Difference between revisions of "Wearables"

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1. Toth, L. P., Park, S., Pittman, W. L., Sarisaltik, D., Hibbing, P. R., Morton, A. L., ... & Bassett, D. R. (2018). Validity of activity tracker step counts during walking, running, and activities of daily living. Translational Journal of the American College of Sports Medicine, 3(7), 52-59.
 
1. Toth, L. P., Park, S., Pittman, W. L., Sarisaltik, D., Hibbing, P. R., Morton, A. L., ... & Bassett, D. R. (2018). Validity of activity tracker step counts during walking, running, and activities of daily living. Translational Journal of the American College of Sports Medicine, 3(7), 52-59.
 +
 
2. Shin, Grace, et al. “Beyond Novelty Effect: A Mixed-Methods Exploration into the Motivation for Long-Term Activity Tracker Use.” JAMIA Open, vol. 2, no. 1, Apr. 2019, pp. 62–72. Silverchair, https://doi.org/10.1093/jamiaopen/ooy048.
 
2. Shin, Grace, et al. “Beyond Novelty Effect: A Mixed-Methods Exploration into the Motivation for Long-Term Activity Tracker Use.” JAMIA Open, vol. 2, no. 1, Apr. 2019, pp. 62–72. Silverchair, https://doi.org/10.1093/jamiaopen/ooy048.
 +
 
3. “Wearables Sales Worldwide by Region 2015-2022.” Statista, https://www.statista.com/statistics/490231/wearable-devices-worldwide-by-region/. Accessed 18 Oct. 2021.
 
3. “Wearables Sales Worldwide by Region 2015-2022.” Statista, https://www.statista.com/statistics/490231/wearable-devices-worldwide-by-region/. Accessed 18 Oct. 2021.
 +
 
4. “Pulsar Calculator Watch.” National Museum of American History, https://americanhistory.si.edu/collections/search/object/nmah_1173543. Accessed 18 Oct. 2021.
 
4. “Pulsar Calculator Watch.” National Museum of American History, https://americanhistory.si.edu/collections/search/object/nmah_1173543. Accessed 18 Oct. 2021.
 +
 
5. “Apple Watch Series 7.” Apple, https://www.apple.com/apple-watch-series-7/. Accessed 18 Oct. 2021.
 
5. “Apple Watch Series 7.” Apple, https://www.apple.com/apple-watch-series-7/. Accessed 18 Oct. 2021.
 +
 
6. Fitzpatrick, Frank. “5 Key Hearables Trends For 2021.” Forbes, https://www.forbes.com/sites/frankfitzpatrick/2021/01/01/5-key-hearables-trends-for-2021/. Accessed 18 Oct. 2021.
 
6. Fitzpatrick, Frank. “5 Key Hearables Trends For 2021.” Forbes, https://www.forbes.com/sites/frankfitzpatrick/2021/01/01/5-key-hearables-trends-for-2021/. Accessed 18 Oct. 2021.
 +
 
7. “Jacquard by Google - Home.” Jacquard by Google, https://atap.google.com/jacquard/. Accessed 18 Oct. 2021.
 
7. “Jacquard by Google - Home.” Jacquard by Google, https://atap.google.com/jacquard/. Accessed 18 Oct. 2021.
 +
 
8. “Best Smart Rings: Put a Ring on It in 2021.” Wareable, 16 June 2021, https://www.wareable.com/fashion/best-smart-rings-1340.
 
8. “Best Smart Rings: Put a Ring on It in 2021.” Wareable, 16 June 2021, https://www.wareable.com/fashion/best-smart-rings-1340.
 +
 
9. “How and Why Google Glass Failed.” Investopedia, https://www.investopedia.com/articles/investing/052115/how-why-google-glass-failed.asp. Accessed 20 Oct. 2021.
 
9. “How and Why Google Glass Failed.” Investopedia, https://www.investopedia.com/articles/investing/052115/how-why-google-glass-failed.asp. Accessed 20 Oct. 2021.
 +
 
10. “Applications of Virtual Reality in Medicine​.” News-Medical.Net, 4 Jan. 2021, https://www.news-medical.net/health/Applications-of-Virtual-Reality-in-Medicine.aspx.
 
