Despite the support healthcare and life science businesses give to the adoption of wearables for patient monitoring, among other things, accuracy remains a bugbear. That presents a challenge for companies such as Fitbit, which developed fitness trackers for consumers but seeks to build a robust healthcare profile for its business. Some of those shortcomings were highlighted in a study published the Journal of Medical Internet Research, but the paper also offered some possibilities for how fitness trackers can play a constructive role in healthcare.
The research is especially interesting because so few of the journal articles available on wearables document clinical trial findings. That was reflected by a search of “wearable technology” on PubMed, cited in the study, revealing that of 1,000 articles published in the past 5 years, only 3 percent of them were clinical trials, although none included acutely ill patients.
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Fifty stable intensive care patients used personal fitness trackers, specifically Fitbit Charge, for heart rate monitoring over a 24-hour period at Kingston General Hospital in Ontario. Accuracy of heart rate recordings was compared with measurements from continuous electrocardiographic monitoring and pulse oximetry was measured as a positive control, the study noted. One noticeable shortcoming of the fitness trackers was they tended to underestimate heart rate values.
However, the paper did offer up some ideas for ways to implement fitness trackers as part of healthcare.
Given that early warning systems can predict cardiac arrest and hospital deaths, fitness trackers could offer a cost-efficient way to augment hospitals’ systems for checking heart rate than conventional heart rate monitoring, the research noted. On the other hand, shortcomings of these consumer-grade wearables include a lack of info on respiratory rate or blood pressure, the paper observed. Wrist-worn trackers are also susceptible to errors in measuring heart rate due. There is also the matter of pulse deficit. The report describes it this way:
“Wrist-worn PPG devices might also be susceptible to errors in heart rate measurement owing to the phenomenon of the pulse deficit, in which beat-to-beat variability in stroke volume alters the amplitude of the pulse. This can be seen in atrial fibrillation, as well as other physiological conditions of acute illness such as cardiac tamponade, status asthmaticus, and various shock states…”
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Fitness trackers could be a useful way to monitor physical rehabilitation, enhanced heart rate monitoring during the acute phases, accurate tracking of mobility during convalescence, and ongoing feedback to both patient and clinician following discharge.
The study concludes that research should focus attention on figuring out which patients would be most suitable for heart rate monitoring using fitness trackers. Software development should work on improving recording accuracy in a diverse set of conditions, particularly those with a pulse deficit.
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