 1.80%). Diastolic blood pressure showed moderate agreement (ICC = 0.827, bias = −1.42 mmHg, 95% LoA: −12.90 to 10.06 mmHg), while systolic blood pressure demonstrated the lowest agreement (ICC = 0.811) with a prominent positive systematic bias of 5.63 mmHg. Temporal trends remained stable across postoperative days, with consistent inter-device bias over time. The clinical acceptability rates of heart rate, respiratory rate and SpO₂ exceeded 99.5%, compared with 92.2% for diastolic blood pressure and only 79.6% for systolic blood pressure. In conclusion, the wearable monitor provides reliable heart rate, respiratory rate, and SpO2 measurements and is suitable for routine postoperative monitoring after knee arthroscopy. However, blood pressure measurements, particularly systolic blood pressure, show notable systematic deviation, and targeted algorithm calibration is needed to improve its blood pressure monitoring performance.

Published in	Clinical Medicine Research (Volume 15, Issue 4)
DOI	10.11648/j.cmr.20261504.12
Page(s)	60-68
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2026. Published by Science Publishing Group

Keywords

Wearable Monitoring, Vital Signs, Bedside Monitor, Measurement Agreement, Knee Arthroscopy, Postoperative Monitoring

References

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APA Style

Wang, M., Zhang, P., Ma, W., Hu-Yan, J., Zhang, E. (2026). Agreement Between Wearable-based Vital-sign Monitoring and Standard Bedside Monitoring in Patients After Knee Arthroscopy. Clinical Medicine Research, 15(4), 60-68. https://doi.org/10.11648/j.cmr.20261504.12

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ACS Style

Wang, M.; Zhang, P.; Ma, W.; Hu-Yan, J.; Zhang, E. Agreement Between Wearable-based Vital-sign Monitoring and Standard Bedside Monitoring in Patients After Knee Arthroscopy. Clin. Med. Res. 2026, 15(4), 60-68. doi: 10.11648/j.cmr.20261504.12

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AMA Style

Wang M, Zhang P, Ma W, Hu-Yan J, Zhang E. Agreement Between Wearable-based Vital-sign Monitoring and Standard Bedside Monitoring in Patients After Knee Arthroscopy. Clin Med Res. 2026;15(4):60-68. doi: 10.11648/j.cmr.20261504.12

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@article{10.11648/j.cmr.20261504.12,
  author = {Min Wang and Pan Zhang and Wenhui Ma and Jing Hu-Yan and Erfei Zhang},
  title = {Agreement Between Wearable-based Vital-sign Monitoring and Standard Bedside Monitoring in Patients After Knee Arthroscopy},
  journal = {Clinical Medicine Research},
  volume = {15},
  number = {4},
  pages = {60-68},
  doi = {10.11648/j.cmr.20261504.12},
  url = {https://doi.org/10.11648/j.cmr.20261504.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20261504.12},
  abstract = {Postoperative vital sign monitoring is essential for early detection of inpatient hemodynamic and respiratory complications. Although conventional bedside monitors serve as the clinical gold standard, their fixed design limits patient mobility and continuous ambulatory monitoring, which hinders early rehabilitation after orthopedic surgery. Wearable monitoring devices have shown great potential for postoperative vital sign surveillance due to their mobility and continuous data collection capabilities, yet real-world validation data in orthopedic postoperative patients remain insufficient, and wearable blood pressure measurement accuracy remains controversial. This study aimed to evaluate the agreement between a wearable monitor and a standard bedside monitor for heart rate, respiratory rate, systolic blood pressure, diastolic blood pressure, and peripheral oxygen saturation (SpO2) in patients undergoing knee arthroscopy. A total of 100 elective knee arthroscopy patients were prospectively enrolled. Paired vital sign data were collected simultaneously via the two devices at four daily time points over two postoperative days. Intra-class correlation coefficient (ICC), Lin’s concordance correlation coefficient, Bland-Altman analysis, temporal trend analysis, and clinical acceptability evaluation were performed for statistical assessment. After excluding five missing values, 3995 paired observations were analyzed. The wearable device showed excellent agreement for heart rate (ICC = 0.994, bias = −0.63 bpm, 95% LoA: −2.97 to 1.70 bpm), good agreement for respiratory rate (ICC = 0.940, bias = −0.51 breaths/min, 95% LoA: −2.71 to 1.68 breaths/min), and moderate-to-good agreement for SpO2 (ICC = 0.872, bias = −0.85%, 95% LoA: −3.50 to 1.80%). Diastolic blood pressure showed moderate agreement (ICC = 0.827, bias = −1.42 mmHg, 95% LoA: −12.90 to 10.06 mmHg), while systolic blood pressure demonstrated the lowest agreement (ICC = 0.811) with a prominent positive systematic bias of 5.63 mmHg. Temporal trends remained stable across postoperative days, with consistent inter-device bias over time. The clinical acceptability rates of heart rate, respiratory rate and SpO2 exceeded 99.5%, compared with 92.2% for diastolic blood pressure and only 79.6% for systolic blood pressure. In conclusion, the wearable monitor provides reliable heart rate, respiratory rate, and SpO2 measurements and is suitable for routine postoperative monitoring after knee arthroscopy. However, blood pressure measurements, particularly systolic blood pressure, show notable systematic deviation, and targeted algorithm calibration is needed to improve its blood pressure monitoring performance.},
 year = {2026}
}

