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Schumann M, Doherty C. Bridging Gaps in Wearable Technology for Exercise and Health Professionals: A Brief Review. Int J Sports Med 2024. [PMID: 39079705 DOI: 10.1055/a-2376-6332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2024]
Abstract
The proliferation of wearable devices, especially over the past decade, has been remarkable. Wearable technology is used not only by competitive and recreational athletes but is also becoming an integral part of healthcare and public health settings. However, despite the technological advancements and improved algorithms offering rich opportunities, wearables also face several obstacles. This review aims to highlight these obstacles, including the prerequisites for harnessing wearables to improve performance and health, the need for data accuracy and reproducibility, user engagement and adherence, ethical considerations in data harvesting, and potential future research directions. Researchers, healthcare professionals, coaches, and users should be cognizant of these challenges to unlock the full potential of wearables for public health research, disease surveillance, outbreak prediction, and other important applications. By addressing these challenges, the impact of wearable technology can be significantly enhanced, leading to more precise and personalized health interventions, improved athletic performance, and more robust public health strategies. This paper underscores the transformative potential of wearables and their role in advancing the future of exercise prescription, sports medicine and health.
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Affiliation(s)
- Moritz Schumann
- Department of Sports Medicine and Exercise Therapy, Chemnitz University of Technology, Chemnitz, Germany
| | - Cailbhe Doherty
- School of Public Health, Physiotherapy & Sports Science, University College Dublin, Dublin, Ireland
- Insight SFI Research Centre for Data Analytics, University College Dublin, Dublin, Ireland
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Eversdijk M, Habibović M, Willems DL, Kop WJ, Ploem MC, Dekker LRC, Tan HL, Vullings R, Bak MAR. Ethics of Wearable-Based Out-of-Hospital Cardiac Arrest Detection. Circ Arrhythm Electrophysiol 2024; 17:e012913. [PMID: 39171393 PMCID: PMC11410148 DOI: 10.1161/circep.124.012913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/23/2024]
Abstract
Out-of-hospital cardiac arrest is a major health problem, and immediate treatment is essential for improving the chances of survival. The development of technological solutions to detect out-of-hospital cardiac arrest and alert emergency responders is gaining momentum; multiple research consortia are currently developing wearable technology for this purpose. For the responsible design and implementation of this technology, it is necessary to attend to the ethical implications. This review identifies relevant ethical aspects of wearable-based out-of-hospital cardiac arrest detection according to four key principles of medical ethics. First, aspects related to beneficence concern the effectiveness of the technology. Second, nonmaleficence requires preventing psychological distress associated with wearing the device and raises questions about the desirability of screening. Third, grounded in autonomy are empowerment, the potential reidentification from continuously collected data, issues of data access, bystander privacy, and informed consent. Finally, justice concerns include the risks of algorithmic bias and unequal technology access. Based on this overview and relevant legislation, we formulate design recommendations. We suggest that key elements are device accuracy and reliability, dynamic consent, purpose limitation, and personalization. Further empirical research is needed into the perspectives of stakeholders, including people at risk of out-of-hospital cardiac arrest and their next-of-kin, to achieve a successful and ethically balanced integration of this technology in society.
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Affiliation(s)
- Marijn Eversdijk
- Department of Medical and Clinical Psychology, Center of Research on Psychological Disorders and Somatic Diseases, Tilburg University, the Netherlands (M.E., M.H., W.J.K.)
- Department of Ethics, Law and Humanities (M.E., D.L.W., M.C.P., M.A.R.B.), Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Mirela Habibović
- Department of Medical and Clinical Psychology, Center of Research on Psychological Disorders and Somatic Diseases, Tilburg University, the Netherlands (M.E., M.H., W.J.K.)
| | - Dick L Willems
- Department of Ethics, Law and Humanities (M.E., D.L.W., M.C.P., M.A.R.B.), Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Willem J Kop
- Department of Medical and Clinical Psychology, Center of Research on Psychological Disorders and Somatic Diseases, Tilburg University, the Netherlands (M.E., M.H., W.J.K.)
| | - M Corrette Ploem
- Department of Ethics, Law and Humanities (M.E., D.L.W., M.C.P., M.A.R.B.), Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Lukas R C Dekker
- Department of Electrical Engineering, Eindhoven University of Technology, the Netherlands (L.R.C.D., R.V.)
- Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands (L.R.C.D.)
| | - Hanno L Tan
- Department of Clinical and Experimental Cardiology (H.L.T.), Amsterdam UMC, University of Amsterdam, the Netherlands
- Netherlands Heart Institute, Utrecht (H.L.T.)
| | - Rik Vullings
- Department of Electrical Engineering, Eindhoven University of Technology, the Netherlands (L.R.C.D., R.V.)
| | - Marieke A R Bak
- Department of Ethics, Law and Humanities (M.E., D.L.W., M.C.P., M.A.R.B.), Amsterdam UMC, University of Amsterdam, the Netherlands
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Borghare PT, Methwani DA, Pathade AG. A Comprehensive Review on Harnessing Wearable Technology for Enhanced Depression Treatment. Cureus 2024; 16:e66173. [PMID: 39233951 PMCID: PMC11374139 DOI: 10.7759/cureus.66173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Accepted: 08/04/2024] [Indexed: 09/06/2024] Open
Abstract
Depression is a prevalent and debilitating mental health disorder that significantly impacts individuals, families, and societies worldwide. Despite advancements in treatment, challenges remain in effectively managing and monitoring depressive symptoms. Wearable technology, which encompasses devices that can monitor physiological and behavioral parameters in real time, offers promising new avenues for enhancing depression treatment. This comprehensive review explores the potential of wearable technology in managing and treating depression. It examines how wearables can monitor depressive symptoms, improve patient engagement and adherence to treatment plans, and provide valuable data for personalized treatment strategies. The review covers the integration of wearable technology in clinical settings, the role of wearables in remote monitoring and telemedicine, and the ethical and privacy considerations associated with their use. Additionally, it highlights case studies and pilot programs demonstrating the practical applications and outcomes of wearable technology interventions. Future directions and innovations are discussed, identifying potential advancements and challenges in this emerging field. This review aims to inform healthcare professionals, researchers, and policymakers about the opportunities and challenges of integrating wearable technology into depression treatment, ultimately contributing to improved mental healthcare outcomes.
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Affiliation(s)
- Pramod T Borghare
- Otolaryngology, Mahatma Gandhi Ayurved College Hospital and Research, Wardha, IND
| | - Disha A Methwani
- Otolaryngology, NKP Salve Institute Of Medical Sciences & Research Centre And Lata Mangeshkar Hospital, Nagpur, IND
| | - Aniket G Pathade
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Pérez-Guerrero EJ, Mehrotra I, Jain SS, Perez MV. Introduction to wearable technology in arrhythmia management. Heart Rhythm 2024:S1547-5271(24)03074-1. [PMID: 39053750 DOI: 10.1016/j.hrthm.2024.07.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 07/16/2024] [Accepted: 07/18/2024] [Indexed: 07/27/2024]
Affiliation(s)
| | - Isha Mehrotra
- Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Sneha S Jain
- Cardiovascular Division, Department of Medicine, Stanford University School of Medicine, Stanford, California; Cardiovascular Institute, Stanford University, Stanford, California
| | - Marco V Perez
- Cardiovascular Division, Department of Medicine, Stanford University School of Medicine, Stanford, California; Cardiovascular Institute, Stanford University, Stanford, California
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de Looff PC, Noordzij ML, Nijman HLI, Goedhard L, Bogaerts S, Didden R. Putting the usability of wearable technology in forensic psychiatry to the test: a randomized crossover trial. Front Psychiatry 2024; 15:1330993. [PMID: 38947186 PMCID: PMC11212012 DOI: 10.3389/fpsyt.2024.1330993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 05/02/2024] [Indexed: 07/02/2024] Open
Abstract
Introduction Forensic psychiatric patients receive treatment to address their violent and aggressive behavior with the aim of facilitating their safe reintegration into society. On average, these treatments are effective, but the magnitude of effect sizes tends to be small, even when considering more recent advancements in digital mental health innovations. Recent research indicates that wearable technology has positive effects on the physical and mental health of the general population, and may thus also be of use in forensic psychiatry, both for patients and staff members. Several applications and use cases of wearable technology hold promise, particularly for patients with mild intellectual disability or borderline intellectual functioning, as these devices are thought to be user-friendly and provide continuous daily feedback. Method In the current randomized crossover trial, we addressed several limitations from previous research and compared the (continuous) usability and acceptance of four selected wearable devices. Each device was worn for one week by staff members and patients, amounting to a total of four weeks. Two of the devices were general purpose fitness trackers, while the other two devices used custom made applications designed for bio-cueing and for providing insights into physiological reactivity to daily stressors and events. Results Our findings indicated significant differences in usability, acceptance and continuous use between devices. The highest usability scores were obtained for the two fitness trackers (Fitbit and Garmin) compared to the two devices employing custom made applications (Sense-IT and E4 dashboard). The results showed similar outcomes for patients and staff members. Discussion None of the devices obtained usability scores that would justify recommendation for future use considering international standards; a finding that raises concerns about the adaptation and uptake of wearable technology in the context of forensic psychiatry. We suggest that improvements in gamification and motivational aspects of wearable technology might be helpful to tackle several challenges related to wearable technology.
