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A Week on the Wrist: Apple Watch Series 4 (hodinkee.com)
41 points by gesticulator 11 months ago | hide | past | web | favorite | 63 comments

From the CDC:

More than 750,000 hospitalizations occur each year because of AFib. The condition contributes to an estimated 130,000 deaths each year. The death rate from AFib as the primary or a contributing cause of death has been rising for more than two decades.3,4

AFib costs the United States about $6 billion each year. Medical costs for people who have AFib are about $8,705 higher per year than for people who do not have AFib.

AFib Facts An estimated 2.7–6.1 million people in the United States have AFib. With the aging of the U.S. population, this number is expected to increase. Approximately 2% of people younger than age 65 have AFib, while about 9% of people aged 65 years or older have AFib. African Americans are less likely than those of European descent to have AFib. Because AFib cases increase with age and women generally live longer than men, more women than men experience AFib.[1]

I think the inclusion of a ECG and afib detection is going to make a huge difference in many people's lives.

Also consider that they may have raised the price, but not hugely significantly. I've had two ECGs done in the past year, and I'm sure each one cost my insurance more than the price difference of the watch.

One of my friends is highly skeptical of Apple's privacy and who will have access to this data, but as far as I can tell Apple does not have access to, or share health data with anyone. Although, maybe we should be concerned about people giving insurance access to this data without realizing the implications to their coverage/premiums.

[1]: https://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_atr...

> One of my friends is highly skeptical of Apple's privacy and who will have access to this data, but as far as I can tell Apple does not have access to, or share health data with anyone.

By default, the data stays on your device or is encrypted end-to-end if you store it in iCloud. A while back you could share your heart data for a health study, but you had to opt in.

That's what I thought, I was trying to find information on their policies about metadata collection or anything like that, I didn't spend much time looking though.

But given Apple's stance and track record with privacy I'd be amazed if they violated that with health data.

Once it's in the cloud, the government (NSA) can read it on demand, encryption or not.

Edit: "No one else, not even Apple, can access end-to-end encrypted information." Strong words, and AES-128, maybe I was wrong.

They can't if the only keys to access it are on your device, unless there's a fundamental flaw in how our cryptography is supposed to work.

> unless there's a fundamental flaw in our cryptography

They compromised elliptic curves. Otherwise it depends on what Apple uses for encryption.

"A minimum of 128-bit AES": https://support.apple.com/en-us/HT202303

If this is your argument, then nothing on this planet is secure or safe from the NSA. Take into account the speculative execution related flaws, like Spectre and Meltdown, found in all major CPUs (including ARM based ones), nothing is unbreakable.

There are many encryption methods safe from the NSA, but you are right, once they attack the CPU backbones almost nothing on the market is unbreakable.


If that were true you would lose access to it if you lost your phone, which you don’t.


As someone who experienced two recent events of tachycardia (strongly suspected to be some kind of SVT, not captured on EKG ... yet) as well as ongoing PVCs 24x7, the heart features are what is going to drive me to replace my S1 with an S4. That and my desire to loosen my direct connection with the phone by putting cellular in the watch itself. I carry around an EKG now with my phone (simple lead 1 device just like what is on the S4), so it will be nice to lose that. And the watch may do a better job of that anyway since it will be directly connected instead of sonically.

I could go on and on about the insurance cost of an EKG. You can buy the EKG (well, at least a decent Holter monitor) for less than what insurance charges to rent it for a day.

I think the inclusion of a ECG and afib detection is going to make a huge difference in many people's lives

I'm quite content with my Garmin Fenix, but this is the one reason I'm considering an Apple Watch this round. I have had (still have?) Wolf-Parkinson's syndrome, had the ablation, haven't had problems since. But, you know, it'd be an excuse to buy a new gadget, right? And it does look like Apple Watch might finally start being usable as a running watch.

And, man, what I would've given for the ECG fifteen years ago when the docs were trying to get a repro. Wore a big mobile ECG thing for a few weeks, then gave up. I don't know that it's fit for purpose, but it would have been nice to just wear an Apple Watch until it repro'ed rather than time-boxing it with a rented device.

The QardioCore is pretty decent too. It can show a flutter on the ecg.

The problem I see with the watch is that you have to manually start it (30 seconds touching the crown).

I think the QardioCore needs the app to record this, but I am not sure.

