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Apple Watch detects irregular heart beat in large U.S. study (reuters.com)
310 points by onetimemanytime 39 days ago | hide | past | web | favorite | 231 comments



I work at a related company (Cardiogram), and there's a surprising amount of signal locked in the humble heart rate sensor -- we've run multiple studies with UCSF showing accurate detection of sleep apnea, high blood pressure, and even diabetes using off-the-shelf heart rate sensors and a deep neural network, DeepHeart: https://blog.cardiogr.am/screening-with-wearables-what-do-th...

If you're an engineer or payer relations expert and you'd like to help build the future of healthcare, definitely drop us a line! hello@cardiogr.am. We're especially looking for Javascript engineers, Android engineers, and salespeople with payer experience.


Payer relations?

Does this mean insurance companies are interested in this heart rate data stream, and are making inferences from it? Are they already collecting it? Do any of these wearables provide this data to these companies without the user's express permission?

Is this a good thing?


The link isn't working for me (in Japan, if that helps) after the renewal, still.

I couldn't find a copy of the page in Google's cache or in the wayback archives.

I'm curious since I don't know anything about Cardiogram at all; is DeepHeart a part of Cardiogram? That is, are all of those detection capabilities part of your app if I have an Apple Watch?


I'm past the edit time limit, but I went to look up the app and downloaded it -- apparently the domain issue is also blocking new signups. :/


Heads up, your DNS is still broken! Will try emailing you a little later...


Some feedback - your website is very lacking in information about what your app actually does, what devices it works with etc. The blue "personal healthcare assistant" looks like a link but isn't.

I'm curious about your service, but without knowing if it's compatible with my smartwatch etc, I wouldn't go as far as downloading the app.


Do you know of an open dataset to experiment on?


Link doesn't work.


Weird - I was able to reproduce an error in loading https://blog.cardiogr.am/screening-with-wearables-what-do-th... by refreshing. I'll investigate, but for now, try refreshing the page.


Something's wrong with your DNS: https://dnschecker.org/#A/blog.cardiogr.am


They forgot to renew their domain:

    Domain name: cardiogr.am
    Registrar: abcdomain (ABCDomain LLC)
    Status: on hold
    ...
    Registered: 2015-03-17
    Last modified: 2019-03-17
    Expires: 2019-03-17


You got it—I renewed it 40 minutes ago. Bear with us as we get the renewal processed and DNS propagated.


One might say it's important kinda like a... heartbeat.


Still not resolving in a lot of places, also making your app not work (I’m in the UK).


Happy 4 year domain birthday!


I’ve tried sending an email to the address you posted here, but the email is failing to send to that address. Very interested in talking about engineering opportunities though!


Do you have to do another study each time you release new firmware?


I saw a few posts on Reddit about how the Apple Watch basically saved people's life:

https://www.reddit.com/r/AppleWatch/comments/a40qm5/heading_...

https://www.reddit.com/r/AppleWatch/comments/9zrdq5/how_an_a...

I'm sure there is a lot more.

(Also all the people losing weight)


I wish there was a heartbeat-measuring watch with the battery life of a dumb watch. My watch goes like 5 years (I've lost count honestly) on its original battery. I'd love to have something watching out for my health but I just can't see myself moving to a smartwatch that needs recharging every 18 hours when I don't even need the smartness crap...


You might like the Withings Steel HR, which has a traditional mechanical watchface, a heart rate sensor, and about 25 days of battery life: https://www.withings.com/us/en/steel-hr/36rgw/shop?screen=de...

Some Garmin and Fitbit models have good battery life — often about a week.


I have worn both the original Fitbit Charge HR and the more recent Charge 2 daily for the past few years.

Aneceotally, because the watch isn't really water resistant (not least because the bands bubble if they get wet often), I have had it run out twice in that time and both times I was on holiday somewhere with no power. Because you are unlikely to actually wear it in the shower, just leave the charger permanently in your bathroom and get in the habit of taking it off and putting it on the charger when you shower. Even if you forget for one or two days it will almost always be sufficiently charged.


Watch out for the Withings watches, I bought the generation before the HR one and it was rather thick, much thicker than I was expecting, I ended up returning it. I love the style of the Withings watches, but way too thick for me compared to the traditional watches. I'm waiting for the smartwatches to get down in thickness before trying another one.


I'm the type of person that loves watches and doesn't like smart watches. Personally I find them to be too much distraction. I'm more of a G-Shock wearing type of user, although I've owned many Garmins over the years for working out, but none enough to wear daily. That was until the Garmin Instinct [0]. You can easily get 10-15 days out of it depending on how much you work out and use the GPS for tracking. I also don't sleep with a watch on, so it's shut off at night. Anyway, point being the Instinct is just enough "smart" yet rugged enough for daily use. One of my favorite watches I've ever owned.

[0] https://buy.garmin.com/en-US/US/p/621802#overview


I'm much like you- with a new fitbit charge 3. The thing is positively addictive. I still wear a sailing watch for sailing, but for everything else I use the fitbit, especially for heartrate when I work out and for sleep tracking, which seems pretty good). I can go 5 days or so before I recharge it, but I've never let it go until it was dead so I don't know how much I can push it.


