USA TODAY International Edition

An Apple reading a day may just make doc shrug

Physicians unsure how to use wearable data

- Dalvin Brown

We use wearables to count calories, measure heart rates and even rate our quality of sleep.

With healthier living in mind, we purchase kid- friendly versions for our children and step- counting options for grandparen­ts. Apple Watches, Fitbits and other fitness trackers are everywhere as data- obsessed users tap away at tiny screens from the gym to the doctor’s office.

It’s clear that consumers love wearables and the informatio­n they provide – but do physicians?

Doctors have mixed views on how patients gather and present informatio­n from gadgets with quasi- medical aspiration­s. Most say its a plus that patients can collect and curate more health- related data than ever before. However, bringing printed out pages of calories burned or counted steps to your

next checkup isn’t exactly advised.

It becomes “just a data dump” at the clinician’s office, according to Neel Chokshi, medical director of the sports cardiology and fitness program at Penn Medicine, which has conducted several studies on the relationsh­ip between consumers and their wearable devices.

Chokshi said some of the informatio­n provided by wearables is actually useful for physicians, but most of it is not. “My hypothesis is ( fitness trackers) can be useful for doctors. We just haven’t figured out how to use them quite yet,” Chokshi said.

A story published in the MIT Technology Review echoed Chokshi’s sentiments, finding that doctors from a number of specialtie­s are unsure what to do with data such as counted steps.

Apple users have access to the Health app, and developers can utilize the HealthKit platform, which offers the ability to track health data including medical records, lab results and medication­s downloaded directly from medical institutio­ns. Android users have Google Fit to help them and their doctors analyze personal health trends.

Products from FitBit, Garmin and others can monitor a user’s heart rate and notify if it goes too high or too low, and there are several astounding stories out there of fitness trackers alerting people of sudden medical emergencie­s.

These benefits to patients are often seen only in extreme cases when the device is charged and worn long enough to identify a person’s irregular heartbeat.

Unfortunat­ely, the informatio­n isn’t easy for doctors to make sense of.

“As clinicians, it can be challengin­g because these tracings are not very clear. Some can be challengin­g to interpret. Other times, patients may really inundate ( staff) with a lot of tracings to look at,” said Shon Chakrabart­i, an interventi­onal cardiologi­st and medical director at Abiomed, which manufactur­es medical devices for people with heart problems.

Then there’s the question of accuracy. Heart rate measuremen­ts, which are a crown jewel of almost all fitness trackers, tend to be the most accurate metric across wearables, according to a Stanford study that examined the precision of the Apple Watch, Basis Peak, Fitbit Surge, Microsoft Band, Mio Alpha 2, PulseOn and the Samsung Gear S2.

There’s still lots of room for technologi­cal error because the trackers measure a person’s heart rate on the wrist rather than closer to the chest, and readings can be skewed by movement and sweat.

None of the seven devices measured energy expenditur­e ( or calories burned) accurately, the study found. Most wearable fitness trackers, except Apple Watch Series 4’ s EKG and irregular rhythm notification features, are not cleared by the FDA or approved to diagnose any conditions.

“I’d like to see significantly more large- scale, peer- reviewed studies validating the accuracy of the data before we start basing care decisions on the data,” said Ripley Hollister, a family medicine specialist who is a board member of the Physicians Foundation.

What doctors do care about is streamline­d data integratio­n and informatio­n that is clinically actionable, Chakrabart­i said. Patients who come into the office with accurate and reliable data about their underlying condition or symptoms could speed things up during medical emergencie­s.

Doctors are OK with their patients’ affinities with wearables, as long as they recognize that the gadgets are noncertified and that the data is nonclinica­l.

Both Chakrabart­i and Hollister wear Apple Watches.

 ?? ROBERT DEUTSCH/ USA TODAY ?? Wrist devices help users monitor their heart rate.
ROBERT DEUTSCH/ USA TODAY Wrist devices help users monitor their heart rate.

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