Saturday, October 3, 2020

Should I get an Apple Watch instead of going to the doctor's?

    Apple's latest technology include the Apple Watch Series 6. What sets this one apart from the others? It can take your blood oxygen level. This comes at a convenient time, with one of the indicators of COVID-19 being low oxygen levels, and appears to be a useful diagnostic tool. However, some express concerns that its actually more dangerous than beneficial. Ethan Weiss, a cardiologist at University of California San Francisco, worries that it might lead people to become more anxious and requests tests they don't need (Chen, Brian X, 2020). In the Apple Watch Series 4, they introduced the ECG function, allowing consumers to take electrocardiograms on their watch. While this is great for people with preexisting heart conditions to monitor their health, for others, it could cause unnecessary concern. The Apple Watch does not solicit any advice on their user's health, but it does keep track of their stats on days that it's worn. 

    One area that may benefit from this type of technology is sleep research. Sleep apnea is a condition where during sleep an individual either stops breathing or has very shallow breathing. Leaving this untreated can lead to increased risk of heart attack, stroke, heart failure, and many more (Sleep Apnea). Sleep apnea can be difficult to detect, especially because many people who have it don't know they do. With something like an Apple Watch that can be worn to bed and measures your oxygen levels during sleep, it could help with a diagnosis after consulting with a doctor. 

    Sleep researchers are torn. Consumer sleep technologies (CSTs), which include smart watches like the Apple Watch and sleep apps, can help make consumers more aware of their sleep habits and how their sleep effects their health. On the other hand, it could lead to more self-diagnosis or treatment which could be dangerous (Ko, Ping-Ru T et al., 2015) In the worst case scenario, consumers may opt to listen to their CSTs over coming in for a doctor's visit. 

    Is the combination of health and technology hurting us more than helping us? I personally have an Apple Watch but I don't wear it to bed because I've never felt a reason to but I could see where someone with preexisting conditions could find it useful. Do you have a smart watch or use any sleep apps? If so, do you find them helpful? 




References: 
Chen, Brian X. “The New Apple Watch Measures Your Blood Oxygen. Now What?” The New York Times, The New York Times, 17 Sept. 2020, www.nytimes.com/2020/09/17/technology/personaltech/new-apple-watch-blood-oxygen-level-review.html.

Ko, Ping-Ru T et al. “Consumer Sleep Technologies: A Review of the Landscape.” Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine vol. 11,12 1455-61. 15 Dec. 2015, doi:10.5664/jcsm.5288

“Sleep Apnea.” National Heart Lung and Blood Institute, U.S. Department of Health and Human Services, www.nhlbi.nih.gov/health-topics/sleep-apnea.


5 comments:

  1. I was unaware of the new tool that is included on the Apple Watch Series 6, but I am interested in learning more after I read your post. Like you, I am conflicted whether this latest technology will be more beneficial than harmful because people will interpret this knowledge differently. This would also depend on how reliable and accurate the program is. As you said, some people will find it helpful if they have preexisting conditions as they can easy monitor their health, while others may use their blood oxygen level to stop them from going to the doctor if they are not feeling well but have a normal blood oxygen level. Another group of individuals that might find this helpful are the elderly. I know this many sound strange since elderly people are not as comfortable with technology, but if Apple could adapt the program to send the blood oxygen levels to an elderly person’s caregiver, family member or assisted living staff, this would alert them if there is a problem. I personally would find this useful because my grandfather lives with my family and I, but he often refuses to wear his emergency alert button because he wants to feel independent. If instead her wore an adapted watch with this program, it could be presented to him as a watch with different apps, he maybe would be more accepting of wearing it. More importantly, his blood oxygen levels could be sent to my family and I notifying us to call for help if his oxygen level is too low because he may not be able to call for help himself or not be wearing his emergency button during that time. The same could be true for when the elderly person is sleeping because they may be dazed or confused due to low oxygen levels and not be able to call for help. As for myself, I do not have a Apple watch, but if I did I probably would wear it while I sleep as I get older because as we age some people start to have more difficulty sleeping and staying asleep and this would be helpful information to know, in order to understand why I may not be sleeping.

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  2. I know some providers are using apple watch data as a way to help patients keep on track with health plans they create with their doctors. The patient gives their doctor access to their health data from their apple watch. By doing so, the provider can track their patients progress. When the patient comes back in for a check up, the doctor already knows how they did and can adjust their plan accordingly.

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  3. I have heard about the new Apple Watch Series 6 and the new pulse oximetry. I think it is a cool idea, but has a lot of edges that need to be smoothed out.

    This is not set in stone since it is a new piece of technology, but I have seen a lot of tech Youtube reviewers questioning the practicality of the pulse oximetry because of its placement. Conventionally, the sensory is placed on the opposite surface of a tissue bed which are suitable for the finger, toe, or earlobe (Jubran, 2015). Because this sensor is on your wrist, there may be questionability in its reliability and possibly its accuracy.

    As far as the combination of heath and technology being helpful or harmful, I think there is a curve (harmful at first which then becomes helpful). A study I found showed that smartphone-based pulse oximetry compared with hospital-grade pulse oximetry did not show significant differences in terms of their measurement (Tomlinson, 2018). I am not sure how accurate pulse oximetry on the phone was when it first came out, but people likely questioned its reliability (like I am now with the Series 6). I personally think that these new technological advances that are about vital signs and health are helpful, but we have not been able to utilize them efficiently. During these times when “pulse ox” has been quite the buzzword, it is doing a lot of harm (raising anxiety), but these new accessibility to pulse oximetry via Series 6 or our phone are tools under our belt that can be helpful in the future. It is a rocky step for sure, but we are able to move forward to smooth the edges by releasing such product.

    References:
    Jubran A. (2015). Pulse oximetry. Critical care (London, England), 19(1), 272.

    Tomlinson, S., Behrmann, S., Cranford, J., Louie, M., & Hashikawa, A. (2018). Accuracy of Smartphone-Based Pulse Oximetry Compared with Hospital-Grade Pulse Oximetry in Healthy Children. Telemedicine and E-Health, 24(7), 527-535.

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  5. I work as medical assistant in a heart clinic and it is a love hate relationship with this technology. When we have patients who have symptoms that occur maybe once or twice a year we do recommend to patients to get the apple watch or another device known as Kardia. These devices work as a somewhat mobile ECG, maybe not as perfect as a 12 lead but actually quite reliable. Again we only recommend these for patients for which it would be inappropriate to do a 30 day event monitor. Like I said though, and as you pointed out, we do not like when we have patients come in and tell us what their watch said. It really doesn't help that the apple watch actively warns you if something is "wrong" and then tries to interpret the data. I have a colleague who's phone health data now reads Afib which is incorrect and was just a instance of premature ventricular contractions which occur in everyone. I am ok with people being able to track their health data but I think the change that should be made to apple watches is the attempt to interpret. I think the watch should definitely not interpret data because this can only cause anxiety, and in my opinion unless someone has a known condition it should be careful with alerts as well. Do you think there are other ways to tweak the technology so that it is less anxiety inducing?

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