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Rapid Review Quiz: Wearable Health Tech
As wearable health technology becomes more sophisticated and accessible, its impact on disease detection, chronic condition management, and preventive care is growing rapidly. From smartwatches that flag abnormal heart rhythms to headbands that analyze sleep stages and wristbands that monitor blood pressure around the clock, these devices are reshaping the landscape of modern healthcare. However, clinical accuracy can vary significantly across devices.
How well do you understand the strengths and shortcomings of these wearable health devices? Check your knowledge with this quick quiz.
The Apple Watch is US Food and Drug Administration (FDA) approved for over-the-counter use as ECG software to help detect cardiac arrhythmias. In May 2024, the FDA qualified Apple's Atrial Fibrillation History Feature as a Medical Device Development Tool (MDDT). This makes it the first over-the-counter wearable tech accepted under the MDDT program for estimating AF burden in clinical research. The feature might serve as a biomarker to evaluate cardiac interventions, such as ablation therapies, during clinical trials.
A new meta-analysis shows that the Apple Watch ECG has high sensitivity and specificity for AF detection compared to standard ECGs. However, expert guidelines and the study itself recommend that providers use the Apple Watch ECG as a screening tool, not for definitive diagnosis. Any positive or suspicious result should be confirmed with a standard 12-lead ECG, which remains the criterion standard for AF diagnosis and can detect other arrhythmias.
Choosing to use the Apple Watch ECG as the sole diagnostic tool ignores its limitations and the need for comprehensive evaluation, potentially missing important cardiac conditions. Advising against all use of the device would overlook its value for early and convenient AF screening, especially in at-risk or hard-to-reach populations. Replacing standard ECGs entirely with the Apple Watch is not supported because the Apple Watch cannot provide the full range of diagnostic information.
Learn more about AF.
A clinical trial showed that after 3 months of using the Dexcom G6, participants had notable improvements in glycemic control. Usage remained high throughout the study, with 91% completing the full 90-day period and wearing the sensor 88% of the time. Compared to fingerstick monitoring, CGM users had lower average glucose levels (184.0-147.2 mg/dL), better time in range (58%-83%), and slight improvements in glucose variability. Additional health benefits included reductions in A1c, BMI, blood pressure (BP), cholesterol, and a lower estimated 10-year cardiovascular risk.
Real-world data also confirmed that patients with poorly controlled type 2 diabetes using CGM for 12 months saw continued improvement in glycemic control, especially when using alert features. This was confirmed in a meta-analysis of randomized controlled trials, which concluded that feedback from CGM positively affects glycemic control in adults, regardless of diabetes status.
In March 2024, the FDA approved Dexcom's Stelo Glucose Biosensor System, the first over-the-counter CGM, designed for adults with type 2 diabetes not using insulin and for the general public interested in tracking glucose patterns related to lifestyle factors.
Learn more about CGM.
The Dreem headband uses portable EEG and motion detection for home-based sleep tracking.
A recent study comparing Dreem to polysomnography (PSG) (the criterion standard for detailed sleep analysis) found mixed accuracy across sleep metrics. Total sleep time and sleep efficiency aligned closely with PSG results due to the device's ability to detect sleep-wake transitions via movement. However, REM sleep was overestimated by about 25 minutes.
Overestimating REM could delay detection of disorders such as Alzheimer's disease and depression (in which sleep disruptions are linked), making the Dreem less reliable for clinical diagnoses that require precise REM data.
Although the device shows potential for general sleep monitoring at home, its limitations (especially in identifying REM) suggest that further validation and algorithm refinement are needed, particularly for use in older adults and people with neurodegenerative conditions.
Learn more about sleep EEG.
A new meta-analysis concluded that wearable activity tracker-based interventions significantly increased daily step counts in older adults compared to usual care (such as prescribed physical activity), highlighting their potential to boost physical activity in this population. Higher step counts are linked to lower cardiovascular mortality and all-cause mortality and reduced frailty risk.
The interventions did not significantly improve BMI or functional mobility (Timed Up and Go test) or reduce sedentary time. These outcomes might require longer interventions or additional components such as dietary changes or targeted exercises.
Learn more about risk factors for coronary artery disease.
Hilo, formerly known as Aktiia (Neuchâtel, Switzerland) is a wearable device that measures BP continuously without a cuff, using optical sensors in a wrist-worn bracelet. It has received regulatory approval in the European Union and Canada.
A new study found that Hilo (Aktiia) closely matched ABPM readings during daytime and across a full 24-hour cycle. However, it consistently recorded higher systolic BP at night, indicating reduced accuracy during sleep. It nonetheless captured overall nighttime dipping trends.
No major discrepancies were found in daytime readings, and claims of inaccuracy during the day were unfounded. The device also did not show overestimation across all periods, only at night. Furthermore, it successfully tracked dipping patterns, supporting its use with some caution for nighttime data interpretation.
Learn more about BP assessment.
