Technology continues to evolve at a stunning rate when it comes to allowing consumers to take control of their health. There are smartwatches that perform ECG’s and can detect a serious and often symptomless heart arrhythmia, atrial fibrillation (AF or aFib) an astounding 97% of the time, continuous blood glucose monitoring for diabetics, and so much more. Wearable tech is alerting people to symptoms they may have previously ignored, leading to diagnosis at much earlier stages of some conditions. Who knows how many lives can be saved because they identified a deadly condition sooner? We will look at a small, yet impressive, sub-section of these devices, apps and the conditions they are helping diagnose and treat.
First and foremost, heart conditions have historically been diagnosed because a patient has symptoms ranging anywhere from mild pain and shortness of breath to full-blown heart attacks or cardiac arrest. With the introduction of smartwatches and devices which work with smartphones for heart monitoring and ECG readings, the wearer can know when there is an abnormality that should be addressed by a doctor. It may not have reached a critical point yet, but early detection of a condition means early intervention before it becomes life-threatening.
Apple Smart Watch
If you want to do more than just monitor your heart rate, Apple’s Smart Watch offerings are going to have more comprehensive functions, with the Electrocardiogram (ECG) function as simply one of many apps. Their main function is to identify atrial fibrillation (A-fib). By placing your index finger on the watch’s crown, and placing your arms in a certain, relaxed position for 30 seconds, the watch will run an ECG and the results will come back with “sinus” (normal), a-fib, or “Inconclusive”.
Cardiac Watch & FitBit
There are other companies that have put forth offerings whose main function is to monitor heart rates, such as the Cardiac Watch and most FitBits, but they don’t offer a full ECG, just heart rate reports to help with workouts and calorie burning. They can be helpful in monitoring your fitness goals, but are not able to provide any sort of diagnostics.
AliveCor Kardia Mobile 6L
If you are looking for JUST an ECG, AliveCor’s Kardia Mobile 6L lets you pair their small ECG reader with any smartphone, and allows the user to place two fingers on the device, place the back of the device on the left ankle or left thigh and get what amounts to a 6-lead ECG reading. According to the website, the Kardia Mobile 6L “Detects AFib, Bradycardia, Tachycardia & Normal heart rhythm. It has a 6-lead EKG that gives your doctor more detailed heart information and provides doctors visibility into certain arrhythmias that are leading indicators of cardiovascular disease.” The full report can then be shared with your doctor.
Despite their advanced capabilities, it should be stressed that none of these devices should be a conclusive test for conditions such as heart attack, stroke, or other heart defects. They are simply ways to provide information you can then use when speaking with your physician. If you suspect you may have one of these issues, you should seek immediate medical attention.
Most Type 1 diabetics take a blood glucose reading anywhere between 5 and 8 (or more) times a day, usually before meals and snacks, before physical activity, and before bed. While this can give a fairly good picture of a person’s day, it also involves sticking their fingers to collect a blood sample that many times a day to take those readings. Continuous glucose monitors (CGMs) have been on the market for a while, but several new devices have become more popular.
Libre is inserted in the upper arm, and the sensor attached to the probe can be scanned with a cell phone, even through clothing, and blood glucose levels are monitored continuously. The size of two quarters stacked on top of each other, it’s small and inconspicuous. One potential disadvantage is that it is currently only approved for use in adults aged 18 and older.
The Dexcom G6 is a CGM which is inserted into the abdomen and can last up to 3 months. It can be used in patients as young as 2 years old, and once synced to a device like a smartphone or a smart watch, can show results continuously.
Devices like these mean not as many finger sticks for diabetics, plus more accurate information is collected throughout the day when a diabetic might not normally take a reading, such as during sleep. This allows the patient and doctor to adjust insulin intake to keep blood glucose levels steady throughout the patient’s full day.
Finding out you have Parkinsons is a life-altering diagnosis. It’s a progressive disorder which affects the deep parts of the brain which control body movement. Most of the time, diagnosis comes in the form of a clinical evaluation by a general neurologist including a full neurological exam which looks for typical signs of Parkinson’s such as Bradykinesia (slowness of movement), loss of balance, rigidity and tremors. But there are devices which can help both identify and treat symptoms.
