Wearables and personal health monitors have impressive capabilities, but a new review from Cedars-Sinai indicates that they don't often affect behavioral change.
Wearables may have exploded in prevalence, but a team from Cedars Sinai says that the devices have yet to entirely prove their medical relevance.
“There is a big difference between using these sensors to track sleep for self-betterment and using them make medical decisions," said Michelle S. Keller, MPH, a clinical research specialist at the Cedars-Sinai Center for Outcomes Research and Education (CORE).
In an expansive literature review led by Benjamin Noah of CORE, the group rooted through hundreds of studies to find only 27 for analysis, 16 of which were considered high-quality research. They looked at host of medical conditions that it is commonly believed wearable biosensors could help address or manage: weight, heart disease, lung disease, chronic pain, stroke, and Parkinson’s. Since many of those concerns can be measured by different outcomes, they grouped their findings by outcome variables, like waist circumference or body fat percentage.
Certain metrics and conditions showed greater benefit from remote monitoring than others. Obstructive pulmonary disease, Parkinson’s disease, hypertension, and lower back pain demonstrated the most intriguing potential, according to the researchers, while general physical activity and weight loss were a mixed bag: unaffected when incentivized with text messages or even cash, but more successful when based upon validated health behavior models.
The authors say that they found “no significant impact on any of the reported clinical outcomes.” This, Noah said, could be attributed to a lack of data, and the fact that many included studies are still in their pilot phases.
“Although some consumer-facing digital health products may be effective for promoting behavior change, there is currently a dearth of evidence that these devices achieve health benefits,” the team wrote. “More research is needed in this field.”
The review adds to a growing conundrum in the health-tech sphere: Wearable technology exists and improves almost by the minute, and its data-gathering capabilities are profound and potentially game-changing for many stakeholders. But to get the data, they have to convince patients to use the devices, and to do that they have to demonstrate some benefit beyond status and novelty.
In a panel last week at the 2018 Consumer Electronic Show (CES) in Las Vegas, Nevada, a host of experts and executives pondered the problem. Verily’s Brooke Basinger spoke of a currently-limited market: There’s a push for patients with diseases that require use of a monitoring devices or application, and there’s a pull for savvy consumers interested in the latest tech and health-monitoring devices (like, for example, CES attendees).
“What I’m a little concerned about is the space in between,” she said. “People who are not yet diagnosed with a disease, but could still benefit from having some of that health information.”
"As of now, we don’t have enough evidence that they consistently change clinical outcomes in a meaningful way," said senior author Brennan Spiegel, MD, director of Health Services Research at Cedars-Sinai. "But that doesn’t mean they can’t."
The new study, "Impact of remote patient monitoring on clinical outcomes: an updated meta-analysis of randomized controlled trials," was published this week in npj Digital Medicine.