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TY  - JOUR
T1  - Agreement Between Wearable-based Vital-sign Monitoring and Standard Bedside Monitoring in Patients After Knee Arthroscopy
AU  - Min Wang
AU  - Pan Zhang
AU  - Wenhui Ma
AU  - Jing Hu-Yan
AU  - Erfei Zhang
Y1  - 2026/10/28
PY  - 2026
N1  - https://doi.org/10.11648/j.cmr.20261504.12
DO  - 10.11648/j.cmr.20261504.12
T2  - Clinical Medicine Research
JF  - Clinical Medicine Research
JO  - Clinical Medicine Research
SP  - 60
EP  - 68
PB  - Science Publishing Group
SN  - 2326-9057
UR  - https://doi.org/10.11648/j.cmr.20261504.12
AB  - Postoperative vital sign monitoring is essential for early detection of inpatient hemodynamic and respiratory complications. Although conventional bedside monitors serve as the clinical gold standard, their fixed design limits patient mobility and continuous ambulatory monitoring, which hinders early rehabilitation after orthopedic surgery. Wearable monitoring devices have shown great potential for postoperative vital sign surveillance due to their mobility and continuous data collection capabilities, yet real-world validation data in orthopedic postoperative patients remain insufficient, and wearable blood pressure measurement accuracy remains controversial. This study aimed to evaluate the agreement between a wearable monitor and a standard bedside monitor for heart rate, respiratory rate, systolic blood pressure, diastolic blood pressure, and peripheral oxygen saturation (SpO2) in patients undergoing knee arthroscopy. A total of 100 elective knee arthroscopy patients were prospectively enrolled. Paired vital sign data were collected simultaneously via the two devices at four daily time points over two postoperative days. Intra-class correlation coefficient (ICC), Lin’s concordance correlation coefficient, Bland-Altman analysis, temporal trend analysis, and clinical acceptability evaluation were performed for statistical assessment. After excluding five missing values, 3995 paired observations were analyzed. The wearable device showed excellent agreement for heart rate (ICC = 0.994, bias = −0.63 bpm, 95% LoA: −2.97 to 1.70 bpm), good agreement for respiratory rate (ICC = 0.940, bias = −0.51 breaths/min, 95% LoA: −2.71 to 1.68 breaths/min), and moderate-to-good agreement for SpO2 (ICC = 0.872, bias = −0.85%, 95% LoA: −3.50 to 1.80%). Diastolic blood pressure showed moderate agreement (ICC = 0.827, bias = −1.42 mmHg, 95% LoA: −12.90 to 10.06 mmHg), while systolic blood pressure demonstrated the lowest agreement (ICC = 0.811) with a prominent positive systematic bias of 5.63 mmHg. Temporal trends remained stable across postoperative days, with consistent inter-device bias over time. The clinical acceptability rates of heart rate, respiratory rate and SpO2 exceeded 99.5%, compared with 92.2% for diastolic blood pressure and only 79.6% for systolic blood pressure. In conclusion, the wearable monitor provides reliable heart rate, respiratory rate, and SpO2 measurements and is suitable for routine postoperative monitoring after knee arthroscopy. However, blood pressure measurements, particularly systolic blood pressure, show notable systematic deviation, and targeted algorithm calibration is needed to improve its blood pressure monitoring performance.
VL  - 15
IS  - 4
ER  -

