Abstract

As the global population continues to age, cardiovascular diseases (CVDs) are becoming increasingly prevalent. In Taiwan, the country entered an aging society as early as 2003 and is projected to become a super-aged society by 2025. Effective management of CVDs is essential to reducing the burden on the healthcare system. Due to their accessibility and practicality, wearable health devices have emerged as useful tools for daily cardiovascular monitoring. However, concerns remain regarding their measurement stability and accuracy.

This study applies Measurement System Analysis (MSA) to evaluate the stability of wearable cardiovascular health monitoring devices. Using Gage Repeatability and Reproducibility (Gage R&R), misclassification probability analysis, and two-way ANOVA with interaction effects, we identify potential sources of measurement error. Considering individual health variability, we aim to identify the most suitable user groups in order to reduce delayed treatment and medical resource waste. From a human factors perspective, we also provide recommendations for consumers when selecting appropriate devices.

Additionally, the study proposes design and calibration improvements to help manufacturers enhance device stability. By understanding measurement variability and its contributing factors, this research aims to improve the accuracy of wearable cardiovascular health monitoring. Ultimately, the findings contribute to better consumer guidance, more reliable product development, and reduced healthcare strain in super-aged societies.

Keywords

Cardiovascular health, wearable monitoring devices, Gage Repeatability and Reproducibility, STEAMS.

Acknowledgements

The authors would like to thank the following personnel for their assistance in this study:

Charles Chen, Yu Hua Cheng, and Yu Cheng Tai for advice in experimental design, statistical analysis, and revising the manuscript.

Biographies

Ni-Hsi Yeh is currently a grade 12 student at Fanghe Experimental High School. From a young age, she has shown strong ambition and passion for social issues and advocacy. Driven by a curiosity to explore societal needs and initiate action, she has participated in short-term mission and service teams in Kenya, Northern Thailand, and Taiwan from elementary through high school.In her junior year, she competed in the 2025 Civic Action Project Competition organized by the Legal Reform Education Foundation (LREF), earning Third Place and the “Most Popular Award.” With a keen interest in addressing population aging and applying technology, she aims to learn more about data analytics and to develop innovative solutions. Through competition participation and presentations, she seeks to broaden her global perspective, cultivate social insight, and objectively contribute to positive change in society.

Zan Chou is a junior year high school student with a long-standing passion for biology and physical sciences at Huaxing High School, he has actively engaged in experimental work since junior high school. His recent exposure to research involving medical instrumentation has deepened his interest in biomedical technologies. To support his experimental analysis, he has begun learning JMP statistical software and applying it to process and interpret physiological data.

Pin-Jen Lai is currently a junior year high school student at Kang Chiao International School Linkou Campus. She is currently interested in pursuing a future in biological and data sciences, with a particular focus on translational research. She has participated in the 2024 iGEM competition to collectively create an optimized biosensor for atherosclerotic plaque. Recognizing the importance of preventive healthcare, she has continued to explore interdisciplinary approaches integrating biotechnology and statistical modeling to support early detection and diagnosis.

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Ms. Yeh Ni-Hsi