5 ms·

> heart rate sensors on consumer wearables can detect multiple major health conditions It sounds so logical and inevitable where this technology is heading for

by jasode 8y ago

> heart rate sensors on consumer wearables can detect multiple major health conditions It sounds so logical and inevitable where this technology is heading for health care. Over 10 years ago, I paid $1200 to wear a Holter monitor[1] for 24 hours. In contrast, a consumer wearable like Apple Watch is $399. Arguably, the Holter monitor fee also included the doctor's time to read the ECG recording. But it also seems like a lot of the rudimentary analysis of heart data from wearables will be done in the cloud with machine learning. Hence, the price of basic diagnosis goes way down. With the increasing aging population in USA, Europe, and Japan that will want to stay on top of medical issues, it seems like a big business opportunity. A bunch of players are going to compete in this space. Good luck to you! [1] link for those not familiar with the device: https://www.google.com/search?q=holter+monitor https://www.google.com/search?q=holter+monitor

JshWright 8y ago
You're never going to diagnose something based on a watch (or other consumer focused wearable). The watch is just telling you that you should go talk to your doctor (so they can get you on a real cardiac monitor and get the level of information needed to make a diagnosis). Consumer wearables aren't going to be replacing Holter monitors. EDIT: A lot of folks seem to be interpreting my comment as implying there is no value in this technology. That is absolutely not the case. There is huge value in widely deployed screening like this (especially since it looks like the specificity is quite high). My point is that these devices will not be replacing diagnostic equipment (in fact, it may very well increase its use as more conditions that would otherwise have gone undetected will now be flagged for further diagnostic testing).
- coder543 8y ago
  The Apple Watch can perform an FDA-cleared diagnosis of certain forms of Atrial Fibrillation, and if what they showed on stage is to be believed, it can produce a really clear ECG that's also FDA-cleared. Just because you're redirected to a doctor doesn't mean the watch did nothing, it just means the watch can't provide a complete patient care cycle. The condition is identified, now what? False-positives can happen even with current medical-grade technology. It's just a question of how the false-positive rate compares. "Never" is just such a strong word, given how quickly technology has advanced, and given how you don't seem to be aware of what exactly the new Apple Watch is supposed to be able to do. Do you work for a Holter-producing company or something?
  - JshWright 8y ago
    I am very aware of what the watch does. A doctor is not going to diagnose atrial fibrillation based on a single ECG lead. They are going to do a more complete ECG (either in-office, or with a Holter monitor style device at home). The watch absolutely plays an important role (it's a widely distributed, high SNR screening tool; that's definitely valuable), but it's not replacing more complete diagnostic tests. As a meta comment... I think it's good to avoid using "you" too much when replying to someone. Respond to what someone said, not assumptions about who they are, what they know, or what their motivations are. For whatever it's worth, I am a software developer and paramedic.
    - wrycoder 8y ago
      It sounds like there is an opportunity for a displayless device on the other wrist.
      - JshWright 8y ago
        And a wire running between them...?
        wrycoder 8y ago
        Bluetooth, I would think.
        JshWright 8y ago
        They would need to be electrically connected (like the leads on a multimeter).
  - DenisM 8y ago
    >Do you work for a Holter-producing company or something? This is against the rules [1]: [...] Please don't impute astroturfing or shillage. That degrades discussion and is usually mistaken. If you're worried about it, email us and we'll look at the data. [...] [1] https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
- GeekyBear 8y ago
  There is value attached to having a device that monitors over the long haul. A tech journalist who was diagnosed with afib after taking part in the Apple Watch heart study reported that he had undergone traditional EKGs more than once without a problem being detected. >It's not the kind of thing that comes up in an EKG unless it is actually happening when the test is occurring. I've had EKGs a number of times, and there was never any indication anything was wrong. I've even had heart tests as a precondition for having bariatric surgery four years ago, and been under general anesthesia, with no adverse results of any kind. https://www.zdnet.com/article/how-apple-watch-saved-my-life/ https://www.zdnet.com/article/how-apple-watch-saved-my-life/
  - JshWright 8y ago
    There's definitely value. I'm not disagreeing with that. The tech journalist in question still underwent more testing after the watch alerted them to make the actual diagnosis. The watch is a great screening tool, but it's not a replacement for more complete diagnostic tests.
    - GeekyBear 8y ago
      Agreed. Doctors are very conservative and would insist on verifying the data with a cardiac event monitor. However it's also true that the more comprehensive tests he had previously undergone didn't spot the problem. Since we're trying to spot an intermittent issue, the quantity of data was more important than the quality of the data.
    - someguydave 8y ago
      Another point most folks seem to be missing: even if you are screened early by one of these devices, it's not at all obvious that subsequent early treatment will deliver extra benefit. It's even less obvious that the extra benefit of early screening and treatment will outweigh the high false positive (and therefore possible overtreatment) costs.
      - GeekyBear 8y ago
- lostapathy 8y ago
  Even if they don't replace higher end gear, consumer devices will allow much better data to determine who needs to be hooked to a dedicated device. More people who need in depth can be brought in to do them, and less people who don't need it can avoid those tests. Even if the amount of uses for high end devices (Holter monitor or whatever) stays the same, consumer wearables should lead to that usage being allocated in a more productive way, which will bring don't costs and improve outcomes.
- matheusmoreira 8y ago
  I agree. I've seen some electrocardiogram peripherals for phones and they apparently only support lead II. Ability to instantly start recording a long II anywhere anytime is awesome but it is not a complete electrocardiogram.
  - JshWright 8y ago
    It's lead I (accross the top of the heart). For lead II you would need an electrode on the left leg.