10. “Applications of Virtual Reality in Medicine​.” News-Medical.Net, 4 Jan. 2021, https://www.news-medical.net/health/Applications-of-Virtual-Reality-in-Medicine.aspx.
 +
 
11. Zhu, Jia, et al. “Laser-Induced Graphene Non-Enzymatic Glucose Sensors for on-Body Measurements.” Biosensors and Bioelectronics, vol. 193, Dec. 2021, p. 113606. ScienceDirect, https://doi.org/10.1016/j.bios.2021.113606.
 
11. Zhu, Jia, et al. “Laser-Induced Graphene Non-Enzymatic Glucose Sensors for on-Body Measurements.” Biosensors and Bioelectronics, vol. 193, Dec. 2021, p. 113606. ScienceDirect, https://doi.org/10.1016/j.bios.2021.113606.
 +
 
12. “Garmin Introduces the Dexcom Connect IQ Apps.” Garmin Newsroom, 13 Oct. 2021, https://www.garmin.com/en-US/newsroom/press-release/wearables-health/people-with-diabetes-can-now-view-dexcom-cgm-data-on-their-garmin-smartwatch-or-cycling-computer/.
 
12. “Garmin Introduces the Dexcom Connect IQ Apps.” Garmin Newsroom, 13 Oct. 2021, https://www.garmin.com/en-US/newsroom/press-release/wearables-health/people-with-diabetes-can-now-view-dexcom-cgm-data-on-their-garmin-smartwatch-or-cycling-computer/.
 +
 
13. Webb, R. Chad, et al. “Epidermal Devices for Noninvasive, Precise, and Continuous Mapping of Macrovascular and Microvascular Blood Flow.” Science Advances, vol. 1, no. 9, Oct. 2015, p. e1500701. PubMed Central, https://doi.org/10.1126/sciadv.1500701.
 
13. Webb, R. Chad, et al. “Epidermal Devices for Noninvasive, Precise, and Continuous Mapping of Macrovascular and Microvascular Blood Flow.” Science Advances, vol. 1, no. 9, Oct. 2015, p. e1500701. PubMed Central, https://doi.org/10.1126/sciadv.1500701.
 +
 
14. Wu, Min, et al. Wearable Technology Applications in Healthcare: A Literature Review | HIMSS. 25 Nov. 2019, https://www.himss.org/resources/wearable-technology-applications-healthcare-literature-review.
 
14. Wu, Min, et al. Wearable Technology Applications in Healthcare: A Literature Review | HIMSS. 25 Nov. 2019, https://www.himss.org/resources/wearable-technology-applications-healthcare-literature-review.
 +
 
15. “Wearables, the FDA and Patient Advice: What Physicians Should Know.” American Medical Association, https://www.ama-assn.org/practice-management/digital/wearables-fda-and-patient-advice-what-physicians-should-know. Accessed 18 Oct. 2021.  
 
15. “Wearables, the FDA and Patient Advice: What Physicians Should Know.” American Medical Association, https://www.ama-assn.org/practice-management/digital/wearables-fda-and-patient-advice-what-physicians-should-know. Accessed 18 Oct. 2021.  
 +
 
16. Redmond, S. J., et al. “What Does Big Data Mean for Wearable Sensor Systems?” Yearbook of Medical Informatics, vol. 9, no. 1, Aug. 2014, pp. 135–42. PubMed Central, https://doi.org/10.15265/IY-2014-0019.
 
16. Redmond, S. J., et al. “What Does Big Data Mean for Wearable Sensor Systems?” Yearbook of Medical Informatics, vol. 9, no. 1, Aug. 2014, pp. 135–42. PubMed Central, https://doi.org/10.15265/IY-2014-0019.
17. News, A. B. C. “From ‘Glassholes’ to Privacy Issues: The Troubled Run of the First Edition of Google Glass.” ABC News, https://abcnews.go.com/Technology/glassholes-privacy-issues-troubled-run-edition-google-glass/story?id=28269049. Accessed 20 Oct. 2021.
 