To help manage symptoms and track the progression of the disease, the FDA has cleared a device called a Personal Kinetigraph™ (PKG™) which a patient can wear for six to ten days before an appointment. The watch-like device collects data on movement and can even remind patients to take medication and record compliance. The data is downloaded and sent to their doctor shortly before their visit. Since someone with Parkinsons may sometimes perform better for their physician than during a normal day, this allows for a more comprehensive view of a patient’s symptoms since the data is collected during a patient’s normal day.
While the PKG is helpful for monitoring symptoms, a different kind of watch was developed by Microsoft which could help Parkinson’s patients function better. One of the most common and difficult symptoms to manage is hand tremors. These tremors can lead to an inability to perform basic tasks such as writing. Why Emma’s Watch works is actually a mystery because there is only speculation for what causes tremors. But experts believe that by interrupting the brain’s ability to feel the tremors by creating sensory “white noise” in the form of vibrations, it can relieve the severity of the tremors and allow the patient to complete tasks instead of being caught up trying to stop them.
While the symptoms of Parkinson’s are treatable, there is no cure. Early diagnosis and start of treatment can make all the difference in the quality of life for those who are faced with its challenges. Devices to help track its progression and improve body movements are welcome additions to physicians treating patients with this disorder.
Alzheimer’s / Dementia
It’s the diagnosis nobody wants either for themselves or their loved ones. Alzheimer’s is the most common form of dementia, making up between 60 and 80% of all cases. While many advances have been made in treatment, there is currently no cure for Alzheimer’s. Like most debilitating illnesses, early detection can make a huge difference in treatment. An article in Nature points out that there are many “cognitive, sensory and motor changes” which occur years before what could be seen as clinical symptoms of Alzheimer’s. To that extent, they theorize that “Mobile and wearable technologies (such as smartphones, tablets, smartwatches, and rings, smart suits) present a unique opportunity to passively detect neurodegenerative diseases in a timely and economical fashion”.
Active Data Gathering
Using devices such as smartphones or tablets to randomly prompt a potential patient to perform a task at random such as a memory test or record a voice to detect tremors, allows doctors to actively gather data. Since the patient is actively participating, there could be outside influences.
Passive Data Gathering
In contrast, wearables such as rings, suits, or watches which capture data unbeknownst to the wearer (for instance, a step counter which also measures gait, or a heart rate monitor which collects variations) allow doctors to gather data passively, when the patient is not aware it is being collected. This gives a more accurate accounting of potential symptoms since it is not influenced by the patient’s actions, and the patient’s surroundings are familiar, such as in their home or at work.
Finding new ways to identify declines in cognition early could be a huge step forward in the development of treatments for this devastating disease, which continues to affect large numbers of the population. In fact, in the US alone it is estimated 5 million people currently suffer from AD.
Usually not fatal, epilepsy presents unique challenges to patients who have this condition. The unpredictability of seizures can lead to complicated situations when it comes to activities such as driving. Having a warning ahead of time could allow patients to put themselves in a safe environment prior to a seizure occurring. Additionally, since epilepsy sufferers frequently have no way to alert caregivers of a seizure if it occurs during the night or even if they are just in another room.
Currently, there is a wearable device in development in Australia which could help predict epileptic seizures up to 30 minutes ahead of time using a non-surgical device which uses artificial intelligence and machine learning. After gathering data from three studies in Australia and the US, the developers are working on something as simple as a cap that can be customized to a patient using generalized data from their studies. While it appears it may be a few years from being commercially available, there is a device on the market now which at least can alert others when an epilepsy patient is having a seizure.
The Embrace 2 by Empatica is an FDA-cleared medical device (so it does require a physician prescription) which can detect tonic-clonic seizures in people over 6 years old. According to the website, “When Embrace2 detects a possible tonic-clonic seizure, it communicates with its companion app Alert on its paired mobile device to alert your caregivers with a phone call and text message. Embrace2 does not predict seizures. It is designed to expedite assistance when a seizure occurs.”
