2024-02-25 03:03:13
Smart watches and digital health technologies for heart monitoring
Wearable digital health technology for heart monitoring has become one of the “hot” medical topics at the moment. In addition to their medical importance, as well as the high psychological importance for their users, these wearable devices have a growing economic importance.
The spread of digital health technologies
With the spread of the use of smart watches to 300 million users in the world, for the purposes of monitoring medical conditions or simply tracking levels and changes in fitness performance (Fitness Tracking), many economic sources expect the market for “wearable digital health technologies” to expand at a growth rate. A compound annual growth rate (CAGR) of approximately 15%, bringing its market size to exceed $80 billion annually over the next few years.
After the products of the digital health technology market were mainly limited in their “customers” to hospitals, health facilities and clinics, for use by medical teams in following up and monitoring patients, today their market has become very broad, and their “customers” are from the general public, within what is known as “wearable devices.” Direct – to – Consumer (abbreviated as D2C).
This expansion in demand for it from wide categories of people, of different ages, and for use in conditions and environments outside medical facilities, obligated the producing companies to provide further development in its technical aspects, to monitor and follow up on many of what is going on in the body physically and psychologically, in order to be able to continue Attracting consumers, especially with the successive competitions among these companies.
Medical challenges
In medical circles, taking advantage of wearable digital health technologies to monitor the heart represents a challenge that requires more scientific and research efforts to make the most of their applications, and to know the implications of what is observed through them in heart rhythm disturbances or other vital indicators that they monitor and monitor in the health of the body. The most important thing is how to direct its production and use so that it is accurate in its measurements, and thus the person benefits from it in a practical way that reflects the correct monitoring of his health condition, whether he is sick or healthy.
It is perhaps no coincidence that the current February issue of the Journal of the American College of Cardiology (JACC) published its scientific statement on “The Promises and Pitfalls of Consumer Mobile Technologies in Cardiovascular Care: The JACC Scientific Statement.” . The most important points in the statement were:
Wearable devices provide affordable and accessible healthcare data, which may facilitate the management of cardiovascular disorders.
-There are concerns about the accuracy, value, and unintended psychological responses to data derived from wearable devices.
Wearable devices promise to produce new paradigms for disease screening, diagnosis and management, thus laying the foundation for personalized medicine.
It is also no coincidence that the January 25 issue of the New England Journal of Medicine (N Engl J Med) contains a scientific review entitled “Wearable Digital Health Technologies in Cardiovascular Medicine.” The January issue of the Cleveland Clinic Journal of Medicine also contains two scientific reviews on the same matter. One is titled “Wearable Heart Monitors: Where Do We Stand?” and the other is titled “Consumer-Level Wearable Heart Monitors: What Does It Do Well, and What Needs Work?”
Also, by searching on the internationally accredited medical website “PubMed” for searching for medical studies, for “wearable digital health technologies,” we notice that the results of 39 medical studies issued since the beginning of the current year, until the day of preparing this article (the 18th of this month) are given. ). These studies not only examine the current uses of wearable digital health technologies in the areas of cardiovascular disease monitoring, but also in the treatment of diabetes, gestational diabetes, palliative care for incurable conditions, monitoring recovery periods after surgical operations, and Suicide attempts, patients with movement disorders and multiple sclerosis, psychological stress, depression, fertility disorders, menstrual disorders, monitoring bladder and urination disorders, and others.
Smart watches and sensor patches
In a previous scientific article, published in the November 30 issue of the New England Journal of Medicine, researchers from the University of Oxford Medical School in Britain presented their definition of “wearable digital health technology” by saying: “Wearable devices ( WDHT is a term used to describe forms of technology worn on the body, such as smart watches or adhesive patches containing sensors, that perform a useful function for the wearer or their healthcare provider. Common examples include devices that track physical activity and sleep or provide physiological data about the wearer, such as heart rate and rhythm or blood glucose levels. Wearable devices are increasingly being used by medical professionals to provide clinical data on and for their patients. “Digital health technology worn by patients and delivered through mobile applications can be used for disease monitoring, diagnosis, alerts or other clinical care services.”
Returning to the scientific statement of the Journal of the American College of Cardiology, the conclusion stated: “Direct-to-consumer (D2C) wearable devices have become increasingly popular in cardiovascular health management, due to their affordability and ability to capture data.” Miscellaneous health.
Wearable devices may enable ongoing partnership between healthcare provider and patient, in reducing the need for repeat clinic-based episodic care (thus reducing healthcare costs).
