Smartwatch heart data less accurate for people with darker skin tones
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WASHINGTON — Wearable devices may be less accurate for the detection of heart rate and rhythm in adults with darker skin tones, according to data from a meta-analysis presented at the American College of Cardiology Scientific Session.
Heart rate measurement and arrhythmia detection can be recorded through the transmission of light across skin via wearable devices like smartwatches; however, melanin alters light absorption and may impact the accuracy of cardiac data for people varying skin tones.
“What first made us interested in the topic was the 2020 article published in The New England Journal of Medicine on how pulse oximeters were three times more likely to miss low blood oxygen levels in Black patients,” Daniel Koerber, MD, an internal medicine resident at the University of Alberta in Canada, told Healio. “Since these devices use a similar technology to smartwatches, we wanted to find out if wearable devices had similar limitations.”
In a systematic review, Koerber and colleagues analyzed data from 10 studies covering 469 participants conducted through July 2021 that stratified heart rate and rhythm data for consumer wearable technology according to participant race and/or skin tone; skin tone was expressed with the Fitzpatrick score (range 1-6).
The frequency-weighted Fitzpatrick score was reported in six studies (n = 293), with a mean participant score of 3.5. Overall, 40% of studies found a significant reduction in accuracy of heart rate measurement with wearable devices in darker-skinned individuals when compared with participants with lighter skin tones and/or gold standard measurements, such as ECG or chest strap monitoring.
“One study found wearable devices record significantly fewer data points for people with darker skin tones, despite no discrepancy in heart rate accuracy,” the researchers wrote in an abstract.
Only one study assessed ECG changes and noted a significant reduction in accuracy of R-R interval measurement in individuals with dark skin compared with ECG data (r = 0.98; P < .05).
In an interview, Koerber noted that most of the studies had very small study populations and very few study participants had skin tones on the darkest end of the Fitzpatrick scale. “Even so, four studies noted a difference in accuracy in people with darker skin tones,” Koerber told Healio. “Combining that information with what we know about pulse oximeters, there is likely a deficit here that needs to be addressed. As such, we encourage smartwatch manufacturers to continue to involve patients with darker skin tones when developing their proprietary algorithms to minimize any discrepancies in accuracy.”
In an ACC press release, Koerber said there is some evidence to suggest that certain wavelengths of light, particularly green light, are more accurate in people across all skin tones.
“It is important to explore alternative options to make sure we can create a more equitable solution in health care and not just in the consumer industry,” Koerber said.
Reference:
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Koerber D, et al. Abstract 1421-123. Presented at: American College of Cardiology Scientific Session; April 2-4, 2022; Washington, D.C. (hybrid meeting).
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