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Role of wearable devices increasing in health care
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CHICAGO — The integration of wearable devices into clinical care is still in its beginning stages, but the devices’ use for ECG and the diagnosis of various arrhythmia disorders remains a top priority for research, according to a presentation at Cardiometabolic Health Congress.
“As of 3 years ago, 77% of people owned a smartphone, not any cellphone, but a phone that has screen interactive capabilities and network connection,” Cardiology Today Next Gen Innovator Mintu Turakhia, MD, MAS, associate professor of medicine and executive director of the Center for Digital Health at Stanford University School of Medicine, said during his presentation. “What we didn’t realize, that was catching on so quickly, is the world of watches and fitness trackers. So right now, almost one in five people in the U.S. have some sort of technology on [their] wrist, whether it’s a fitness band or a smartwatch.”
Wearable technology such as headbands, smartwatches and sensors embedded in clothing have built-in functionalities that can include ECG, electromyography and electroencephalogram. However, these devices all have similar flaws that include difficulty with continuous electrode recording, real-time vs. offline processing, battery life and compliance, according to Turakhia.
“Can you actually leverage these devices that people buy for other reasons, not because they’re screening themselves, but because they want technology on a watch and use that to help identify disease,” Turakhia said. “The first thing that happened is people took advantage of the fact that the camera flash on a phone, which is typically right next to the camera sensor. This means you can shine a light through your finger, and it also means that the camera can detect changes in blood flow. Any off-the-shelf photodiode camera can do this. It doesn’t have to be high quality. The transillumination of a finger looking at blood flow is the same as pulse oximetry.”
The latest advancements in detection and diagnosis have included artificial intelligence technology. Via this method, researchers trained the AI software, EchoMD AutoEF (Bay Labs), which has received FDA 510(k) clearance, by feeding it approximately 4 million echocardiograms with the purpose of calculating left ventricular ejection fraction, according to Turakhia.
“Again, not to replace our own need to read these, but to make our lives easier; however, you need a lot of data. Bay Labs is a company that used 4 million [echocardiograms] just to train their models,” Turakhia said. “So, you can power this through a deep learning algorithm; it doesn’t need to sleep; there are no work hours restrictions. This is why it can work so well. It’s the scale. Could you use this to replace things like the CHA2DS2-VASc? These are things we’re exploring. We’re not quite there yet, but the idea is maybe you can use this in the future.”
Wearable devices could play a major role in the movement toward telehealth, Turakhia concluded.
“What do we do with these technologies? How do you keep a doctor in the loop?” he asked. “This is how we handle this now; someone has [a] watch, they see us, we do something. This is where we’re going; someone has a watch ... they can press a button, and for not very much money, have a telehealth visit right away. We did this in the Apple Heart Study.” – by Scott Buzby
Reference s :
Turakhia MP. Wearables and digital health in arrhythmia management: Where are we headed? Presented at: Cardiometabolic Health Congress; Oct. 10-13, 2019; Chicago.
Turakhia MP, et al. Joint American College of Cardiology and Journal of the American College of Cardiology Late-Breaking Clinical Trials. Presented at: American College of Cardiology Scientific Session; March 16-18, 2019; New Orleans.
Disclosure: Turakhia reports he received research support from the American Heart Association, Apple, AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Cardiva, iRhythm, Janssen, Medtronic, NIH, SentreHeart and Department of Veterans Affairs; received consultant fees and/or honoraria from Abbott, Medscape, Medtronic, Myokardia and Precision Health; and is an adviser and/or board member for AliveCor, CyberHeart, Forward, iBeat, Metrica Health and Zipline.