The CardioWatch 287-2 is a state-of-the-art wearable device designed to continuously monitor
respiration rate with high accuracy. Accurate monitoring of respiration rate is crucial for a wide range
of health applications, including managing respiratory and cardiovascular conditions, monitoring
patients during physical activity, and early detection of respiratory anomalies. Wearable technology
like the CardioWatch 287-2 provides a non-invasive, convenient method for continuous respiration
rate monitoring, greatly enhancing patient outcomes and providing valuable real-time data to
healthcare providers.

enabling timely medical interventions and better management of chronic respiratory conditions. For
patients with conditions such as obstructive sleep apnea, chronic obstructive pulmonary disease
(COPD), or during post-operative recovery, continuous monitoring can detect abnormalities early and
prevent severe complications.
To validate the respiration rate algorithm of the CardioWatch 287-2, multiple clinical studies were
conducted across different centers and populations, comparing its performance against established
reference devices such as end-tidal CO2 monitors, NOX-T3 devices, and impedance-based respiration
rate measurements. These studies aimed to evaluate the device’s accuracy, reliability, and consistency
across a diverse population in both resting and active states. The validation process included
participants with various demographics, ensuring the device’s robustness and applicability in realworld
scenarios.
This white paper summarizes the findings from these extensive validation studies..
Study Summaries
Study Centre: Haaglanden Clinics, The Hague, the Netherlands
Study Period: October-December 2020
Publication DOI: https://doi.org/10.1101/2023.07.25.23293134
Study Population: 26 patients at rest (18 suspected of obstructive sleep apnea, 8 healthy)
Reference Device: NOX-T3
Population Characteristics:
- Age: 47 ± 16 years
- Female: 8 (31%)
- BMI: 28.6 ± 7.4 kg/m²
- Skin type: II-V
Measurement Pairs:
- 31083 breaths
Results:
- Average root mean square error (Arms): 0.60 brpm
- Correlation: R = 0.964 (95% CI: 0.963 – 0.965)
- Bias: -0.14 (95% CI: -0.21 to -0.08) brpm
- 95% LoA: -1.28 (95% CI: -1.35 to -1.22) to 1.71 (95% CI: 0.93 – 1.06) brpm

Conclusion
The comprehensive validation studies demonstrate that the CardioWatch 287-2 respiration rate algorithm provides highly accurate and reliable respiration rate measurements across various populations and conditions. The low (average) root mean squared error (Arms/RMSE), and high correlation coefficients indicate strong agreement with reference measures such as NOX-T3 measurements, and impedance recordings through ECG electrodes. The algorithm’s performance remains robust across different population characteristics.
The validation studies for the CardioWatch 287-2 respiration rate algorithm indicate a high level of accuracy and reliability across various populations and conditions. The low average root mean square error (Arms) and high correlation coefficients affirm the algorithm’s strong agreement with established methods.
The Haaglanden study, conducted at Haaglanden Clinics, demonstrated the device’s reliability in a clinical setting with a population suspected of obstructive sleep apnea, highlighting the device’s precision in a clinical context, making it suitable for monitoring patients with respiratory conditions.
The MULTI-VITAL-study at Reinier de Graaf Gasthuis highlighted the device’s accuracy in a critical care setting during cardiac catheterization, emphasizing its potential for high-stakes medical environments.
Overall, these comprehensive validation studies demonstrate that the CardioWatch 287-2 respiration rate algorithm delivers highly accurate and reliable measurements across a wide range of populations and conditions. The algorithm’s consistent performance across different demographics underscores its robustness and versatility.
These findings highlight the CardioWatch 287-2’s potential for widespread use in clinical settings, offering reliable respiration rate monitoring to support better health outcomes. The device stands out as a valuable tool for patients and healthcare providers, enhancing the ability to manage respiratory health effectively through both in-clinic and at-home monitoring, improving overall patient care.