With advances in both seizure prediction and seizure identification, more lives of those with epilepsy could be saved. This could offer peace of mind to both patients and their caregivers.
Arguably one of the most devastating diseases to gain prevalence in the past decade is Amyotrophic lateral sclerosis (ALS – also known as Lou Gehrig’s disease). A progressive disease which shuts down voluntary muscular movements over time and eventually leads to death, ALS is exponentially cruel in that the patient’s brain remains unaffected, thereby “trapping” their personality in a body that does not cooperate. This is referred to as “Locked-In Syndrome” (LIS).
While there is currently no wearable technology available to predict ALS, a device called EyeControl was developed by an ALS patient for ALS patients who have reached the LIS stage of their disease to communicate. The EyeControl website states “Using audio feedback and eye gestures, the EyeControl is a standalone portable device that allows for immediate and around-the-clock communication.” The patient wears what looks like a pair of eyeglasses with a camera mounted on the front which tracks their eye movements. They are able to scroll through an audible menu and choose dialog by blinking. In addition, they can also call for help by blinking 3 times. As long as they are wearing the device, they can communicate no matter where they are. This small, wearable communication tool is groundbreaking in they are striving to make it affordable to everyone.
The prognosis for most people afflicted with ALS is not good. It is one of those diseases which is only diagnosed after everything else has been ruled out. So by the time it is identified, most patients will live only another 2 to 5 years on average. LIS occurs at the end stages of the disease when communication with loved ones is most critical. Devices like EyeControl, while it may not be medically necessary, is certainly crucial to a patient’s mental state.
Dealing with depression, anxiety, eating disorders, sleep disorders, and other dissociative disorders can be debilitating. What if there was a way to deal with the symptoms in a way other than with medications? Say, a headset and app that work together to deliver electrical impulses to the brain instead of changing the chemistry at play?
A new device called Flow was recently given class IIa medical device certification in the UK which does just that. According to the website, “The headset works by delivering gentle electrical pulses into the brain, based on a well-researched area of scientific discovery called Transcranial Direct Current Stimulation (tDCS).” It goes on to explain how, since the brain is an electrochemical system it responds to both chemical and electric treatment for imbalances which cause these disorders. Flow uses electricity rather than medication. It’s not available in the United States as of the writing of this article, but if it proves to be highly effective, imagine the possibilities! The app is more generic than specific, offering advice and information on lifestyle changes which could help the patient change their thought patterns.
The challenge most developers face when trying to find an effective app to help those who suffer from depression and anxiety, is the complexity of human emotion. When combined with differences in personality and coping mechanisms, both subtle and enormous, it can be difficult to design a “one size fits all” app for real-time interventions.The result is usually something which helps the user focus on more positive thoughts and emotions, or allows them to practice “mindfulness” and exercises to calm what can be circular thoughts.
Apple’s health studies
Not surprisingly, Apple has enormous reach when it comes to their customers. With the Apple Watch set to sell 33 million units in 2019, that’s a lot of potential data to mine. The company has recently announced it is launching three health studies using both the Apple Watch and the iPhone. This research will include a Women’s Health study, a Heart and Movement study, and a Hearing study.
By using the Research app, users will need to opt-in to the studies in order for Apple and the researchers to collect their data. Some of the data, such as heart and movement information, can be collected passively, while other information such as menstrual cycle data will require the participant to log in and actively participate.
The possibilities of such data gathering could potentially be groundbreaking in its ability to provide predictive patterns or diagnostics. It cannot be denied it allows researchers access to volumes of data they have not had access to previously – and with the consumer actually paying (by purchasing the device and opting in) to participate. It turns the usual research tactics on its head. It should be fascinating to watch how medical practices change with these new technologies.
Disclaimer: AED Superstore and its research team do not endorse, nor do they receive payment for mention of, any devices mentioned in this article. Likewise, these products have not been tested by anyone at AED Superstore. This article is for informational purposes only and should not be used for medical diagnosis. If you are concerned you may have one of the conditions listed, please see a physician for proper diagnosis.