 
  
 +
17. News, A. B. C. “From ‘Glassholes’ to Privacy Issues: The Troubled Run of the First Edition of Google Glass.” ABC News, https://abcnews.go.com/Technology/glassholes-privacy-issues-troubled-run-edition-google-glass/story?id=28269049. Accessed 20 Oct. 2021.
  
 
Submitted by Kevin Kindler
 
Submitted by Kevin Kindler
 
[[Category:BMI512-FALL-21]]
 
[[Category:BMI512-FALL-21]]

Revision as of 20:44, 22 October 2021

Wearable Technology

Wearable technology (also - wearables, wearable devices) is defined as technology that takes intelligence typically reserved for mobile devices and utilizes some or all of the functionality in a form factor that can be worn by the user. This differs from a device such as a mobile phone in that a mobile phone is carried with you and not on you. Many of these wearable devices can detect, monitor, analyze, and/or communicate information from built-in sensors with an mHealth application, directly to the cloud, or to some form of receiver/transmitter. They may include physiologic monitors that transmit vital signs, but can be used for many other indications as well.

Some common examples of wearable technology include watches, fitness trackers, headphones, clothing, jewelry, glasses/head-mounted displays, and skin electronics (such as stickers). Each of these function in different capacities and range from early alpha builds to fully functioning consumer devices purchased by millions of people around the world.

User Uptake

Initial approaches to wearable technology for everyday users often involved some form of activity tracker. Activity trackers were often plagued by short-term use and overall low user-adoption. These devices often relied on accelerometers for step counting - which demonstrated 10-15% step error count compared with research-grade devices. This suggested that wearables may be useful for behavior tracking, but not likely for research studies. [1] Despite these issues, there have been more recent studies that have examined incorporating personal context and characteristics (pre-existing health conditions, athleticism and physical activity, quest for quantification, gamification) and social context (community and competition) leading to better long-term adoption of these devices. [2]

The first Fitbit device to make waves was released in 2009. Since then, many companies have entered and exited the market, and numerous acquisitions have also shaped the wearable landscape. Statistics from 2015 show worldwide wearable sales around 96 million units, and in 2021 it is estimated that 928 million units will be sold worldwide [3]. It should be noted that while wearable technology is just now seeing substantial growth, the first wearable was actually released in 1975 - the Pulsar digital calculator watch. [4]

Variety of Form Factors and Uses in Medicine

Smartwatches are the most commonly recognizable form of wearable device. Much of this attention can be attributed to the success of the Apple Watch in both the US and globally. The most recent introduction to the Apple Watch line incorporates oxygen saturation tracking, FDA compatible single-lead EKG, sleep tracking, workout tracking, activity tracking with calorie burn, and competitions. [5] Other key players in the wrist worn wearable market include: Samsung, Xiaomi, Fitbit, Huawei, and Garmin.

In terms of medical wearables, continuous glucose monitors are likely one of the most recognizable technologies that have transformed care for patients with diabetes. There are many FDA approved models that have the capability to change the way providers care for patients with diabetes. They can improve patient satisfaction and quality of life.

Hearables - the term applied to the use of smart features in headphones - are also starting to see growth. Headphones themselves are often not considered to be smart technology, but the integration of biometric tracking (with a focus on wellness) or sound amplification/isolation (with a focus on hearing aids) transform the technology and allow for its appropriate designation as wearable technology. There has been an increasing share of the wearable market shifting towards hearables as well. Other potential uses of this technology going forward include further integration of AI assistants, biometric validation, wellness applications, and speech recognition and voice analytics. [6]

Clothing can be used as wearable technology. One such example is Project Jacquard by Google’s ATAP group. [7] As the size of components have decreased over time, incorporating them in smaller devices such as rings, necklaces, and other jewelry items is becoming more commonplace. Two such examples of this include Oura and McLear – both of which are rings that include sensors capable of tracking activity, sleep, and NFC for the purpose of interacting with terminals for contactless payment, locks, etc. [8]

