Review History

All reviews of published articles are made public. This includes manuscript files, peer review comments, author rebuttals and revised materials. Note: This was optional for articles submitted before 13 February 2023.

Peer reviewers are encouraged (but not required) to provide their names to the authors when submitting their peer review. If they agree to provide their name, then their personal profile page will reflect a public acknowledgment that they performed a review (even if the article is rejected). If the article is accepted, then reviewers who provided their name will be associated with the article itself.

View examples of open peer review.


  • The initial submission of this article was received on July 21st, 2021 and was peer-reviewed by 2 reviewers and the Academic Editor.
  • The Academic Editor made their initial decision on September 21st, 2021.
  • The first revision was submitted on October 12th, 2021 and was reviewed by the Academic Editor.
  • A further revision was submitted on November 11th, 2021 and was reviewed by the Academic Editor.
  • The article was Accepted by the Academic Editor on November 15th, 2021.

Version 0.3 (accepted)

· Nov 15, 2021 · Academic Editor


Thank you for addressing the suggested revision.

Version 0.2

· Nov 1, 2021 · Academic Editor

Minor Revisions

Thank you for addressing the reviewer comments. I have only one minor revision required. In Table 4, for references 4 and 13, it is unclear what parameter the 'other' column is referring to. Please address this. Otherwise, I believe the manuscript is well written has addressed its aims in undertaking a scoping review of this subject.

Version 0.1 (original submission)

· Sep 21, 2021 · Academic Editor

Major Revisions

This is a well-written manuscript and addresses an important and growing area in healthcare delivery. There are several issues that require addressing. The most pressing issue, as outlined by Reviewer 2, is to ensure that relevant studies related to wearables and respiratory conditions have not been missed. There is very little reference and discussion throughout the manuscript concerning respiratory monitoring - this needs to be addressed. Please ensure that your search has been comprehensively undertaken and is broad enough to detect relevant respiratory studies. Further discussion should be added concerning the role of wearable technology and respiratory conditions.

[# PeerJ Staff Note: Please ensure that all review and editorial comments are addressed in a response letter and any edits or clarifications mentioned in the letter are also inserted into the revised manuscript where appropriate.  It is a common mistake to address reviewer questions in the response letter but not in the revised manuscript. If a reviewer raised a question then your readers will probably have the same question so you should ensure that the manuscript can stand alone without the response letter.  Directions on how to prepare a response letter can be found at: #]

Reviewer 1 ·

Basic reporting

In this article, Khungaqji et al provide a systematic review of how physiological data from wearable technology is used to assist clinical decision making. The aim of the review was to map out the current body of literature to identify knowledge gaps and thereby inform future research in the cardio-respiratory field. The English used is proficient, the references appear appropriate and the rationale for the study is presented clearly.

Experimental design

The methods used for the literature review appear appropriately described and executed. The review appears appropriately organised.

Validity of the findings

Within the introduction, the authors correctly state that the literature to date has focussed on the design, reliability and validity of these devices in controlled settings, and that the next phase is to translate this data into clinical useful decision making.
The conclusion states that although wearables are able to accurately collect physiological data, there is a need for specialist physicians to review the raw data before making a definitive diagnosis. They also comment on the lack of data from the respiratory domain, and a large bias towards AF detection in the cardiovascular domain. These are all correct, and point towards the current limitations in both sensor technology and the software algorithms designed to interpret the raw data which they provide.

Additional comments

The article is clearly written and the methodology, findings and conclusions are all appropriate. The discussion provides further details about the current gaps in the literature and also some of the limitations of the current technologies. In terms of answering the aims of the review, in providing a detailed map of the current literature, the authors have successfully identified current knowledge gaps and areas for future research including: 1) Application of wearable devices for clinical decision making; 2) Extending the use of these devices outside the diagnosis of AF within the cardiovascular domain and 3) The use of wearable devices for respiratory conditions. The latter appears to be an area with a significant knowledge gap.


Basic reporting

No comment.

Experimental design

1. The authors are addressing a timely issue, in wearable tech and cardiorespiratory decision making. On the face of it, this number of articles seems quite low for my anecdotal observations of the literature, as well as clinical practice. For example, our study about smart watch and afib was recently published but not included here (10.1001/jamanetworkopen.2021.5821). I am not requesting you cite my work (it may fall out of the study period), it simply provides an immediate example of my concerns related to the search. I provide additional issues related to respiratory below. Also, health systems are suing "hospital at home" nowadays- would these types of articles provide relevant articles?

2. Study reports no respiratory studies, which seems incorrect. On quick Google search, I found doi: 10.2196/10046. Is this study applicable? Search criteria includes "respiratory" but not "pulmonary," which could be an issue. Also see DOI: 10.2147/COPD.S193037. Also, COVID-specific searches could change the number of resulting manuscripts.

3. Clinical decision making is part of the search. I think this needs to be better defined in the text. For example, decision making by the clinician? Decision making by the patient or someone lese? I wonder if this part of the query really limits the results.

Validity of the findings

4. "To date, studies employing wearables to facilitate clinical decisions have largely focused
upon the cardiovascular domain." This does not seem like a conclusion since the denominator is limited to CV studies.

Additional comments

5. The biggest gap is prospective, randomized studies link to health outcomes, which was not mentioned in "gaps." Also, what about issues surrounding integration with electronic health records/interoperability?

All text and materials provided via this peer-review history page are made available under a Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.