There isn't any way around that unless you wear the strap (like the QardioCore) or otherwise have a semi-permanent lead attached to your other arm. You need an electrode on each arm one way or another, or use one of the other EKG leads that uses electrodes on on your chest.

>I've had two ECGs done in the past year, and I'm sure each one cost my insurance more than the price difference of the watch.

Average cost of an ECG in the US is $188.

Before or after insurance? I got charged just under $400 to use a Holter monitor for a day. I could buy the device for under $300. And I paid another $400 for a tech (not a Dr, mind you, just a tech) to confirm that the automatic analysis from the computer was accurate.

That was technically with insurance, but on a high-deductible plan so I basically paid it out of pocket.

Single visit test.

Haptic feedback is huge. I think it is one of the most important ui innovations in the last few years, and the occasional ridicule apple receives for putting so much effort into it is extremely misguided.

Haptic feedback removes the most crippling weakness of the touchscreen, the inability to use it without looking.

> Haptic feedback removes the most crippling weakness of the touchscreen, the inability to use it without looking.

I wouldn't go as far as to say that. But it does make interacting with a touch screen feel a lot more "physical".

I am more thinking about going. There is no reason why we wont soon begin to see implementations where you can find interact-able elements without looking by simply dragging your finger around on the screen.

Wait, how? Haptic feedback lets you know you did something. A simple "bounce" is convenient when directly interacting; However, it does nothing to let you know what you did. To the point that it almost equivalent to the bouncing icon on your task bar.

That is, I expect the natural response to most of these feedbacks is to look at your watch. That not the case?

It can help you differentiate between whether it register a quick tap on the touch screen vs a force press.

Not that they do it on the watch, but it could also have a ratcheting-type feel when you scroll to indicate a) that you're scrolling or b) how fast you're scrolling.

The Steam Controller actually used this to great effect.

Oh, I get that it can help. I actually really like the feature. What I didn't get, was how it could help you use it without looking. Touchscreens require you to know what is on the screen, pretty much period. Right?

Ever want to skip a song on your iphone while driving? You know basically where the buttons are, but not exactly and since there is no feedback you cant tell if you are hitting a button, or just empty screen. With feedback you could allow the user to drag their finger around until they located a button based on the feedback.

Isn't that why you just use the bluetooth capabilities of your car and then use the buttons on the steering wheel? :)

That said, I don't drive much. At all. I do bike, so I have used the similar feature of the headphones I wear. Never wanted to try and use the phone.

Not to denounce the tech but if the song skips I can be fairly confident I was accurate. Dragging my finger blindly around seems likely to have adverse effects.

> The most apparent size difference is actually the thickness – the 0.7mm shaved off the back (mostly from the sensor array) makes a huge difference in terms of comfort and you feel it the moment you put one of these new models on.

Does it really? I think this is an exaggeration. I went from a 10.5mm first-generation Apple Watch (which is thinner that this one!) to a 11.4mm Series 2, and I couldn't notice the difference. So I'm not optimistic on this being a perceivable difference–I guess I'll see on Friday.

I'll speak up and agree with the parent.

I don't really like the Apple Watch, so my bias is limited. But, I've had a S0 (returned), S1 (returned), and S2 (sits on night stand most of the time).

For whatever reason, the S2 is noticeably thinner and more comfortable for me. It may be because I have relatively small, bony wrists but YMMV.

Hell, I'm not sure how Apple measures the thinness, but eyeballing a borrowed S0 vs my S2, I can eyeball a thickness difference, albeit maybe just with the glass circle thing jutting out from the bottom?

In case anyone is curious why I don't care for the Apple Watch:

- I care about truly few notifications (texts).

- I expect to lift my wrist and look at the watch and see the date and time immediately, every time. The Apple Watch doesn't really do this. Sometimes it shows me an audio interface instead, which you can disable. But a lot of the time, the Watch doesn't even flip on when I turn my wrist unless I turn it a specific way and speed.

My S3 very reliably presents text notifications to me. I wonder why yours doesn't.

As an aside, I'm also curious why you keep buying them if you just keep returning them.

I didn't say anything about text notifications being unreliable. Sorry if my wording is confusing.

On your second point, I kept going back and forth on the Watch's usefulness and WatchOS was being frequently updated upon, delivering new features rapidly. I'm over that now, hence my low interest in the subsequent S3 and S4 releases.

Are you sure it's the thinness and not the weight difference? 700 microns sounds inconsequential.