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Author Information

Min Wang

Department of Anesthesiology, Yan'an University Affiliated Hospital, Yan’an, China
Pan Zhang

Department of Anesthesiology, Yan'an University Affiliated Hospital, Yan’an, China
Wenhui Ma

Department of Anesthesiology, Yan'an University Affiliated Hospital, Yan’an, China
Jing Hu-Yan

Department of Anesthesiology, Yan'an University Affiliated Hospital, Yan’an, China
Erfei Zhang

Department of Anesthesiology, Yan'an University Affiliated Hospital, Yan’an, China

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Plain Text BibTeX RIS

APA Style

Wang, M., Zhang, P., Ma, W., Hu-Yan, J., Zhang, E. (2026). Agreement Between Wearable-based Vital-sign Monitoring and Standard Bedside Monitoring in Patients After Knee Arthroscopy. Clinical Medicine Research, 15(4), 60-68. https://doi.org/10.11648/j.cmr.20261504.12

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ACS Style

Wang, M.; Zhang, P.; Ma, W.; Hu-Yan, J.; Zhang, E. Agreement Between Wearable-based Vital-sign Monitoring and Standard Bedside Monitoring in Patients After Knee Arthroscopy. Clin. Med. Res. 2026, 15(4), 60-68. doi: 10.11648/j.cmr.20261504.12

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AMA Style

Wang M, Zhang P, Ma W, Hu-Yan J, Zhang E. Agreement Between Wearable-based Vital-sign Monitoring and Standard Bedside Monitoring in Patients After Knee Arthroscopy. Clin Med Res. 2026;15(4):60-68. doi: 10.11648/j.cmr.20261504.12

Copy | Download

@article{10.11648/j.cmr.20261504.12,
  author = {Min Wang and Pan Zhang and Wenhui Ma and Jing Hu-Yan and Erfei Zhang},
  title = {Agreement Between Wearable-based Vital-sign Monitoring and Standard Bedside Monitoring in Patients After Knee Arthroscopy},
  journal = {Clinical Medicine Research},
  volume = {15},
  number = {4},
  pages = {60-68},
  doi = {10.11648/j.cmr.20261504.12},
  url = {https://doi.org/10.11648/j.cmr.20261504.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20261504.12},
  abstract = {Postoperative vital sign monitoring is essential for early detection of inpatient hemodynamic and respiratory complications. Although conventional bedside monitors serve as the clinical gold standard, their fixed design limits patient mobility and continuous ambulatory monitoring, which hinders early rehabilitation after orthopedic surgery. Wearable monitoring devices have shown great potential for postoperative vital sign surveillance due to their mobility and continuous data collection capabilities, yet real-world validation data in orthopedic postoperative patients remain insufficient, and wearable blood pressure measurement accuracy remains controversial. This study aimed to evaluate the agreement between a wearable monitor and a standard bedside monitor for heart rate, respiratory rate, systolic blood pressure, diastolic blood pressure, and peripheral oxygen saturation (SpO2) in patients undergoing knee arthroscopy. A total of 100 elective knee arthroscopy patients were prospectively enrolled. Paired vital sign data were collected simultaneously via the two devices at four daily time points over two postoperative days. Intra-class correlation coefficient (ICC), Lin’s concordance correlation coefficient, Bland-Altman analysis, temporal trend analysis, and clinical acceptability evaluation were performed for statistical assessment. After excluding five missing values, 3995 paired observations were analyzed. The wearable device showed excellent agreement for heart rate (ICC = 0.994, bias = −0.63 bpm, 95% LoA: −2.97 to 1.70 bpm), good agreement for respiratory rate (ICC = 0.940, bias = −0.51 breaths/min, 95% LoA: −2.71 to 1.68 breaths/min), and moderate-to-good agreement for SpO2 (ICC = 0.872, bias = −0.85%, 95% LoA: −3.50 to 1.80%). Diastolic blood pressure showed moderate agreement (ICC = 0.827, bias = −1.42 mmHg, 95% LoA: −12.90 to 10.06 mmHg), while systolic blood pressure demonstrated the lowest agreement (ICC = 0.811) with a prominent positive systematic bias of 5.63 mmHg. Temporal trends remained stable across postoperative days, with consistent inter-device bias over time. The clinical acceptability rates of heart rate, respiratory rate and SpO2 exceeded 99.5%, compared with 92.2% for diastolic blood pressure and only 79.6% for systolic blood pressure. In conclusion, the wearable monitor provides reliable heart rate, respiratory rate, and SpO2 measurements and is suitable for routine postoperative monitoring after knee arthroscopy. However, blood pressure measurements, particularly systolic blood pressure, show notable systematic deviation, and targeted algorithm calibration is needed to improve its blood pressure monitoring performance.},
 year = {2026}
}

