8 ms·
Doctors used an ER patient's FitBit data to justify electrical cardioversion
- joshschreuder 11y agoI thought the HR detection on consumer fitness gear wasn't very accurate, yet we are able to base medical decisions off it? Have I been misled?
- InclinedPlane 11y agoThey're not very accurate. But some heart rate symptoms are obvious enough to make even poor quality measurements useful enough to make a medical decision.
- abraae 11y agoLike atrial fibrillation, which I UST found out I have. I've been capturing my heart rate from a polar h7 chest band to an Android app, then visualising with grafanas stddev. The pattern is strikingly obvious
- gertef 11y agoThis is covered in the article.
- joshschreuder 11y agoYeah, the article mentions that they only cover pulse tracking, not arrhythmias, but I was under the impression that even the pulse tracking was somewhat iffy due to the nature of how the tracking is performed. In fact, the article says there's a class action lawsuit because of it, which means using this data in a medical context could have gone very badly potentially.
- cordite 11y agoGiven that they were seeing if a precondition is true (arrhythmia started within last 48 hours), and the data showed that there was a significant change over time, it seems somewhat reasonable to act on if the patient wasn't totally sure. Physicians usually want to know what is different or regular for the specific patient over time, whether or not a value seems high for one person doesn't mean that action needs to be taken--but when that value changes significantly or shows a trend in a particular direction over time, that is information relevant to what procedure they decide next. It is entirely possible that the fitbit started recording data differently at or after the seizure, supposing it got shifted in the event. However, that does not invalidate the trend of the data as a whole. In this case, the patient was seemingly able to help acquire such data. If the patient said they were one way or the other, or if the patient depended on a device to fulfill that judgement, is it really the physician's fault to choose what the patient provides? IANAL
- mindcrime 11y agoI may have been told wrong, but I'm sure I recall being told that some consumer heart rate monitors (the kind with a chest strap) are approximately as accurate as what's used in a doctor's office. Now something that doesn't use a chest strap... I don't know. Probably those are less accurate? And/or maybe I'm the one who's been misled.
- abraae 11y agoAccording to this article http://www.tomsguide.com/us/heart-rate-monitor,review-2885.html http://www.tomsguide.com/us/heart-rate-monitor,review-2885.h..., several consumer products are accurate to within 1 beat of an EKG.
- Tharkun 11y agoThis is certainly true for the optical sensors. I wonder what the long term effect is of shining a bright LED at a small patch of skin like that?
- brandonb 11y agoWe (Cardiogram) have been working with UCSF cardiology on exactly this problem: detecting abnormal heart rhythms using Apple Watch data. The more data our algorithm sees, the more accurate it gets. If you own an Apple Watch, you can join our study / download Cardiogram for iOS: https://mRhythmStudy.org https://mRhythmStudy.org https://itunes.apple.com/us/app/cardiogram/id1000017994?ls=1&mt=8 https://itunes.apple.com/us/app/cardiogram/id1000017994?ls=1... We also gave a talk at Strata last week going into some of the technical and organizational challenges on applying deep learning to medicine: conferences.oreilly.com/strata/hadoop-big-data-ca/public/schedule/detail/47144 If anybody has questions on heart rate sensors, machine learning in medicine, or anything else, shout out!
- brandonb 11y agoAnd if you're curious as to what atrial fibrillation looks like when measured on an Apple Watch in workout mode, here's an example (bottom-right corner): https://twitter.com/bballinger/status/714500654308306946 https://twitter.com/bballinger/status/714500654308306946
- melling 11y agoI've been participating. I noticed that when I'm doing a workout my Watch"s heart rate monitor might drop to 65 bpm from 120, for example, then recover on another reading. Does this mean that the Watch isn't always accurate?
- brandonb 11y agoThank you for participating! And that's exactly what we're measuring—how accurate is the Watch, and in what circumstances does it make errors? The anecdotal evidence is very conflicting, which is why we're comparing the AW to a few different clinical gold standards to get hard metrics.
- esm 11y agoLooks awesome. Did you find HIPAA or the need for an extremely low error rate to be burdensome in building the app?
- gozur88 11y agoI'm not convinced here. Sure, they may have wanted to look at the FitBit for confirmation, but surely the patient could tell them it had been only three hours since he started to have trouble? You're not going to confuse three and twenty four hours.
- woof 11y agoFrom the article: "It wasn't clear, though, when it had started"
- gozur88 11y agoLike I said, I'm skeptical. When your heart rate starts to soar you know it.
- c-slice 11y agoI'd have to agree with you. I cant see how the fitbit data was important in the decision making process.. it was mostly just an extra confirmation. Definitely something the patient can verbally provide to the care team in most situations.
- stared 11y agoI recommend using https://www.alivecor.com/ https://www.alivecor.com/ (I have one) - this one actually performs ECG (can be used on hands, but the best results are when used on one's chest). Just measuring pulse gives a very indirect, and unspecific, information of arrhythmia. (Still, it is great that even such data can be used to save health or live.)