Readiness, recovery, and strain: an evaluation of composite health scores in consumer wearables

• DOI: 10.1515/teb-2025-0001
• Publication Date: 2025-04-09T14:26:26Z
• Authors: Cailbhe Doherty; Maximus Baldwin; Rory Lambe; David Burke; Marco Altini

Abstract

Introduction Consumer wearables increasingly provide users with Composite Health Scores (CHS) – integrated biometric indices that claim to quantify readiness, recovery, stress, or overall well-being. Despite their growing adoption, the validity, transparency, and physiological relevance of these scores remain unclear. This study systematically evaluates CHS from leading wearable manufacturers to assess their underlying methodologies, contributors, and scientific basis.

Content Information was synthesised from publicly available company documentation, including technical white papers, user manuals, app interfaces, and research literature where available. We identified 14 CHS across 10 major wearable manufacturers, including Fitbit (Daily Readiness), Garmin (Body Battery™ and Training Readiness), Oura (Readiness and Resilience), WHOOP (Strain, Recovery, and Stress Monitor), Polar (Nightly Recharge™), Samsung (Energy Score), Suunto (Body Resources), Ultrahuman (Dynamic Recovery), Coros (Daily Stress), and Withings (Health Improvement Score). The most frequently incorporated biometric contributors in this catalogue of CHS were heart rate variability (86 %), resting heart rate (79 %), physical activity (71 %), and sleep duration (71 %). However, significant discrepancies were identified in data collection timeframes, metric weighting, and proprietary scoring methodologies. None of the manufacturers disclosed their exact algorithmic formulas, and few provided empirical validation or peer-reviewed evidence supporting the accuracy or clinical relevance of their scores.

Summary and outlook While the concept of CHS represent a promising innovation in digital health, their scientific validity, transparency, and clinical applicability remain uncertain. Future research should focus on establishing standardized sensor fusion frameworks, improving algorithmic transparency, and evaluating CHS across diverse populations. Greater collaboration between industry, researchers, and clinicians is essential to ensure these indices serve as meaningful health metrics rather than opaque consumer tools.