Google Glass was initially released in 2013 and made available for all consumers (that were willing to pay $1500 for a device) in 2014. Adoption of Google Glass was poor in general consumer markets due to concerns over cost, practical applications of the technology, and privacy and safety. [9] Since Glass has rebranded and focused on specific markets, along with other augmented reality (AR) headsets (such as Microsoft HoloLens), it has had better adoption in sectors such as healthcare, industry/manufacturing, and the military. Virtual reality (VR) has seen broader adoption than AR among consumers, likely attributed to its initial development and background in gaming. Both AR and VR demonstrate clear potential for medical applications such as: medical training (visualizations), treatment of patients (visual explanations, exposure therapy for mental health), pain management, physical therapy and rehabilitation (distraction, perform functions of a specific activity), addiction, health education, and fitness. [10]

Recent research has shown the effectiveness of sensors applied and worn directly on the skin. They have the potential to serve as glucose sensors in future wearable technology. [11] While it may take time for this research to develop beyond its initial stages, wearable makers have shown that medical devices can safely and securely export/share data with consumer technology. An example of this is Garmin’s partnership with Dexcom to add a display field and notification for blood sugar to allow athletes with diabetes to participate in sports and activity more safely. [12] A separate skin sensor in development can be applied to measure blood flow and can serve as a clinical tool for monitoring in conditions that are either vascular primary or common conditions with vascular components such as atherosclerosis, sickle cell, diabetes, chronic kidney disease, and vasculitis. [13]

Other forms of technology that could be considered as wearables include the following (listed with some associated brands): shoes (Under Armor, Xiaomi), shoe insoles (Lechal), breathalyzer (BACtrack), brain sensing headbands (MUSE), fertility tracker (Tempdrop), concussion monitors (Q-Collar), contact lenses (Mojo), posture tracking (Upright Go), and bras (OMbra, Vitali).

Wearables collect measurements from the patient’s body and the surrounding environment. Much of this information can be harnessed in order to provide users or their care providers with insights into their health and wellbeing.

A 2019 HIMSS analysis reviewed potential medical applications of wearable technology and divided their use into the following primary categories: 1) Prevention of diseases and maintenance of health, 2) Patient management, and 3) Disease management. [14]

Within prevention of diseases and maintenance of health, they include fall detection and prevention, physical activity monitoring, mental status monitoring, sports medicine, weight control and monitoring, and public education. In patient management, they include cancer survivors, patients with strokes, patients with brain or spinal cord injuries, and patients with chronic pulmonary disease. In disease management, they include heart disorders, blood disorders, diabetes management, Parkinson’s disease, autism, and depression. [14] While these functions can apply to all patients, many of these functions are especially important in geriatric populations and warrant additional studies for this purpose. Each of these applications rely on one or more of the many sensors available in wearable technology.

Regulatory Approval of Wearables

In order to state a medical device is intended for diagnosis, treatment, or prevention of disease, it must be approved by the FDA first. [15] The Center for Devices and Radiological Health (CDRH) within the FDA has comprehensive resources discussing the laws, regulations, guidelines, and policies relating to device approval. Similar to medications, devices can also be granted emergency use authorization. If devices do not have approval through the FDA, their use can only describe the general benefits of an activity a device is intended to track.

Privacy, Security, and the Quantified Self

One of the most challenging aspects of wearable technology adoption is a person’s willingness to collect data on themselves. There is a balance between seeking insight from devices and making sure those devices are protected and only share data with authorized partners. As discussed in a paper related to the use of big data applied to wearables, theoretical barriers and concerns related to use of wearables include: discomfort of wearing a device, data security on device and between devices, impact on lifestyle (activity limitations), unfavorable style, impact on health insurance costs, location tracking, device hacking, and privacy of collected data. [16]

There are also privacy concerns related to use of these devices in public. For example, one could not tell when a person with Google Glass was recording data. This led to its ban in many restaurants, bars, theaters, museums, and other locations. [17] The inclusion of a growing number of sensors – especially microphones, speakers, and cameras – may present ongoing challenges with these devices if there are no clear rules regarding their use in sensitive locations going forward.

