Unless its a GPS based device, altimeters depend on atmospheric pressure differences to calculate elevation. If the weather pattern is steady (like a big high pressure system) then a pressure based altimeter can be very accurate but in most cases it needs to be set to a known elevation everytime its used. Using Brad Washburn's convenient stainless steel survey points on Washington and surrounds, my old Casio pressure based altimeter was good to plus or minus 5 feet over the course of a day when the barometric pressure was steady. When camping I use the pressure based altimeter as a weather tracker, if the reported elevation goes down over the night, it means high pressure is coming in usually indicative of nice weather, on the other hand an increase in elevation means low pressure is moving in and that usually means rain.