Apple Heart Study Shows Promising Results on Wearable Devices, But Cardiologists Remain Unconvinced
Wed, April 21, 2021

Apple Heart Study Shows Promising Results on Wearable Devices, But Cardiologists Remain Unconvinced

Results show the watches were able to detect atrial fibrillation (AFib), a condition in which the heart beats abnormally and is linked with the risk of stroke. / Photo by belchonock via 123rf

 

Apple CEO Tim Cook said the company's greatest contribution would be to health. Now, that vision seems to be taking shape in an Apple-sponsored study released by Stanford Medicine in The New England Journal of Medicine. Titled the Apple Heart Study, the researchers looked into the data of people who owned an Apple Watch.

Results show the watches were able to detect atrial fibrillation (AFib), a condition in which the heart beats abnormally and is linked with the risk of stroke. These findings are promising, but experts are skeptical about whether or not such devices are the right tool to be used to monitor people's health.

 

Detecting silent killers

AFib is the most common arrhythmia worldwide and in 2010, it was found that the estimated global prevalence was 0.5 percent or nearly 33.5 million individuals. It's also the leading cause of stroke, accounting for about 130,000 deaths and 750,000 hospitalizations every year in the US.

Aside from an irregular heartbeat, CNN says AFib may also lead to blood clots and heart failure among other heart-related problems. It adds that those who are living with the condition suffer from chest pain, palpitations, shortness of breath, and fatigue.

However, this is the situation for most of them as others who have AFib don't experience any of the said symptoms—making the condition a potentially silent killer. It's this risk that the researchers of the Apple Heart Study were hoping to address with the results of their study.

"This is one of the first large-scale studies to use wearables to screen patients for a serious medical condition," Mitesh Patel, director of the Penn Medicine Nudge Unit and who was not involved in the study, told CNN.

Patel added that future research should test methods to integrate these technologies into effective engagement strategies "to change patient behavior to treat or reduce their risk from these conditions."

 

 

The first of its kind

The researchers consider the Apple Heart Study the first virtual study and one of the largest studies that looked into consumer devices to get a better understanding of human health. Over 400,000 Apple Watch users participated and were monitored in the study for over eight months to check for AFib.

Information about their heartbeat was then sent to the users via their iPhones and watches. The results show that only about 0.5 of the participants (a little over 2,000 people) received a notification of an irregular pulse. Only about 25 percent of that group also accomplished the protocol of wearing a patch to monitor their heartbeat for two weeks before returning it to the researchers.

CNBC reports other key findings in the study, including the 84 percent of subsequent notifications that were confirmed to be AFib among those Apple Watch Users identified to have an irregular pulse. In terms of age, over three percent of participants aged over 65 received such notifications—indicating that the condition is more prevalent among older users.

The researchers also found that the Apple Watch detected some instances of AFib at their early stage, suggesting the condition happened infrequently enough causing the subsequent patch to not pick it up. However, the researchers note this doesn't mean that there were a lot of false-positive results.

Fewer people sent back the patches than they expected, the investigators added. Only a quarter of the group did, suggesting that having people actively participate in monitoring (wearing a patch and returning it) was more of a challenge than just having them wear the watch.

 

 

Questions on digital health efforts

While the results point to a promising possibility of using wearable devices like the Apple Watch to monitor people's health, experts remain cynical of the ability of these tools.

For instance, the study results didn't account for all of the participants as about 79 percent of those who got an initial notice that they may have AFib either didn't complete the study or were excluded from it. Business Insider reports most of them dropping out or failing to do one of the remote visits needed in the research.

It adds that the Apple Watch did not detect AFib in some people who actually had the condition. The paper shows that at least 3,000 who later got a diagnosis of the condition did not receive a notification from Apple—which could be a bigger problem than the research would like to show, according to  Mohamed Elshazly, an assistant professor of medicine at Weill Cornell Medical College who reviewed the study's design and saw its preliminary results.

"There will be a large percentage of people wearing the Apple Watch thinking they are accurately monitored and safe from afib," even though they actually have the condition, Elshazly added.

Technological advancements are making it easier for people to understand their health better and with devices such as the Apple Watch, they can do so in the comfort of their home. The digital transformation that allows people to monitor their health, get tested virtually, and instantly get results is the future of health and healthcare.

However, more work needs to be done to see this future and ensure that these technologies won't lead to issues that would endanger people's lives.

 

Technological advancements are making it easier for people to understand their health better.  / Photo by dolgachov via 123rf