Background
As the sensing capabilities of wearable devices improve, there is increasing interest in their application in medical settings. Capabilities such as heart rate monitoring may be useful in hospitalized patients as a means of enhancing routine monitoring or as part of an early warning system to detect clinical deterioration.
Objective
To evaluate the accuracy of heart rate monitoring by a personal fitness tracker (PFT) among hospital inpatients.
Methods
We conducted a prospective observational study of 50 stable patients in the intensive care unit who each completed 24 hours of heart rate monitoring using a wrist-worn PFT. Accuracy of heart rate recordings was compared with gold standard measurements derived from continuous electrocardiographic (cECG) monitoring. The accuracy of heart rates measured by pulse oximetry (Spo
2
.R) was also measured as a positive control.
Results
On a per-patient basis, PFT-derived heart rate values were slightly lower than those derived from cECG monitoring (average bias of −1.14 beats per minute [bpm], with limits of agreement of 24 bpm). By comparison, Spo
2
.R recordings produced more accurate values (average bias of +0.15 bpm, limits of agreement of 13 bpm,
P
<.001 as compared with PFT). Personal fitness tracker device performance was significantly better in patients in sinus rhythm than in those who were not (average bias −0.99 bpm vs −5.02 bpm,
P
=.02).
Conclusions
Personal fitness tracker–derived heart rates were slightly lower than those derived from cECG monitoring in real-world testing and not as accurate as Spo
2
.R-derived heart rates. Performance was worse among patients who were not in sinus rhythm. Further clinical evaluation is indicated to see if PFTs can augment early warning systems in hospitals.
Trial Registration
ClinicalTrials.gov NCT02527408; https://clinicaltrials.gov/ct2/show/NCT02527408 (Archived by WebCite at http://www.webcitation.org/6kOFez3on)
BackgroundWearable devices generate signals detecting activity, sleep, and heart rate, all of which could enable detailed and near-continuous characterization of recovery following critical illness.MethodsTo determine the feasibility of using a wrist-worn personal fitness tracker among patients recovering from critical illness, we conducted a prospective observational study of a convenience sample of 50 stable ICU patients. We assessed device wearability, the extent of data capture, sensitivity and specificity for detecting heart rate excursions, and correlations with questionnaire-derived sleep quality measures.Results Wearable devices were worn over a 24-h period, with excellent capture of data. While specificity for the detection of tachycardia was high (98.8%), sensitivity was low to moderate (69.5%). There was a moderate correlation between wearable-derived sleep duration and questionnaire-derived sleep quality (r = 0.33, P = 0.03). Devices were well-tolerated and demonstrated no degradation in quality of data acquisition over time.ConclusionsWe found that wearable devices could be worn by patients recovering from critical illness and could generate useful data for the majority of patients with little adverse effect. Further development and study are needed to better define and enhance the role of wearables in the monitoring of post-ICU recovery.Trial registrationClinicaltrials.gov, NCT02527408
Electronic supplementary materialThe online version of this article (10.1186/s40560-017-0261-9) contains supplementary material, which is available to authorized users.
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