Resources:

1. Toth, L. P., Park, S., Pittman, W. L., Sarisaltik, D., Hibbing, P. R., Morton, A. L., ... & Bassett, D. R. (2018). Validity of activity tracker step counts during walking, running, and activities of daily living. Translational Journal of the American College of Sports Medicine, 3(7), 52-59.

2. Shin, Grace, et al. “Beyond Novelty Effect: A Mixed-Methods Exploration into the Motivation for Long-Term Activity Tracker Use.” JAMIA Open, vol. 2, no. 1, Apr. 2019, pp. 62–72. Silverchair, https://doi.org/10.1093/jamiaopen/ooy048.

3. “Wearables Sales Worldwide by Region 2015-2022.” Statista, https://www.statista.com/statistics/490231/wearable-devices-worldwide-by-region/. Accessed 18 Oct. 2021.

4. “Pulsar Calculator Watch.” National Museum of American History, https://americanhistory.si.edu/collections/search/object/nmah_1173543. Accessed 18 Oct. 2021.

5. “Apple Watch Series 7.” Apple, https://www.apple.com/apple-watch-series-7/. Accessed 18 Oct. 2021.

6. Fitzpatrick, Frank. “5 Key Hearables Trends For 2021.” Forbes, https://www.forbes.com/sites/frankfitzpatrick/2021/01/01/5-key-hearables-trends-for-2021/. Accessed 18 Oct. 2021.

7. “Jacquard by Google - Home.” Jacquard by Google, https://atap.google.com/jacquard/. Accessed 18 Oct. 2021.

8. “Best Smart Rings: Put a Ring on It in 2021.” Wareable, 16 June 2021, https://www.wareable.com/fashion/best-smart-rings-1340.

9. “How and Why Google Glass Failed.” Investopedia, https://www.investopedia.com/articles/investing/052115/how-why-google-glass-failed.asp. Accessed 20 Oct. 2021.

10. “Applications of Virtual Reality in Medicine​.” News-Medical.Net, 4 Jan. 2021, https://www.news-medical.net/health/Applications-of-Virtual-Reality-in-Medicine.aspx.

11. Zhu, Jia, et al. “Laser-Induced Graphene Non-Enzymatic Glucose Sensors for on-Body Measurements.” Biosensors and Bioelectronics, vol. 193, Dec. 2021, p. 113606. ScienceDirect, https://doi.org/10.1016/j.bios.2021.113606.

12. “Garmin Introduces the Dexcom Connect IQ Apps.” Garmin Newsroom, 13 Oct. 2021, https://www.garmin.com/en-US/newsroom/press-release/wearables-health/people-with-diabetes-can-now-view-dexcom-cgm-data-on-their-garmin-smartwatch-or-cycling-computer/.

13. Webb, R. Chad, et al. “Epidermal Devices for Noninvasive, Precise, and Continuous Mapping of Macrovascular and Microvascular Blood Flow.” Science Advances, vol. 1, no. 9, Oct. 2015, p. e1500701. PubMed Central, https://doi.org/10.1126/sciadv.1500701.

14. Wu, Min, et al. Wearable Technology Applications in Healthcare: A Literature Review | HIMSS. 25 Nov. 2019, https://www.himss.org/resources/wearable-technology-applications-healthcare-literature-review.

15. “Wearables, the FDA and Patient Advice: What Physicians Should Know.” American Medical Association, https://www.ama-assn.org/practice-management/digital/wearables-fda-and-patient-advice-what-physicians-should-know. Accessed 18 Oct. 2021.

16. Redmond, S. J., et al. “What Does Big Data Mean for Wearable Sensor Systems?” Yearbook of Medical Informatics, vol. 9, no. 1, Aug. 2014, pp. 135–42. PubMed Central, https://doi.org/10.15265/IY-2014-0019.

17. News, A. B. C. “From ‘Glassholes’ to Privacy Issues: The Troubled Run of the First Edition of Google Glass.” ABC News, https://abcnews.go.com/Technology/glassholes-privacy-issues-troubled-run-edition-google-glass/story?id=28269049. Accessed 20 Oct. 2021.

Submitted by Kevin Kindler