The Revolution of Wearables: Advancing Public Health Research
Introduction:
In recent years, the utilization of smartwatches and fitness trackers in public health research has grown exponentially. These wearable devices have opened up new possibilities for conducting rigorous, large-scale studies that were previously unimaginable. Researchers can now gather valuable data on various diseases, allowing for a deeper understanding of their causes, symptoms, and treatment methods. The potential impact of these studies is immense, as they can significantly expand our knowledge and drive advancements in healthcare. In this article, we will explore the growing trend of using wearables in public health research and the incredible possibilities they offer.
Expanding the Scope of Research:
Wearable devices are already being used to investigate a wide range of diseases, including heart, respiratory, neurological, and liver diseases. They are also being utilized to study gynecological conditions, certain cancers, diabetes, sleep quality, autism, and mental illness. The versatility of these devices makes them invaluable tools in the field of medical research. They enable scientists to collect real-time data from a large and diverse sample of individuals, enhancing the accuracy and reliability of their findings. This wealth of data allows researchers to delve deeper into the complexities of diseases and gain insights that were previously unattainable.
A Revolutionary Study: Apple Women’s Health Study:
A prime example of the potential of wearable devices in research is the Apple Women’s Health Study. In collaboration with Harvard and the National Institute of Environmental Health Sciences (NIEHS), Apple initiated a 10-year project that aims to collect data from up to 1 million iPhone and smartwatch users. The study focuses on gathering information about menstrual cycles and other health and lifestyle factors such as sleep and stress. By analyzing this data, researchers hope to advance the diagnosis and treatment of health conditions related to menstrual cycle disturbances. This ambitious project illustrates how wearables can transform the way we approach medical research, allowing for unprecedented scale, diversity, and depth of data collection.
The Rise of Wearables:
The increasing popularity of smartwatches and fitness trackers is evident, with nearly half of Americans currently using these devices. Beyond monitoring steps and calorie burn, wearables offer a wealth of additional health-related data. Through smartphone apps, users can access information about breathing rate, heart rate, blood oxygen levels, and sleep duration. The convenience and accessibility of these devices have made them an integral part of daily life for many individuals. Academic medical centers have also recognized their potential and have partnered with tech giants like Apple, Google, Samsung, Alphabet, and Amazon, as well as tech startups and nonprofits, to harness the power of wearables in research.
The Impact of the Pandemic:
The COVID-19 pandemic has further accelerated the adoption of wearable devices in healthcare. Medical institutions began utilizing these devices to remotely monitor patients and track symptoms. Symptom checkers and outbreak apps enabled individuals to monitor their infection exposure and identify hotspots. These real-world applications demonstrated the potential of wearables to capture large data sets consistently and efficiently. Consequently, the number of trials using portable devices for data collection has been steadily increasing in recent years. This trend has paved the way for the exploration of novel wearable devices such as glasses, rings, necklaces, “hearables,” and even “smart” clothes in medical research.
The Role of Big Tech:
Technology companies like Apple, Samsung, and Google have played a significant role in advancing wearable research. They have developed open-source platforms that allow researchers to create applications and tools that securely capture health information from wearable devices. These platforms have democratized research participation, making it more accessible to a broader range of individuals. For instance, the Apple Heart Study, in collaboration with Stanford University School of Medicine, enrolled over 400,000 Apple Watch users from all 50 states within eight months. This study demonstrated the ability of smartwatches to identify irregular heart rhythms and ultimately led to the FDA classifying watches’ Electrocardiogram (EKG) application as a medical device. The collaboration between technology companies and medical institutions has paved the way for groundbreaking research and has the potential to reshape the future of healthcare.
Challenges and Future Directions:
While wearables hold immense promise, there are still challenges to overcome. Ensuring the clinical-grade accuracy of data gathered by these devices remains a priority. Additionally, concerns about privacy and cybersecurity in the healthcare sector must be addressed to maintain public trust. Access to wearables and reliable internet connectivity also remains a barrier, particularly in rural and underrepresented populations. However, as the acceptance and affordability of these devices continue to increase, these barriers are likely to diminish.
Looking ahead, the future of public health research lies in the hands – or rather, the wrists – of individuals. Wearables have democratized research participation, allowing individuals from various backgrounds to contribute valuable data. By combining wearable technology with large-scale studies, researchers can gain insights into the complex relationship between our bodies, behaviors, and the environment. From understanding the impact of environmental exposures to identifying the links between abnormal periods and health conditions, wearables enable researchers to delve into new realms of knowledge. The potential for advancements in diagnosis, treatment, and prevention is immense.
In conclusion, the revolution of wearables in public health research has opened up exciting possibilities for advancing medical knowledge. The use of smartwatches and fitness trackers allows for rigorous, large-scale studies on a range of diseases that were inconceivable in the past. Collaborations between academic medical centers and tech giants have propelled this trend further, leading to groundbreaking projects and initiatives. While challenges remain, the future of wearables in healthcare looks promising. By embracing these devices, researchers can tap into the power of data and make significant strides in improving public health around the world.
Summary:
Wearable devices such as smartwatches and fitness trackers are transforming the field of public health research. These devices enable rigorous, large-scale studies on various diseases, expanding our knowledge and driving advancements in healthcare. The Apple Women’s Health Study, in partnership with Harvard and the NIEHS, exemplifies the potential of wearables in research. The popularity of wearables is on the rise, and academic medical centers are collaborating with tech giants to harness the power of these devices. The COVID-19 pandemic has further accelerated the adoption of wearables in healthcare. Challenges remain, including ensuring data accuracy, privacy concerns, and access to devices and the internet. However, the future of wearable research is promising, offering opportunities for groundbreaking discoveries and advancements in public health.
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September 1, 2023: The future of public health could be in your hands (or wrist, to be precise).
