Study design · Digital biomarkersUpdated September 28, 2026

Software for digital biomarker validation studies

Validating a sensor-based measure means comparing it with reference measurements, in the right people, at the right times. Capture holds the reference assessments, participant-reported context and device summary metrics in one study with aligned timestamps.

  • Reference measures as site forms
  • Device metrics per session
  • Participant context from home

Free sandbox · No credit card · 21 CFR Part 11 aligned

Validation plan · Gait speed from wrist sensor
VerificationAnalyticalClinical
Sensor output accuracy
Algorithm vs reference test
Relates to clinical state
Study with participants
Analytical and clinical validation need study data

Key points

  • The widely used V3 framework separates verification (does the sensor measure accurately?), analytical validation (does the algorithm produce the intended measure?) and clinical validation (does the measure reflect the clinical state in the target population?).
  • Analytical and clinical validation need studies with participants, comparing the digital measure with reference measurements.
  • FDA has issued guidance on digital health technologies for remote data acquisition in clinical investigations, covering fitness for purpose, verification and validation.
  • Timestamps matter: digital and reference measurements must be aligned in time to be compared.
  • Validation studies need context from participants (activities, symptoms, device wear) to interpret sensor data.

Study design

What a validation study actually records

A digital biomarker validation study usually has three streams of data. First, reference measurements: a timed walk in clinic, a clinician-rated scale, polysomnography, a spirometry result. Second, the digital measure: summary metrics derived by the algorithm for defined time windows. Third, context: when the device was worn, what the participant was doing, how they felt. Validity is established by comparing the first two, with the third explaining the gaps.

Capture handles the reference measurements as site forms (performance tests are PerfO site forms), participant context as recurring questionnaires on their phones, and device summary metrics as structured numeric fields per session or day. Every record is time-stamped and attributed, so alignment in analysis is straightforward.

Raw sensor data

High-frequency raw sensor data usually stays in the device platform or a dedicated data lake. The study database should hold the metrics, time windows and identifiers needed for the analysis, and a clear link to where raw data lives. See EDC for wearable device studies.

Session alignment · Subject 004-0017

Clinic 4-m walk

1.12 m/s

Sensor gait speed

1.08 m/s

Wear time

94%

Sessions with reference and device data22/24
Context diary completed20/24
Reference, device and context aligned

Reference measures

Reference assessments recorded like any endpoint

Reference tests are run by site staff and recorded as site forms with range checks, units and assessor attribution. Participant-reported context comes from phone questionnaires with completion windows, so each session's data is complete.

  • PerfO and ClinRO site forms.
  • Recurring context questionnaires.
  • Exports with codes, labels and timestamps.
6-minute walk test template
PRO

Patient-reported

Participant, own phone

ObsRO

Observer-reported

Caregiver

ClinRO

Clinician-reported

Site staff, clinic tablet

PerfO

Performance outcome

Site-run test, e.g. chair rise

Set up reference and context forms

Build a validation study skeleton in the free sandbox.

Build your validation study free

Study build

Validation study checklist

Concept of interest defined

What the digital measure is supposed to capture, in which population.

Reference measures chosen

Accepted reference for each aspect being validated.

Time alignment rules

How sessions are defined and matched.

Wear and quality criteria

Minimum wear time and data quality for a valid session.

Context captured

Participant diaries for activities and symptoms.

Consent covers device data

See the wearable data consent template.

Examples

Digital measures, reference measures and the context they need

Digital measurePossible referenceContext to capture
Gait speed from a wearableTimed walk test in clinicWalking aids, pain, falls
Daily step countObserved walking, activity questionnaireIllness days, weather, device removal
Sleep duration and efficiencyPolysomnography or sleep diaryBedtime routine, naps, medication
Tremor severityClinician-rated tremor scaleMedication timing, activities during recording
Cough frequencyManually counted recordingsEnvironment, other sounds, symptoms
Heart rate variabilityClinical ECGPosture, activity, caffeine, stress

The right reference depends on the concept of interest and the intended context of use.

Wear adherence

Missing device data is the main threat to validity

A digital measure is only as good as the hours it covers. Participants take devices off to charge them, forget them after showering, or stop wearing them when they feel unwell, and those gaps are rarely random. Define in advance what counts as a valid day or session, monitor wear time during the study, and ask participants about the reasons for gaps in their context diary, so the analysis can handle missing data honestly.

Short context questionnaires on the participant's own phone, with a completion window and reminders, are the simplest way to capture that information. See the wearable data sharing consent template for how to explain wear expectations up front.

FAQ

Questions teams ask before they switch

Something not covered here? Ask us directly.

What is the difference between a digital biomarker and a digital endpoint?

A digital biomarker is a characteristic measured by a digital device that indicates a biological or clinical state. A digital endpoint is such a measure used to assess treatment effect in a trial.

How many participants does a validation study need?

It depends on the analysis, such as agreement with the reference or sensitivity to change. Plan it with a statistician, as for any study.

What is the V3 framework?

A framework separating verification, analytical validation and clinical validation of digital measures from sensor-based technologies.

Does Capture store raw sensor data?

Capture stores structured summary metrics, reference assessments and participant context. Raw high-frequency data usually stays in the device platform.

How are reference measures recorded?

As site forms completed by the assessor, with units, range checks and attribution.

Is there regulatory guidance?

Yes. FDA has issued guidance on digital health technologies for remote data acquisition in clinical investigations.

Can I try it free?

Yes, in the free sandbox.

Validate digital measures properly

Reference, device and context data in one study. Free sandbox.

Build your validation study free