2018 Spring
Some cardiologists are scratching their heads when patients present them with their Fitbit® data, assuming their doctors can use the information to help diagnose and treat their conditions. The good news and the bad news is that fitness trackers and smart phones collect huge amounts of information about us every day—how much we move, how fast our hearts beat, and in some instances, how much and how well we sleep. So could all of that information help a patient’s healthcare team? Venkatesh Raman, MD, and colleagues in the MedStar Heart & Vascular Institute’s Electrophysiology Program hope to find out.
“The challenge is how the data can be analyzed, curated and delivered to the healthcare team in actionable form and within a manageable workflow.” —Venkatesh Raman, MD
Dr. Raman, assistant professor at Georgetown University School of Medicine, and researchers at the fitness tracker giant would like to identify cases of atrial fibrillation (AFib) before health problems arise. While AFib occurs in fewer than 2 percent of people younger than 65, the risk rises to 10 percent in people older than 80. The most feared consequence is stroke; 20 to 25 percent of all non-bleeding strokes are attributed to AFib. However, “one-quarter of stroke patients have no clearly identifiable cause,” says Dr. Raman. “A significant portion of these strokes may be due to AFib, but detection is often challenging without the use of a loop recorder device implanted in the chest.” He and the Fitbit team have completed a study protocol to accelerate development of an AFib detection algorithm using data from the wristband sensor, which would avoid issues associated with a permanent implant and allow screening to be applied more broadly. The early results are very promising.
AFib is only one health target Fitbit and other companies are exploring. Trackers and smart phones might monitor other cardiac, pulmonary and endocrine conditions. For example, and already available, continuous glucose monitoring systems for diabetes could send data to a patient’s smart phone and relay that information to the provider team. This kind of active technological engagement can minimize office visits and lab tests, shortening potential delays in treatment to make useful changes faster and easier for the patient.
One of the biggest challenges is the deluge of data our devices generate. The human heart can beat well more than 100,000 times each day, and not all of those heartbeats are helpful to a patient or doctor. “It can be difficult for doctors to know what to do with all of the information,” says Dr. Raman. “The challenge is how the data can be analyzed, curated and delivered to the healthcare team in actionable form and within a manageable workflow.”
Rising to that challenge is what will turn these personal wellness gadgets into true digital health tools