I have a Garmin and wouldn't recommend it to anyone. It's not accurate so it's essentially useless


What we need is a Seiko Kinetic with HR.


Purely anecdotal, but my Series 3 goes about two days on a full charge. I can usually get away with just charging it in the morning while I shower and get ready, and otherwise just wearing all the time. Workouts deplete the battery more, mostly because I’m usually using the GPS in addition to the more frequent heart rate monitoring.


I feel like if I got a watch that did this I'd want it to last at least 3 months on a charge, so I could stop having to remember to charge it... otherwise it's like having a second phone on my hand that I don't need.


Everyone has their own threshold, and I respect that, but personally I haven't found it too onerous. I don't wear watches to bed, so I 3D printed a base for the watch charger (it's a magnetically attached inductive charger, no plug) and I just take the watch off my wrist and set it on the charger as I go to bed. Faster than when I had a dumb watch, because I still had to set it down the same way, and the Apple Watch unlatches with a single pull.

But ... like I said, everyone has their own needs. And if you don't want all the smart crap, it's a pretty expensive heartbeat monitor.


It's not really the issue of it being 'onerous' (although it is), but that for me, in a watch, reliability is king... heck, if it wasn't, I'd just be using my phone, like many people already do (and which I've also been tempted to do). But there are times when I forget to, say, charge my phone. [1] It's not often, but stuff goes wrong once in a while. Now if I'm short on time the last thing I need is to have to discover I'm out of battery and waste time having to fiddle with a battery pack or something. None of this is an issue when you have a normal dumb watch that lasts a few years. You always have a way to tell what time it is and to set yourself alarms so you can meet your commitments no matter what goes wrong.

[1] Or it crashes, or randomly starts draining its battery insanely faster because Google decided to force feed it an update or due to other reasons I can't fathom... but that's another story.


thats essentially what makes apple watch a non-starter for my smartwatch needs, it accepts only the most regular of charge schedules. I much prefer the pebble or samsung gear which I charge like once a week only for an hour and can rely on as my wallet and sleep tracking even if my phone is dead.

I don't want to baby multiple devices, one main work tool is fine to manage battery on a daily basis for instance AirPods charge roughly once a week or less depending on usage pattern. There's plenty of tech that balances battery and powerdraw appropriately. I find apple watch misses this mark unless a lot of functions are turned off.


I take Apple watch off when I shower and put it on the charging puck. After the shower, I put it back on my wrist. Seems pretty easy if one bathes regularly.


Really confused how this comment went from a -3 accumulated over several hours to 0 in the span of maybe 10 minutes...


My Amazfit Bip ($99) is supposed to have 45 days and lasts about 30 days on minute heart rate monitoring intervals (based on a month and a half of trying it).

I wanted something a bit smaller, to fit under the shirt cuff, so got the Mi Band 3 ($50) which lasts about 10 days (probably 20 days if you don't allow it to display notifications and set a higher HR interval).

The Mi app is pretty bad, which forces you to buy an extra app (for me, Notify & Fitness, for Google Fit sync).


I second the Amazfit Bip. Mine has around 40 days of battery life.

On iOS, I use AmazTools [1] to sync the heart rate data to the Health app.

[1] https://itunes.apple.com/us/app/amaztools/id1386033880?mt=8


In regards to the Mi Band 3, there is an app called Mi Band Master, which works a lot better then the original. It exists for both Android and iPhone. I use it for sleep monitoring, and notifications. Battery lasts for about 2 weeks.


Huh, interesting, thanks for the pointers! 45 days might be bearable.


My apple watch 4th edition, gets about 3 days on a charge, and charges quite fast. Its very easy to manage.


You should look at brands like Garmin and Polar, then. Samsung and Apple put these bright, colorful OLED panels on their smartwatches and drain the batteries too fast. Garmin in particular does a good job of building smartwatches with almost all the features of a Galaxy Watch or Apple Watch, but with a lot more battery life because they aren't wasting so much energy on the bright, pretty screen. Instead, they focus on lower energy LCD panels with backlights. The reason they do this is largely because they are fitness and sports focused and you don't want your watch dying on a two day hike and leaving you stranded, but in day-to-day activity I love having that extra battery life. It makes the drawbacks of a less vibrant screen totally worth it. I still get all my emails, texts, calls, music, etc. except I also get sleep tracking (because I'm not taking it off every time to charge) and less stress.


I've done a fair amount of research and am still pretty conflicted. I really only care about having a smart watch for the gym. I definitely need music and heart rate tracking but I would also like some app support for workout tracking. Most recently I've started using http://fitbod.me. My main goal is to not carry my phone around at the gym and not be any more connected (read: distracted) than I currently am with my phone.

The Garmin Forerunner 645 Music covers what I need short of the app support. The Nike Apple Watch Series 3 looks very tempting but I really don't like the aesthetic and I feel like it's just perpetuating the problem of being too online all the time. Though it's a far more feature rich device for less than the 645.

I'm thinking I'll sit back and wait for broader app support.


