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Why are doctors wary of wearables?

33 点作者 NN885 个月前

11 条评论

NoPicklez5 个月前
The problem is people having devices monitor different metrics of their body without the knowledge to know what to do about what they see.<p>As mentioned in the article, wearables monitoring heart rate variability do quite a good job of telling people ahead of time that your body might be trying to fight something. During covid devices monitoring HRV would spike before people started to present with the symptoms of COVID-19.<p>Monitoring every aspect of your body and going to the hospital at any sign of &quot;out of baseline&quot; metrics is silly. There will always be a group of people that get a &quot;high heart rate&quot; notification and think its an emergency, or start to make generalised diagnosis of issues.
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lifeisstillgood5 个月前
So I have high blood pressure (middle age it seems sucks), and have been under a cardiologist for 18 months. The first thing he said was “this wearable is good”, so of course I bought it and it’s been on my wrist consistently.<p>The company is legit but has made considerable effort not to allow the data out of their eco-system (exports only to pdf, no ability to send to Apple Health etc).<p>So I notice that I send a quarters worth of pdfs to the doctor, whose secretary <i>prints them out</i> and he flips through them with a strange expression trying to work out what’s going on.<p>I have taken a few frustrating lunchtimes to parse out the pdfs and have gotten to the point I can get the data and graph it - but what to usefully do with it is interesting<p>Company: Aktiia - look for mikado-aktiia on github
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rapjr95 个月前
I worked in research on wearables for more than a decade, including research with medical doctors. The number one reason we got from doctors about not using wearable data was that they didn&#x27;t know what to do with it, what it meant. If blood pressure is too high when they&#x27;ve had you sit still for a while and taken a measurement in their office with their machine, they know how to interpret that. If you show them a continuous blood pressure trace from a persons whole day, they have no idea what to do with it. How much should your BP go up when you are doing something strenuous? How much should it go down when you sleep? They don&#x27;t know. The volume of data also dismayed them. Present a years worth of heart rate data and who has time to look through it all and understand what it means? You need to know the context of the readings, what the person was doing, what was going on in the environment, even what the person was thinking, and wearable data comes with little context (mainly just accelerometer and gyro data, but it can&#x27;t tell if you are eating dinner or watching tv or typing on a keyboard). The UI&#x27;s for looking at the long term data are terrible, and it requires a lot of processing power to get a reasonable response time, and there is no ability to query the data, such as looking for time-offset correlations between one type of reading and another. The data just is not very usable without context. A person looking at their own data for the day remembers the context, what they did that day, but how about a month ago? A year ago? Sensor accuracy still needs improvement also (e.g., did your body temperature go up today because you&#x27;re getting sick or because you spent the day outside when it was hot instead of staying inside in the air conditioning? If the sensor is affected by ambient temperature there is no way to tell.) Wearable health sensing is good enough to be somewhat useful to an individual, but it needs to be developed a lot more to be useful to a doctor (though it can provide clues that are useful sometimes). There need to be a lot of RCT&#x27;s to understand just what the data means, what is normal for a person, what indicates a problem. There is also the fear that if the doctors help develop this technology it will replace a lot of their diagnostic function. That could be good, but it could also result in everyone trusting the machine&#x27;s decisions rather than looking at what is actually happening with the person.<p>To give an example, a wearable might indicate a sudden change in gait for an elderly person. Is that a sign of mental decline? Muscle deterioration due to age? A stroke? Or were they playing baseball two days ago with a grandchild and injured themselves? New shoes? It could be any of these and more besides. If the machine does not evaluate all the possibilities it can only choose from the ones it does implement, which raises the likelyhood it will be wrong.
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robertlagrant5 个月前
There is definitely a world in which various sensors send data somewhere and a thing crunches the numbers and figures out you have a trend to somewhere bad. It&#x27;s just the doctors were trained in a world before sensors, and they&#x27;re understandably wary of people googling symptoms, and sensors aren&#x27;t that good, and the software is limited, and we as regular humans aren&#x27;t used to understanding this sort of information about ourselves.<p>The only question is: are we going to go back to a world without wearables, and the potential benefits and drawbacks they bring? Or are we going to improve them and adapt ourselves to them?
snitzr5 个月前
While I&#x27;m sure a wearable could be occasionally useful or even save a life, most don&#x27;t do much. It&#x27;s telling that mainstream fitness wearables tout their data collection ability but never use this data in marketing to prove they make people healthier. I think most fitness wearables are cashing in on pseudo medical device branding as a way to charge hundreds of dollars for electronics that cost very little to manufacture. I&#x27;d be wary of those kinds of devices if I were a doctor.
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int_19h5 个月前
Are they wary of wearables? Whenever I go to a specialist these days, I usually see an Apple Watch on their wrist.
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smileysteve5 个月前
&gt; would the data from my wearable have helped healthcare professionals with my treatment?<p>This presumes doctors practicing medicine 2.0 have any effective treatment. For the flu, sure there is tamiflu; or COVID, paxlovid; but absent those 2, for the short term interference; the best options are somewhere between zinc lazenges, creatine, water, and sleep.<p>Both the flu and COVID now have vaccines, which are more effective and preventative than interfering treatments. Anti-biotics should, generally, rarely be given at early stage, unless there are significant factors, as they have both individual and population level side effects.<p>Now, can a glucose monitor or testing cortisol or liver proteins more often tell you something? Yes, but not with much more actionable items than eat healthy, work out, sleep more, drink less (Yes, there is hrt, glp1s - but those are unlikely to be prescribed if the issue is not significant over a longer term)
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pie4205 个月前
the answer, as always, is hypochondria. i used to be a hypochondriac and it is crazy how much more im seeing my peers have hypochondria
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ashoeafoot5 个月前
Author should have induced a artificial ahead of time fever. Sauna, hot bath, insulation (bed rest well wrapped). Go all in, guns blazing before it goes all out.
nextworddev5 个月前
Doctors are obsessed with job security
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whoomp123425 个月前
because they are gimmicks and its fair to be wary of gimmicks
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