Wearables focus on health: Is the information they offer reliable? | Health & Wellness

The latest Fitbit activity bracelets, in addition to measuring the steps taken by the user, record the heart rate, include a function that allows detecting if there is atrial fibrillation and monitor oxygen and respiratory rate, among other parameters. The Apple Watch Series 7, the smart watch from the Cupertino firm, performs electrocardiograms when used with the ECG application. The Oura ring, which is advertised as “the best sleep monitor on the market”, also includes body temperature sensors and promises to integrate all the data it collects about the user’s body to tell them how ready they are to exercise, if they are point or if, on the contrary, it should rest.

It’s been a long time since the wearables, those devices that are worn 24 hours a day and that measure different parameters of the user’s body, are much more than a pedometer that connects to the mobile phone. Typically, these devices go further and also monitor elements that even not long ago we could only measure in a doctor’s office. However, these are consumer devices, that is, they have not been developed with a medical context in mind. In 2022, it is expected that 3.445 million products will be sold worldwide, an increase of 13.2% compared to 2021, according to the consulting firm Abi Research. But, to what extent can we trust the data that they give us through tiny sensors that contrast with the cumbersomeness of many medical devices?

“There is great variability between the different devices,” explains Antoni Baena, director of the University Master’s Program in Digital Health at the Open University of Catalonia (UOC), referring to the studies that have been published on the subject. “Of course, the most expensive ones tend to be the most reliable, since they include much better receivers,” he notes. But it doesn’t just depend on the device: there are parameters that are easier to measure than others, which results in data that is more in line with reality. Thus, although these devices usually fail “when analyzing energy expenditure”, the steps, beats per minute and some aspects of sleep are quite reliable, Baena lists.

Sleep is one of the star elements that measure wearables. When the user wakes up, the application associated with the device will tell him how much and how well he has slept, as well as what percentage of those sleeping hours he has dedicated to deep sleep. “Specifically that, the deep sleep thing, is not to be trusted,” says Javier Puertas, vice president of the Spanish Sleep Society (SES). In addition, he explains that there are many myths about the stages of sleep that these applications do not always clarify. Deep sleep is just one of the phases and should not take up the whole night. “Deep sleep is normally 20% of the night and decreases with age,” says Puertas. But if you don’t know this, you can wake up after five hours of sleep, find that you’ve “only” had one hour of deep sleep, and feel like you’ve had a bad night’s sleep for those few hours.

What they can measure with some reliability wearables it is the total number of hours you have slept, but an expert stresses that it is important not to obsess. “It can generate a concern about sleep that is contrary to sleep: if we go to bed worried about whether we are sleeping more or less deeply and we think that we can do something about it, all we are going to do is introduce a parameter of concern in the sleep environment, which is the opposite of what will allow us to sleep well”, he says. This obsession has already begun to be called orthosomnia as a result of an article published in 2017 in the Journal of Clinical Sleep Medicine in which a detected trend was alerted: patients who went to the doctor because their wearables they were told that they slept poorly, which in turn made them sleep worse.

In general, however, it does seem that the data provided by the devices is quite close to reality. “Regarding other more complex variables that have been included in the latest devices such as ECG, oxygen level, respiratory rate or, about to come out, sugar level, the few studies that are still relatively new technologies have found that the records are reliable”, explains Antoni Baena. “Now imagine the power of screening that these devices can have, that not diagnostic”, he assures.

Another useful contribution of the measurements carried out by the wearables, even those that do not have the best precision, is that by taking them over a period of time, a data history is created in which the evolution can be seen and any changes checked. “The same thing happens on a scale. It may not be well calibrated and it may weigh more or less, but the important thing in these cases is the variation in weight as a useful indicator for the health professional”, explains Vicente Traver, director of the Technological Innovations for Health and Welfare (SABIEN) of the Institute for Applications of Information Technologies and Advanced Communications of the Polytechnic University of Valencia (UPV). This information, the expert believes, can help speed up a visit to a specialist doctor and even reduce the time it takes to reach a diagnosis. However, you always have to be careful and find the balance. “Being in favor of patient empowerment, we cannot promote hypochondria,” says Traver.

Awareness about healthy habits

The fear that users become obsessed with all that information about our health provided by wearables it is legitimate, but at the moment it seems that this effect is minority. A study published in 2021 in the journal challenges, for example, tried to find a correlation between the use of fitness devices (wearables, mobile applications, etc.), sports addiction and tendency to anxiety. She didn’t find it.

“We cannot claim to empower the population in terms of health, but not doing so for fear of alarmism or hypochondria would be paternalistic”, indicates Antoni Baena. “What is different is that a lot of work is needed in the communication of reasonable and purposeful health information, which helps to improve self-care and not the other way around”, he adds.

All the experts consulted agree that the most positive of the wearables It is precisely that: they make the population aware of the impact of lifestyle on our health. “The best thing about the arrival of these devices is that people have begun to pay attention to sleep,” concedes Javier Puertas, from the SES. “I always say that most of society has sleep models that are counterproductive: the successful person is the one who sleeps few hours. It seems that being productive is best and sleep is unproductive slavery. We do not have an education on sleep hygiene as an investment in our health, something that no one doubts about other aspects such as diet or physical exercise, ”he explains. Now sleep is mentioned more and more often as one of the pillars of healthy living.

“The wearables They are useful to generate awareness when adopting and maintaining an adequate lifestyle that results in a better quality of life. In addition, having this data and the fact that the user himself has access to it makes him see the relationship between lifestyle and health, for example, seeing how his diet or the steps he takes have an impact on his heart rate, his glucose level or in the quality of their sleep”, adds Vicente Traver, from the UPV.

At present, the health-related data collected by wearables of consumption remain in the hands of the user, who is the one who can decide whether to show something to his doctor or not. Only if they are medical devices provided to the patient by a health professional, this data can be automatically transmitted to the health system. The forecast is that the wearables and other consumer devices continue to improve and collect increasingly accurate and reliable data. Traver explains that, for example, virtual assistants “can help a lot to collect information about the user’s health because it is already possible to detect different cardiovascular or respiratory diseases through voice analysis.”

In addition, it indicates that there is research for the prevention of stroke or detection of unwanted loneliness, cognitive impairment and other mental illnesses. In order to detect these and other disorders, the investigations “will not be based solely on the combination of artificial intelligence and the data acquired at that time, but will require having a historical data of that same user so that the recommendations and alerts be accurate,” he explains. The issue of privacy will also have a lot to say here, he points out, to what extent will we allow wearables and other devices to know and process such sensitive information.

His vision of the future is that of a combination of medical and non-medical devices. “We must keep medical devices for diagnosis, while many of the non-medical devices can be used to monitor diseases or to maintain a healthy lifestyle, beyond these wearables they should not replace health professionals. In any case, these devices (with a highly variable range of quality and precision) will always provide information that may be useful to the health professional, but he must be the one who decides what data to use for subsequent decision-making”, he concludes.

You can follow THE COUNTRY Health and Wellness in Facebook, Twitter and Instagram.