Copy | Download

TY  - JOUR
T1  - Agreement Between Wearable-based Vital-sign Monitoring and Standard Bedside Monitoring in Patients After Knee Arthroscopy
AU  - Min Wang
AU  - Pan Zhang
AU  - Wenhui Ma
AU  - Jing Hu-Yan
AU  - Erfei Zhang
Y1  - 2026/10/28
PY  - 2026
N1  - https://doi.org/10.11648/j.cmr.20261504.12
DO  - 10.11648/j.cmr.20261504.12
T2  - Clinical Medicine Research
JF  - Clinical Medicine Research
JO  - Clinical Medicine Research
SP  - 60
EP  - 68
PB  - Science Publishing Group
SN  - 2326-9057
UR  - https://doi.org/10.11648/j.cmr.20261504.12
AB  - Postoperative vital sign monitoring is essential for early detection of inpatient hemodynamic and respiratory complications. Although conventional bedside monitors serve as the clinical gold standard, their fixed design limits patient mobility and continuous ambulatory monitoring, which hinders early rehabilitation after orthopedic surgery. Wearable monitoring devices have shown great potential for postoperative vital sign surveillance due to their mobility and continuous data collection capabilities, yet real-world validation data in orthopedic postoperative patients remain insufficient, and wearable blood pressure measurement accuracy remains controversial. This study aimed to evaluate the agreement between a wearable monitor and a standard bedside monitor for heart rate, respiratory rate, systolic blood pressure, diastolic blood pressure, and peripheral oxygen saturation (SpO2) in patients undergoing knee arthroscopy. A total of 100 elective knee arthroscopy patients were prospectively enrolled. Paired vital sign data were collected simultaneously via the two devices at four daily time points over two postoperative days. Intra-class correlation coefficient (ICC), Lin’s concordance correlation coefficient, Bland-Altman analysis, temporal trend analysis, and clinical acceptability evaluation were performed for statistical assessment. After excluding five missing values, 3995 paired observations were analyzed. The wearable device showed excellent agreement for heart rate (ICC = 0.994, bias = −0.63 bpm, 95% LoA: −2.97 to 1.70 bpm), good agreement for respiratory rate (ICC = 0.940, bias = −0.51 breaths/min, 95% LoA: −2.71 to 1.68 breaths/min), and moderate-to-good agreement for SpO2 (ICC = 0.872, bias = −0.85%, 95% LoA: −3.50 to 1.80%). Diastolic blood pressure showed moderate agreement (ICC = 0.827, bias = −1.42 mmHg, 95% LoA: −12.90 to 10.06 mmHg), while systolic blood pressure demonstrated the lowest agreement (ICC = 0.811) with a prominent positive systematic bias of 5.63 mmHg. Temporal trends remained stable across postoperative days, with consistent inter-device bias over time. The clinical acceptability rates of heart rate, respiratory rate and SpO2 exceeded 99.5%, compared with 92.2% for diastolic blood pressure and only 79.6% for systolic blood pressure. In conclusion, the wearable monitor provides reliable heart rate, respiratory rate, and SpO2 measurements and is suitable for routine postoperative monitoring after knee arthroscopy. However, blood pressure measurements, particularly systolic blood pressure, show notable systematic deviation, and targeted algorithm calibration is needed to improve its blood pressure monitoring performance.
VL  - 15
IS  - 4
ER  -

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