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More Patients are Relying on Data from Smart Watches — But How Accurate are They?

How much can you rely on a patient's smart watch for health and behavior data? What the research says.

Last month, the final results from the ongoing Apple Heart Study were published in the New England Journal of Medicine. The study focused on the ability of the Apple Watch to detect atrial fibrillation in users. The researchers, led by Marco Perez, MD, associate professor of cardiovascular medicine at Stanford University Medical Center, recruited more than 400,000 participants in eight months to determine the watch’s reliability in identifying and informing wearers of an irregular pulse.

“What the Apple Heart Study shows us is that atrial fibrillation is just the beginning,” said Perez. “We can look ahead to other areas of preventive medicine. Further research will help people make more informed health decisions.”

What Did the Study Find?

Participants in the study wore an Apple Watch that monitored for irregular heart rhythms. If a participant received notice of an irregular pulse, they would be prompted to attend a telemedicine visit, obtain an ECG patch test, and take an end-of-study survey. The study found a low incidence of Apple Watch wearers receiving an irregular pulse notification. And while a low incidence of notifications could indicate a low rate of false positives, there were a number of participants who did not receive an irregular pulse notification that were still diagnosed with AFib.

The Highlights

  • Among all participants notified of an irregular pulse, 34% had AFib on subsequent ECG patch readings, and 84% of all notifications were concordant with AFib.
  • Of the 929 people that completed the end-of-study survey who got an irregular pulse notification, 43% received a new diagnosis of AFib.
  • Of the 293,015 people in the study who did not receive an irregular pulse notification and completed the end-of-study survey, 1% said they had since received a new diagnosis of AFib.

Why Does the Study Matter?

Although there’s a lot of hope for the potential of new, high-tech devices like the Apple Watch, some cardiologists have raised concerns that the FDA has downplayed the risk of unreliable readings. Thankfully, the Apple Heart Study could help inform the future use of these devices and the complex medical issues they raise.

“As the number of app-based health studies grows, developing additional methods to maximize self-report data accuracy and engagement will be an important area of investigation,” said Mintu Turakhia, MD, associate professor of cardiovascular medicine at Stanford University, in a statement. “These important findings lay the foundation for further research into the use of emerging wearable technologies in clinical practice and demonstrate the unique potential of large-scale app-based studies.”

Board member of the Preventive Cardiovascular Nurses Association Kathy Berra, MSN, NP-BC, FAANP, FPCNA, FAHA, FAAN, is excited about the future of wearable technology in healthcare. Not only has she observed changes in her patients’ motivation and behavior, but she sees the potential for clinicians to receive essential data about their patients accurately.

“For clinicians, if you’re not embracing remote electronic technology, you’re really not keeping up with where things are going,” Berra says. “If you learn about [the devices patients are wearing] and understand what they can and can’t do, then you can use that information clinically. If you dismiss it, you’re going to potentially be missing a life-saving opportunity.”

Apple has since released a new research app, enrolling participants for three new studies: the Apple Heart and Movement Study, the Apple Women’s Health Study, and the Apple Hearing Study.

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