Big Tech is changing the way we monitor our health. Should we let him do it?
With the introduction of wearable technologies like the Apple Watch, patients have been able to monitor their health like never before. Advocating for patients to take charge of their own health has been a goal for many doctors, hospitals, and big tech companies looking to disrupt a system ripe for change.
One of the unique features of the Apple Watch is that it can screen for an irregular heartbeat known as atrial fibrillation, a condition that the Centers for Disease Control and Prevention says will affect 12.1 million people in the United States. by 2030. Diagnosing and treating atrial fibrillation can help prevent strokes and other conditions that cause thousands of deaths each year. In 2018 alone, the CDC calculated that nearly 180,000 people died from conditions related to atrial fibrillation.
The Apple Watch uses an “optical heart sensor to detect the pulse wave at the wrist and look for variability in the intervals between beats” and sends a notification to the wearer if the rhythm suggests atrial fibrillation. But what happens when someone with no history of atrial fibrillation receives a notification that a watch has detected an irregular rhythm? Should the person wait and inform the family doctor at the next visit? Search online? Go to the emergency room? Many choose the latter.
A 2020 Mayo Clinic study looked at 264 patients who presented to the emergency room with an alert from their watch explicitly telling them they had an abnormal heart rhythm. The researchers found that nearly 90% of patients who presented with this alert did not have a “clinically feasible cardiovascular diagnosis.” What does it mean? This means that after performing a series of tests, doctors did not find anything abnormal in the vast majority of patients. These were false alarms.
In medicine we use the term “false positive” to refer to a person who tests positive for a disease but does not actually have it. The tests are designed to have a low rate of false positives, so that when patients are positive there is relative certainty that they have the disease.
For patients who presented to the emergency room after receiving alerts on their watch, they underwent tests to confirm if they indeed had an irregular heartbeat. They received electrocardiographs to see how their hearts were beating, chest x-rays to see what their heart looked like, and blood tests to check for other abnormalities. For the majority of patients, these tests came back negative. They did not have an irregular heartbeat; the alerts were false positives.
Performing these tests is essential for diagnosing irregular heart rhythms and underlying heart conditions, but the tests also add up. The average cost of an emergency room visit in Texas is $ 2,318, the sixth highest in the country, according to data collected by hospital pricing specialists. In the United States alone, unnecessary care and testing costs more than $ 200 billion annually.
Additionally, these tests can harm patients by exposing them to ionizing radiation, creating unnecessary anxiety, and overloading an already strained healthcare system.
Obviously, wearable technologies have transformed our lives and had a positive impact on the way we monitor our health, but as doctors we have some skepticism about new technologies. We are cautious of new technologies and slow to adopt them. The scientific process used to advance medicine is as beautiful as it is confusing.
New devices and ways of thinking must go through a rigorous peer review process that evolves at an almost imperceptible rate to ensure that they produce the desired effect: prolong life, not shorten it.
As healthcare professionals, we must ensure that all devices used to help patients collect data are rigorously researched and accompanied by advice from their physician on how best to use and interpret the information they are providing. they get.
Inevitably, technology companies will continue to innovate and develop new technologies that disrupt our healthcare system, but the more these companies get involved, the more they need to be aware of the ramifications of their technologies on their customers and our patients.
Brian Carr is a resident of oral and maxillofacial surgery in Dallas. He wrote this column for The Dallas Morning News.
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