Really wish someone would step up to the plate with an Android or open platform smartwatch that even approaches the level of quality of the Apple watches. Their watches are slick but I'm very much opposed to "buying in" to the system. Correct me if I'm wrong, but an Apple watch without an iPhone to talk to (and subsequent iCloud account, apple text messages, Apple music etc) is just a very pretty watch with swappable faces, yea?

I don't believe you can even get to the pretty watch with swappable faces part without an iPhone to activate it. It's very definitely only for iPhone users — as of now, at least.

How do you define "quality"? There are smart watches from Samsung, Garmin, and other vendors which are superior in some ways but worse it others. It depends on what you want. All of those are open in the sense that you can write your own apps.

Wait, I wasn't sure if any of those have a cellular radio in them - that was the first thing that comes to mind. I do like the Galaxy Watch quite a bit though, though it requires "buy in" to Samsung's suite of things (Samsung Pay instead of Android Pay/Google Pay for example... which is just me preferring google stuff over samsung to be fair).

The Samsung Gear watch includes 4G LTE connectivity just like the Apple watch.

Xiaomi makes nice watches but it probably has the same issues you're wanting to avoid, and you're very much buying into their system.


Yep, one of the things keeping me from going Android is rendering my 250$ toy that I bought a year and a half ago useless.

You need an iPhone to even set it up I’m afraid

This article has all the elements of a sponsored review but it was done extremely well and the author provided many detail information which I have to give him credit for that. The ECG feature is the only reason I would ever buy an iWatch, if it works as advertised. Apple is smart to focus in the health niche as there are no other valid reasons an average person would ever need a smart watch in their life.

>no other valid reasons an average person would ever need a smart watch in their life.

I'm not a particular smart watch fanboy but here are a few reasons:

- notifications (of which I use very few)

- GPS tracking (hiking, running, etc.). That's partly health but not really.

- Potentially do some phone-related things when your phone isn't handy.

Apple is smart to focus in the health niche as there are no other valid reasons an average person would ever need a smart watch in their life.

Imagine how nice notifications (and the ability to respond if necessary) are for people who work long shifts where they can't have their phone with them!

Notifications are amazing for say, shift workers who are too busy to check their phones...like doctors and nurses.

A couple of years ago I really wanted to get a smart watch. After reading and reading and reading about them, I realised: buying a smart watch is actually pretty dumb. For the same amount of money, I could buy an automatic watch which will never need a battery replaced, never spy on me, never require patches, never fall out of software support — and will be with me for years to come.

So I went out and bought a few nice automatic watches, and I’ve been incredibly happy since. Each of my watches tells time, each looks good, and each will still be running years after every smart watch sold in 2016 is powered off.

This particular Apple watch is IMHO too big, and mesh bracelets look very 1980s to me.

Years ago I wanted to buy a computer but then I realized that I could also buy a bike which is much better because a bike doesn't use electricity /s

Any operation you can do on a computer I can do on my abacus. It never needs to be charged and I enjoy the mechanical nature of its computations. Saved a bunch of money too!

Spoken like someone who has not yet paid to service an automatic watch. :P

Although automatic watches in the price range of an Apple Watch - $300-500 - can be pretty durable, their service costs are high enough to justify replacing the damn thing with a new watch once that time rolls around in 5-10 years.

Do you really have to actually service them at 5 year intervals? I have Seiko SKX with a 7S26 movement that still people routinely say it goes 10+ years without a service. When you do, it's about $100 since the movement is so common and cheap. Seiko and Casio both make fine quartz watches that are solar powered and have much lower maint cost than an automatic watch (though typically not seen as a nice or luxurious watch). The swatch thin-line watches are quite nice and replacing the batteries is cheap.

Well, you don’t have to, but the watch is basically a total loss once it requires a service. You could service it preserve the sentimental value, but if OP wanted a hearty watch they would’ve bought a G-Shock or quartz.

(Tangent: folks in the watch community are “particular” about the watches they purchase. In 2018 quartz is out of style, even though they run longer and resist shock more than automatic watches. In my mind, OP traded one trendy watch - the Apple Watch - for another watch trend.)

Probably not. But if you own a Rolex Daytona, you would, just for peace of mind.

Rolex used to replace all worn parts in their movements as part of their servicing at no extra charge. Do they still do this? If so, then I would push off the service as long as possible. If you wear out a bunch of parts after 20 years they'll be replaced in a single service. I think the average service interval for them is 10 years (not that they recommend that but what people usually do) and the servicing is like $750 last I remember.

