Generation of a Free-Living Ground-Truth Validation Dataset for Wearable Measures of Physical Activity, Sedentary Behavior, Sleep, and Heart Rate in Adults (OxWEARS): Protocol for a Cross-Sectional Study

Abstract Background Wearable devices enable continuous measurement of physical activity, sedentary behavior, sleep, and heart rate under free-living conditions. However, most validation studies rely on small, homogeneous samples; are conducted under laboratory conditions; or lack gold standard ground-truth measurements, limiting the generalizability and accuracy of derived metrics. There is a pressing need for open-access, large-scale, free-living validation datasets that include multisensor data from diverse body locations and participant demographics to aid in model development. Objective The Oxford Wearable ECG, Activity, Circadian Rhythm, and Sleep Validation Study (OxWEARS) aims to (1) validate accelerometer-based measurement of physical behaviors across 5 body sites against annotated camera data; (2) validate measurements of sleep and sleep staging from 5 different body sites against polysomnography; (3) validate wrist-worn photoplethysmography heart rate measurements against chest-worn electrocardiogram; and (4) generate a comprehensive, annotated, and anonymized dataset for open-access research use. Methods This cross-sectional study will recruit approximately 160 adults (aged ≥40 years) stratified by age, sex, and BMI from the Oxford BioBank. Over 3 days and 4 nights, participants will wear sensors on the wrists, chest, hip, thigh, and ankle. Ground-truth measures will be obtained from a chest electrocardiogram patch for heart rate, a first-person camera for activity annotation, an ankle-worn accelerometer for step count, and at-home polysomnography for sleep. An under-mattress sensor will collect measures of sleep, respiration rate, and bedtime, and a subjective sleep diary will also be obtained. Signals from different wear locations will be compared against the ground truth using precision, recall, F 1 -score, κ, and agreement metrics. Results Recruitment commenced in November 2024, with 15 participants enrolled by May 2025. Overall, 50% of eligible adults contacted were happy to consent to the study, with excellent compliance with the protocol observed to date. Data collection is ongoing and expected to conclude in 2026, with the final annotated dataset made publicly available as soon as possible thereafter. Conclusions The OxWEARS study will generate an openly accessible dataset containing more than 10,000 annotated hours from a stratified sample of adults. This will directly support scalable, generalizable human activity recognition efforts, while also enabling robust development and benchmarking of wearable-derived health metrics.