Data validation, patient privacy, reimbursement among concerns with wearable devices.
Researchers showed interest in the assessment of physical activity through step counters as early as the 1960s, but the practice was not accepted as scientific research until the 1990s. Wearable technology has come a long way since then and so has the overall interest in using these devices as research tools. Today, however, there are lingering questions regarding which information collected from such devices is most relevant and what should be done with it.
“It is great to have the data, but it is just more data and it may not be actionable data,” Brett D. Owens, MD, professor of orthopedic surgery at Brown University Alpert Medical School, told Orthopedics Today. “That is the challenge in all of research, seeing the signal through the noise.”
As orthopedic researchers begin to integrate wearable devices into their research protocols, the devices will need to be validated and the data collected verified as accurate, Nikhil N. Verma, MD, director of sports medicine at Rush University Medical Center and Midwest Orthopaedics at Rush, said.
“Most devices I am familiar with are still undergoing that validation to make sure that, in fact, the data that are being collected are reasonable and accurate data before they can be used,” Verma said.
With the surplus of wearable technology available today, which includes the iWatch (Apple) and Fitbit (Fitbit), devices that provide the most accurate data for research need to be identified, Owens said.
Research by Mitesh Patel, MD, and colleagues on the accuracy of step counts generated by smartphones vs. wearable devices showed that although most of the devices were accurate, smartphones were more accurate than watches.
“One of the reasons for that may be because smartphones were worn in your pants pocket and these devices all have an accelerometer which measures the movement of your hip,” Patel, assistant professor at University of Pennsylvania, told Orthopedics Today. “If you are swinging your arms, sometimes if I am giving a talk and I am standing in the same place, I can get a bunch of steps when I am not actually moving [my feet].”
Currently, standard medical practice includes using validated surveys to collect patient-reported outcome measures (PROMs). However, Stephen Lyman, PhD,associate scientist at Hospital for Special Surgery, noted PROMs surveys may be limited by patient health literacy.
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