Data reliability and exacerbation of disparities
However, challenges arise from the unregulated use of these devices, including questionable data reliability, potential for misinterpretation of information, unintended psychological effects, and an influx of clinically non-actionable data, which may overwhelm the healthcare system.
Moreover, these technologies can exacerbate, rather than alleviate, health disparities. Experience with wearable devices in the treatment of atrial fibrillation underscores these challenges. The mainstream use of wearable devices requires a collaborative approach among stakeholders to ensure effective integration into cardiovascular care. Wearable devices hold the promise of innovative models for screening, diagnosing and managing diseases, expanding therapeutic avenues, and establishing personalized medicine.
In a recent scientific review published in the New England Journal of Medicine on wearable digital health technologies in cardiovascular medicine, the research group consisted of researchers from Yale University School of Medicine, the University of Colorado, and Stanford University. “This review focuses on the three most common cardiovascular conditions for which remote patient monitoring is used: hypertension, heart failure, and atrial fibrillation,” they stated in the first part of their presentation. The goal of remote patient monitoring is to use health data collected and transmitted remotely to improve treatment outcomes, through:
– Monitoring lifestyle behaviors that patients can change (such as sleep and activity).
– Controlling risk factors.
– Detect clinical deterioration or change in health condition, before it worsens.
The researchers explained, “Most doctors are familiar with remote monitoring of implantable electronic devices in the heart (such as pacemakers, defibrillators, and insertable cardiac monitors), which are It has been around for decades.”
300 million smart watch users in the world
Digital health technologies… wearables and others
Researchers from Yale University Schools of Medicine, the University of Colorado and Stanford University report that “wearable” digital health technologies in cardiovascular medicine include three main types:
– Software (such as Mobile Health Apps and Predictive Analytics applications).
– Hardware (such as sensors, monitors, and wearable devices).
– Telehealth platforms are increasingly being integrated into a range of contexts in cardiovascular medicine to support patient care, physician interactions, interpretation of imaging results and the flow of clinical care.
Common wearable devices include smart watches and other devices worn on the wrist, skin – surface patches, and wearable electrocardiogram (ECG) devices.
Here, “wearable” digital health technologies in cardiovascular medicine capture physiological data for patients, which can be transmitted and used by medical care delivery teams, in order to manage their risk factors and treat the cardiovascular diseases they suffer from.
In contrast, the researchers explained that there are digital health technologies in cardiovascular medicine that are “non-wearable.” Such as blood pressure monitors, etc.
In fact, cardiology has long been ahead of all other branches of medicine in using modern technologies to treat and monitor patients, through the use of different types of devices that are implanted inside the patient’s body. Likewise, cardiology is still ahead of all other branches of medicine in the use of modern technologies through devices that are “worn” or “not worn” by patients and healthy people as well.
Challenges of unregulated use of these devices include questionable data reliability and the potential for misinterpretation of information
The smart watch… optical imaging for measurements of pulse rate, oxygen saturation, and evaluation of heart rhythm
Within their scientific presentation, researchers from Yale University School of Medicine, the University of Colorado, and Stanford University say: “Watch-based devices are able to detect pulse rate and oxygen saturation via an optical sensor and a diode on the back of the watch face.” , using intermittent or semi-continuous photoplethysmography. “In smart watches and bands, the photoplethysmography sensor can be programmed to record intermittent pulse pachygrams during periods of noise-free signal (i.e., limited activity and good contact between the sensor and the wrist).”
They explained that 2 of 3 large studies were conducted in the United States, which included more than 400,000 people who did not have atrial fibrillation, and that they “demonstrated a high positive predictive value for noticing atrial fibrillation.” They added: “Although there may be false positives, this result may be, in part, due to the paroxysmal nature (appearance and then disappearance) of atrial fibrillation, which is missed if the patient returns to the normal rhythm (pulse rate). Heart) after noticing the presence of an irregular pulse in it.
Therefore, additional ECG (in clinic) or ambulatory ECG monitoring may be appropriate, depending on the clinical suspicion.” “The irregular heartbeat notification algorithms in these consumer devices are FDA-cleared for use only in patients not previously diagnosed with atrial fibrillation,” they added.
In the study published in the Cleveland Journal of Medicine, the researchers stated: “The validity of wearable devices detecting the presence of atrial fibrillation has been validated due to the ease of identifying irregular time intervals (between heartbeats). “In general, the sensitivity of smart devices to detect atrial fibrillation is remarkably high.”
However, it is still unclear whether these portable devices can detect other, more important and more common types of arrhythmia, such as supraventricular tachycardia. As well as in types of rhythm disturbances that involve risk, such as cases of prolonged Q-T interval.
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