Researchers are using smartwatches and fitness trackers to conduct rigorous, large-scale studies that would have been impossible in the past. It is a growing trend that can greatly expand our knowledge about a variety of diseases.
“There really is no disease that is not affected by this type of research,” said Calum MacRae, MD, PhD, vice president for scientific innovation in the Department of Medicine at Brigham and Women’s Hospital.
Wearable devices are already being used to investigate heart, respiratory, neurological, and liver diseases, as well as gynecological conditions, certain cancers, diabetes, sleep quality, autism, and mental illness.
In a recent example, up to 1 million iPhone and smartwatch users can sign up to share data about their menstrual cycles and other health and lifestyle factors like sleep and stress. 100,000 people have already signed up for this Apple Women’s Health Studya 10-year project between Harvard, Apple, and the National Institute of Environmental Health Sciences (NIEHS) that is unprecedented in size and scope.
Doctors know that an irregular menstrual cycle can be a sign of many things, from infertility to heart disease, diabetes, or even cancer. Many doctors believe that a menstrual history should be considered a vital sign, like pulse or blood pressure, but say that menstrual and reproductive health is woefully underfunded and understudied.
With a larger and more diverse sample of people studied, the researchers hope to advance the diagnosis and treatment of health conditions related to menstrual cycle disturbances.
“We can ask questions that we couldn’t before,” said Shruthi Mahalingaiah, MD, one of the study’s principal investigators and an assistant professor of environmental, reproductive, and women’s health at the Harvard TH Chan School of Public Health.
The rise of wearables
Nearly half of Americans use smartwatches or fitness trackers, according to a survey 2022. Beyond calorie burn and steps, the technology can provide, via smartphone apps, information about breathing rate, heart rate, blood oxygen level and sleep duration.
Academic medical centers are working with digital giants like Apple, Google, Samsung, Alphabet, and Amazon, as well as tech startups and nonprofits. The coronavirus pandemic accelerated the trend, as medical institutions tested wearable devices to monitor patients from home. Symptom checkers and outbreak apps helped monitor infection exposure and identify hotspots, and showed how large data sets could be captured consistently.
Trials using portable devices for data collection represent less than 1% of all trials worldwide. But that number is growing, increasing by several hundred in recent years, according to Clinicaltrials.gov (the National Library of Medicine’s registry of clinical trials).
This trend goes beyond the doll to use glasses, rings, necklaces, “hearables” and even “smart” clothes. And the growing universe of medical-grade wearables helps too: smart patches that track vital signs, blood pressure devices, and continuous glucose monitors, which are often prescribed by a doctor but also available in retail stores.
“You can live anywhere in the country and participate in research using portable devices,” said Ray Dorsey, MD, professor of neurology at the Center for Health Technology at the University of Rochester Medical Center in New York. Previously, volunteers had to travel to medical centers for tests and updates, which often limited the scope of the studies.
Big tech, big studios
In recent years, technology companies such as Apple, Samsung, and Google have introduced and refined open source platforms that allow researchers to create applications and tools that securely capture health information from people using wearable devices.
In 2015, a smartphone app, developed by Dorsey’s URMC team and partners, used Apple’s ResearchKit in a Parkinson’s disease trial. The researchers recruited more than 2,000 volunteers in one day, an unheard of number at the time. In the end, the study enrolled more than 9,000 people, who performed tasks such as walking to measure changes in gait. The published findings helped researchers better understand how Parkinson’s symptoms varied from day to day, Dorsey said.
In 2017, in partnership with Stanford University School of Medicine, the Apple Heart Study enrolled more than 400,000 Apple Watch users from all 50 states in just 8 months. The study showed that smartwatches could identify irregular heart rhythms, such as atrial fibrillation. It also paved the way for the FDA to classify watchesElectrocardiogram (EKG) application as a medical device. Since then, EKG apps for smartwatches from Fitbit, Samsung, and Garmin have received similar clearances.
The Apple Women’s Health Study launched in 2019 along with two other ambitious projects: the Apple Heart and Movement Study, led by MacRae at Brigham and Women’s Hospital, in partnership with the American Heart Association; and the University of Michigan Apple Hearing Study.
The Apple Women’s Health Study taps into a greater mix of people by race, ethnicity, age, socioeconomic status and location, compared to the much smaller scope of previous studies. The data collected relates to exercise, sleep, and environmental and behavioral factors, and monthly surveys capture personal details that the app can’t.
“This gives us the ability to take very granular information into account in our analyses,” said Huichu Li, PhD, study co-author and researcher at the Harvard School of Public Health.
Among the early results: The slightly longer menstrual cycles that can be caused by COVID vaccines were found to be temporary. More generally speaking, irregular and infrequent periods were found to be more frequent in the Black and Asian people studied, while menstrual cycles were longer for Asian, Hispanic, and overweight people.
An analysis of more than 50,000 people provided insights into the links between abnormal periods and health conditions such as polycystic ovary syndrome, endometrial hyperplasia, and cancer.
“Future studies will dig into the data and look at the impact of environmental exposures, behavior, and stress on menstrual cycles,” Mahalingaiah said.
Challenges and the future
The promise of wearables is tempered by challenges. Much more testing is needed to ensure the devices provide clinical-grade data. Concerns about threats to privacy and cybersecurity persist in the healthcare sector, according to research by professional services firm Deloitte.
These new types of studies have limits. People must own smartwatches and smartphones, technology that is less common in rural and underrepresented populations, and they must have reliable access to the Internet.
But greater acceptance of the devices (by consumers and healthcare providers) means the trend is likely to grow.
“I don’t see a world where this type of research slows down,” said Urvi Shah, senior manager of Life Sciences and Healthcare at Deloitte Consulting.
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