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Affiliation(s)
- Peter C. de Looff
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
- Science and Treatment Innovation, Fivoor, Rotterdam, Netherlands
- National Expercentre Intellectual Disabilities and Severe Behavioral Problems, De Borg, Bilthoven, Netherlands
- Department of Developmental Psychology, Tilburg University, Tilburg, Netherlands
| | - Matthijs L. Noordzij
- Department of Psychology, Health and Technology, Twente University, Enschede, Netherlands
| | - Henk L. I. Nijman
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
- Science and Treatment Innovation, Fivoor, Rotterdam, Netherlands
| | | | - Stefan Bogaerts
- Science and Treatment Innovation, Fivoor, Rotterdam, Netherlands
- Department of Developmental Psychology, Tilburg University, Tilburg, Netherlands
| | - Robert Didden
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
- Trajectum, Specialized and Forensic Care, Zwolle, Netherlands
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Moorthy P, Weinert L, Schüttler C, Svensson L, Sedlmayr B, Müller J, Nagel T. Attributes, Methods, and Frameworks Used to Evaluate Wearables and Their Companion mHealth Apps: Scoping Review. JMIR Mhealth Uhealth 2024; 12:e52179. [PMID: 38578671 PMCID: PMC11031706 DOI: 10.2196/52179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 12/15/2023] [Accepted: 02/01/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Wearable devices, mobile technologies, and their combination have been accepted into clinical use to better assess the physical fitness and quality of life of patients and as preventive measures. Usability is pivotal for overcoming constraints and gaining users' acceptance of technology such as wearables and their companion mobile health (mHealth) apps. However, owing to limitations in design and evaluation, interactive wearables and mHealth apps have often been restricted from their full potential. OBJECTIVE This study aims to identify studies that have incorporated wearable devices and determine their frequency of use in conjunction with mHealth apps or their combination. Specifically, this study aims to understand the attributes and evaluation techniques used to evaluate usability in the health care domain for these technologies and their combinations. METHODS We conducted an extensive search across 4 electronic databases, spanning the last 30 years up to December 2021. Studies including the keywords "wearable devices," "mobile apps," "mHealth apps," "physiological data," "usability," "user experience," and "user evaluation" were considered for inclusion. A team of 5 reviewers screened the collected publications and charted the features based on the research questions. Subsequently, we categorized these characteristics following existing usability and wearable taxonomies. We applied a methodological framework for scoping reviews and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. RESULTS A total of 382 reports were identified from the search strategy, and 68 articles were included. Most of the studies (57/68, 84%) involved the simultaneous use of wearables and connected mobile apps. Wrist-worn commercial consumer devices such as wristbands were the most prevalent, accounting for 66% (45/68) of the wearables identified in our review. Approximately half of the data from the medical domain (32/68, 47%) focused on studies involving participants with chronic illnesses or disorders. Overall, 29 usability attributes were identified, and 5 attributes were frequently used for evaluation: satisfaction (34/68, 50%), ease of use (27/68, 40%), user experience (16/68, 24%), perceived usefulness (18/68, 26%), and effectiveness (15/68, 22%). Only 10% (7/68) of the studies used a user- or human-centered design paradigm for usability evaluation. CONCLUSIONS Our scoping review identified the types and categories of wearable devices and mHealth apps, their frequency of use in studies, and their implementation in the medical context. In addition, we examined the usability evaluation of these technologies: methods, attributes, and frameworks. Within the array of available wearables and mHealth apps, health care providers encounter the challenge of selecting devices and companion apps that are effective, user-friendly, and compatible with user interactions. The current gap in usability and user experience in health care research limits our understanding of the strengths and limitations of wearable technologies and their companion apps. Additional research is necessary to overcome these limitations.
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Affiliation(s)
- Preetha Moorthy
- Department of Biomedical Informatics, Center for Preventive Medicine and Digital Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Lina Weinert
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
- Section for Oral Health, Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Christina Schüttler
- Medical Center for Information and Communication Technology, University Hospital Erlangen, Erlangen, Germany
| | - Laura Svensson
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Brita Sedlmayr
- Institute for Medical Informatics and Biometry, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Julia Müller
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Till Nagel
- Human Data Interaction Lab, Mannheim University of Applied Sciences, Mannheim, Germany
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Apoorva S, Nguyen NT, Sreejith KR. Recent developments and future perspectives of microfluidics and smart technologies in wearable devices. LAB ON A CHIP 2024; 24:1833-1866. [PMID: 38476112 DOI: 10.1039/d4lc00089g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
Wearable devices are gaining popularity in the fields of health monitoring, diagnosis, and drug delivery. Recent advances in wearable technology have enabled real-time analysis of biofluids such as sweat, interstitial fluid, tears, saliva, wound fluid, and urine. The integration of microfluidics and emerging smart technologies, such as artificial intelligence (AI), machine learning (ML), and Internet of Things (IoT), into wearable devices offers great potential for accurate and non-invasive monitoring and diagnosis. This paper provides an overview of current trends and developments in microfluidics and smart technologies in wearable devices for analyzing body fluids. The paper discusses common microfluidic technologies in wearable devices and the challenges associated with analyzing each type of biofluid. The paper emphasizes the importance of combining smart technologies with microfluidics in wearable devices, and how they can aid diagnosis and therapy. Finally, the paper covers recent applications, trends, and future developments in the context of intelligent microfluidic wearable devices.