by jasode 8y ago

JshWright 8y ago

You're never going to diagnose something based on a watch (or other consumer focused wearable). The watch is just telling you that you should go talk to your doctor (so they can get you on a real cardiac monitor and get the level of information needed to make a diagnosis). Consumer wearables aren't going to be replacing Holter monitors. EDIT: A lot of folks seem to be interpreting my comment as implying there is no value in this technology. That is absolutely not the case. There is huge value in widely deployed screening like this (especially since it looks like the specificity is quite high). My point is that these devices will not be replacing diagnostic equipment (in fact, it may very well increase its use as more conditions that would otherwise have gone undetected will now be flagged for further diagnostic testing).

coder543 8y ago
The Apple Watch can perform an FDA-cleared diagnosis of certain forms of Atrial Fibrillation, and if what they showed on stage is to be believed, it can produce a really clear ECG that's also FDA-cleared. Just because you're redirected to a doctor doesn't mean the watch did nothing, it just means the watch can't provide a complete patient care cycle. The condition is identified, now what? False-positives can happen even with current medical-grade technology. It's just a question of how the false-positive rate compares. "Never" is just such a strong word, given how quickly technology has advanced, and given how you don't seem to be aware of what exactly the new Apple Watch is supposed to be able to do. Do you work for a Holter-producing company or something?
- JshWright 8y ago
  I am very aware of what the watch does. A doctor is not going to diagnose atrial fibrillation based on a single ECG lead. They are going to do a more complete ECG (either in-office, or with a Holter monitor style device at home). The watch absolutely plays an important role (it's a widely distributed, high SNR screening tool; that's definitely valuable), but it's not replacing more complete diagnostic tests. As a meta comment... I think it's good to avoid using "you" too much when replying to someone. Respond to what someone said, not assumptions about who they are, what they know, or what their motivations are. For whatever it's worth, I am a software developer and paramedic.
  - wrycoder 8y ago
    It sounds like there is an opportunity for a displayless device on the other wrist.
    - JshWright 8y ago
      And a wire running between them...?
      - wrycoder 8y ago
        Bluetooth, I would think.
        JshWright 8y ago
        They would need to be electrically connected (like the leads on a multimeter).
- DenisM 8y ago
  >Do you work for a Holter-producing company or something? This is against the rules [1]: [...] Please don't impute astroturfing or shillage. That degrades discussion and is usually mistaken. If you're worried about it, email us and we'll look at the data. [...] [1] https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
GeekyBear 8y ago
There is value attached to having a device that monitors over the long haul. A tech journalist who was diagnosed with afib after taking part in the Apple Watch heart study reported that he had undergone traditional EKGs more than once without a problem being detected. >It's not the kind of thing that comes up in an EKG unless it is actually happening when the test is occurring. I've had EKGs a number of times, and there was never any indication anything was wrong. I've even had heart tests as a precondition for having bariatric surgery four years ago, and been under general anesthesia, with no adverse results of any kind. https://www.zdnet.com/article/how-apple-watch-saved-my-life/ https://www.zdnet.com/article/how-apple-watch-saved-my-life/
- JshWright 8y ago
  There's definitely value. I'm not disagreeing with that. The tech journalist in question still underwent more testing after the watch alerted them to make the actual diagnosis. The watch is a great screening tool, but it's not a replacement for more complete diagnostic tests.
  - GeekyBear 8y ago
    Agreed. Doctors are very conservative and would insist on verifying the data with a cardiac event monitor. However it's also true that the more comprehensive tests he had previously undergone didn't spot the problem. Since we're trying to spot an intermittent issue, the quantity of data was more important than the quality of the data.
  - someguydave 8y ago
    Another point most folks seem to be missing: even if you are screened early by one of these devices, it's not at all obvious that subsequent early treatment will deliver extra benefit. It's even less obvious that the extra benefit of early screening and treatment will outweigh the high false positive (and therefore possible overtreatment) costs.
    - GeekyBear 8y ago
lostapathy 8y ago
Even if they don't replace higher end gear, consumer devices will allow much better data to determine who needs to be hooked to a dedicated device. More people who need in depth can be brought in to do them, and less people who don't need it can avoid those tests. Even if the amount of uses for high end devices (Holter monitor or whatever) stays the same, consumer wearables should lead to that usage being allocated in a more productive way, which will bring don't costs and improve outcomes.
matheusmoreira 8y ago
I agree. I've seen some electrocardiogram peripherals for phones and they apparently only support lead II. Ability to instantly start recording a long II anywhere anytime is awesome but it is not a complete electrocardiogram.
- JshWright 8y ago
  It's lead I (accross the top of the heart). For lead II you would need an electrode on the left leg.