And that's great for you. I was totally against smart watches when they first appeared and didn't see any great use for the Apple Watch.

I eventually bought one and I wear it every single day. Things I do with it:

1. Most important feature is notifications from iMessage, WhatsApp, SMS and a small number of apps that I want notifications from (e.g. British Airways app telling me which gate to go to). On occasion I reply using the watch.

2. Meeting reminders. I go to a lot of meetings. Knowing when they are coming up and where they are is super useful.

3. Activity. I like the gentle push to make me walk a bit more.

4. Timers. Use these often when cooking or making tea.

I have an original Apple Watch. Not sure the Series 4 is compelling for me, but the health features are what will drive me to buy a new watch at some point.

You’re not part of the target customer base just as someone who loves walking is not a target customer for any car maker. It’s as simple as that.

If you do use a smartphone, then a smart watch is quite close to the tracking part (except for some additional data collection about heart rate that you may consider invasive).

Size is an opinion so I won't argue there. It's not especially big or heavy as watches go though. However...

>and mesh bracelets look very 1980s to me.

You know you can get different bands. I have a leather band--admittedly way too expensive--but it's very nice leather and is very comfortable.

Anyone have thoughts on if this is worthwhile?

Out of FAANG, I find Apple the closest to capitulation because they need to keep their luxury product audience buying their product instead of competitors who seem more willing to take risks.

Every Apple announcement seems more like an 'evolution than revolution' per the article, and this doesnt seem any different.

Is this the best watch on the market?

EDIT: whoops- PRAISE APPLE, thank you steve jobs for your sacrifice.

Apple has been about continual incremental improvements for longer than about revolutionary changes. Look at how many years passed between the introduction of new product categories and this becomes clear.

In the current context, if introducing an FDA approved ECG in a consumer device is not revolutionary, then I don’t know what you mean by that term.

Some quotes from articles on this topic of incremental changes on Fast Company and Daring Fireball.

> When critics ding Apple for its failure to introduce “breakthrough” devices and services, they are missing three key facts about technology: First, that breakthrough moments are unpredictable outcomes of ongoing, incremental innovation; second, that ongoing, behind-the-scenes innovation brings significant benefits, even if it fails to create singular disruptions; and, third, that new technologies only connect broadly when a mainstream audience is ready and has a compelling need. “The world thinks we delivered [a breakthrough] every year while Steve was here,” says Cue. “Those products were developed over a long period of time.” [1]

> But even when Apple enters new product categories, they don’t invent the categories themselves. The iPad wasn’t the first tablet. The iPhone wasn’t the first smartphone or touchscreen handheld device. The iPod wasn’t the first digital music player. [2]

> Historically, those sorts of big new things have only come two or three times per decade. [2]

[1]: http://www.fastcompany.com/3062090/tim-cooks-apple/playing-t...

[2]: https://daringfireball.net/2014/02/fitting_facts_to_the_narr...

> Is this the best watch on the market?

Without a doubt. Google Wear lacks focus, Pebble is dead, and there's more offerings like Garmin or Fitbit that are nice but have a smaller scope. But yes, this is still an "evolutionary" release.

There are still a lot of tradeoffs in the space. The Garmin Fenix is arguably better for serious runners and backpackers in part because of better battery life and probably being more rugged.

But they're huge even for 6 ft. large-limbed me.

And I could never get my remanufactured Fenix 3 to consistently measure distance accurately on twisty turny trails no matter what settings I played with.

Battery life is definitely still an issue. In fact, I often travel with just a cheap Timex so it's one less thing I need to bother with.

The tracking issues have largely been cleaned up on the Fenix 5. It works well enough day to day for me, showing notifications from apps on my phone, allows me to blacklist apps, and has all of the features I need as a "serious" runner and backpacker/hunter. The Apple Watch isn't playing in that space though.

I was a bit on the fence between Apple and Garmin before a trip earlier this year where I really wanted a new GPS watch. I decided to spring for the Apple Watch but I wouldn't be surprised if there were another Fenix in my future at some point.

Evolutionary, sure, but I've been happy with mine. I bought the cheapest one since I wasn't sure it would be useful, ended up liking the damn thing so much I'm going to buy an S4 shortly. Cellular, because I'm getting to where I'd rather not carry the phone around but I want to maintain minimal connectivity (and most of that connectivity these days is non-voice).

Everyone is absolutely entitled to their own use case and should buy whatever suits them. It's a free market.

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