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Affiliation(s)
- Sasikala Apoorva
- UKF Centre for Advanced Research and Skill Development(UCARS), UKF College of Engineering and Technology, Kollam, Kerala, India, 691 302
| | - Nam-Trung Nguyen
- Queensland Micro and Nanotechnology Centre, Griffith University, 170 Kessels Road, Nathan, 4111, Queensland, Australia.
| | - Kamalalayam Rajan Sreejith
- Queensland Micro and Nanotechnology Centre, Griffith University, 170 Kessels Road, Nathan, 4111, Queensland, Australia.
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O'Reilly D, McGrath J, Martin-Loeches I. Optimizing artificial intelligence in sepsis management: Opportunities in the present and looking closely to the future. JOURNAL OF INTENSIVE MEDICINE 2024; 4:34-45. [PMID: 38263963 PMCID: PMC10800769 DOI: 10.1016/j.jointm.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 09/29/2023] [Accepted: 10/01/2023] [Indexed: 01/25/2024]
Abstract
Sepsis remains a major challenge internationally for healthcare systems. Its incidence is rising due to poor public awareness and delays in its recognition and subsequent management. In sepsis, mortality increases with every hour left untreated. Artificial intelligence (AI) is transforming worldwide healthcare delivery at present. This review has outlined how AI can augment strategies to address this global disease burden. AI and machine learning (ML) algorithms can analyze vast quantities of increasingly complex clinical datasets from electronic medical records to assist clinicians in diagnosing and treating sepsis earlier than traditional methods. Our review highlights how these models can predict the risk of sepsis and organ failure even before it occurs. This gives providers additional time to plan and execute treatment plans, thereby avoiding increasing complications associated with delayed diagnosis of sepsis. The potential for cost savings with AI implementation is also discussed, including improving workflow efficiencies, reducing administrative costs, and improving healthcare outcomes. Despite these advantages, clinicians have been slow to adopt AI into clinical practice. Some of the limitations posed by AI solutions include the lack of diverse data sets for model building so that they are widely applicable for routine clinical use. Furthermore, the subsequent algorithms are often based on complex mathematics leading to clinician hesitancy to embrace such technologies. Finally, we highlight the need for robust political and regulatory frameworks in this area to achieve the trust and approval of clinicians and patients to implement this transformational technology.
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Affiliation(s)
- Darragh O'Reilly
- Department of Intensive Care Medicine, Multidisciplinary Intensive Care Research Organization (MICRO), St James’ Hospital, Dublin, Ireland
| | - Jennifer McGrath
- Department of Intensive Care Medicine, Multidisciplinary Intensive Care Research Organization (MICRO), St James’ Hospital, Dublin, Ireland
| | - Ignacio Martin-Loeches
- Department of Intensive Care Medicine, Multidisciplinary Intensive Care Research Organization (MICRO), St James’ Hospital, Dublin, Ireland
- Department of Respiratory Intensive care, Hospital Clinic, Universitat de Barcelona, IDIBAPS, CIBERES, Barcelona, Spain
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Verbeke K, Jain C, Shpendi A, Borry P. Governance of research and product improvement studies in consumer mental health apps. Interviews with researchers and app developers. Account Res 2023:1-28. [PMID: 37943178 DOI: 10.1080/08989621.2023.2281548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 11/06/2023] [Indexed: 11/10/2023]
Abstract
Consumer mental health apps (MHAs) collect and generate mental health-related data on their users, which can be leveraged for research and product improvement studies. Such studies are associated with ethical issues that may be difficult for researchers and app developers to assess. To improve ethical study conduct, governance through rules, agreements and customs could be relied upon, but their translation into practice is subject to barriers. This qualitative interview study with 17 researchers and app developers looked into the role and impact of governance standards on consumer MHA studies. Interviewees experienced a significant number of rules, agreements and customs, although not all of the governance standards that can potentially be applicable. Standards did have an impact on the interests of researchers and app developers, app users and society, but this impact was mediated by several barriers related to their conceptualization and implementation. Conceptualization barriers impacted the development of a standard, the inclusion of relevant concepts and the coordination between standards. Implementation barriers concerned the resource cost of understanding a standard, as well as suboptimal enforcement. The framework developed in this study can support more effective efforts to improve the governance of future consumer MHA studies.
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Affiliation(s)
- Kamiel Verbeke
- Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Charu Jain
- Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Ambra Shpendi
- Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Pascal Borry
- Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
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