A fitbit might be a good match, my girlfriend's Alta HR lasts a handful of days between charges.

I bought it for her primarily for the hypnograms.


My fibit charge 3 goes more than week before needing a charge.


My pebble watch lasts 10 days. Its kind of an awkward length though because things that I charge nightly I do all at once but I often forget to change my watch. Thankfully it falls back to dumb time only mode for a day before turning off


The Suunto 9 GPS watch claims up to 120 hours between charges depending on how you configure the GPS. It's mostly marketed to ultra-runners and hikers who need that kind of battery life.


I bought a 9 usd band that travks heartbeat every minute that last for a week or more before recharging


get a wireless charger and put it on your nightstand, problem solved.


In my experience you can wear it 23.5 hours a day as long as you charge during your morning shower and checking your email.


Sorry for the stupid question, what do you mean by people losing weight?


Apple added gamification elements to the Apple Watch.

“Closing the rings” which means completing 100% of the move, stand and exercise targets adds a competitive element to fitness which has worked well for many users.


I haven't yet found the rings and other features to be nearly as motivating as when all of my friends had Fitbits and we were connected through their service. That was one thing that kept me from switching faster, I didn't want to give up the Fitbit social network.


FWIW, Apple Watch has a similar thing; it just has fewer users on in the network…


I had not seen that. Thanks for the tip!


The challenges app helps with that: Challenges - Compete, Get Fit by FitNow https://itunes.apple.com/us/app/challenges-compete-get-fit/i...


You might like this. Haven't tried it, but saw it announced by someone local who'd worked on it and thought it was a great idea and strong design:

https://steps.im/



It tracks your calories, exercize time, and number of hours you’ve been active (walked for at least a minute).


Here's a good one from a well-known tech journalist, from the very first Watch. http://www.loopinsight.com/2015/06/16/apple-watch-my-most-pe...


Thank you for posting these! This inspired me to take the time to run an ECG, and enable auto-ECGs with notifications.


It should be noted though that this study does not say that an Apple Watch will overall provide medical benefits. It also doesn't follow automatically from the fact that it detects things with a certain reliability.

The interactions of early detection and medical benefits and downsides are complicated and it will require a lot more science to figure out whether a device like an Apple Watch can provide benefit.


>It also doesn't follow automatically from the fact that it detects things with a certain reliability.

There's more information on this here:

https://www.apple.com/healthcare/site/docs/Apple_Watch_Arrhy...


If I'm reading this right, the Apple Watch was actually more accurate in detecting arterial fibrilation episodes than the ECG patch they used for initial confirmation. The Apple Watch identified 2,000 people. The patch confirmed 33% of those, but then another 51% were confirmed by some undisclosed method.


That's not an accurate interpretation. Atrial fibrillation episodes are not constant- they come and go, and different people will have them at different frequencies. It's possible that people had an episode while wearing the watch but haven't had any episodes while wearing the ECG.

ECGs are also less comfortable to wear than watches, so it's possible the people they sent them to didn't wear them as often (it's even possible that they didn't wear them at all).


All good arguments for the watch it seems. I was a little eye roll at the ECG feature Apple added, but I’m happy to be proven wrong.


The ECG really has it's moments. I have arrhythmia (not Afib) and it's handy to be able to correlate what I'm feeling with actual evidence. And I can print it out and take with me at my next appt to discuss with the doc.

But if you have a perfectly boring, normal heart, I can see not using it very often. At least it's unobtrusive if you aren't interested in it.


They mention ECG patch, so it might not have been too bad. Those are good for longer studies than a typical Holter monitor, and they are waterproof so you can shower with them. I agree that a real Holter monitor is a bit of a pain in the ass and probably would affect compliance rate.


A proper study would probably compare the amount of hours of data.


I can see a future where my doctor gives me a wristband to wear for a month then return as a part of each annual checkup.

Though maybe it gets even better than that and we just all start wearing watches again.

I want that feature but I'm not a watch wearer.


The future is your insurance company making you wear a smart watch 24/7 if you don’t want to pay a huge premium. I predict it’s going to be a huge quagmire over the next decade or so.


It would be a huge invasion of privacy for an insurance company to do this - and not only privacy, but the fact that insurance companies can discriminate based on this data means that the healthy don't end up subsidising the unhealthy (which is the whole point of insurance). SO premiums go up regardless, and only the insurance company win in this scenario.

Right now, the right choice is to combat this problem before it becomes a real problem. Before it sets root as cultrually acceptable to hand over your biometrics data to private companies without the right payment and compensation.


> but the fact that insurance companies can discriminate based on this data means that the healthy don't end up subsidising the unhealthy (which is the whole point of insurance).

I agree with your premise about the point of insurance. How is the discussed idea any different than insurance companies giving different rates to older people and denying coverage for pre existing conditions, in terms of discrimination against the non healthy?


It’s not different, but denying coverage for pre existing conditions is illegal in the US. Also, there is a limit to the ratio between the highest premium and lowest premium in the insurance pool, along with out of pocket maximums so you will still end up with the healthy subsidizing the unhealthy.

Incentives to make people healthier should not be a problem with these constraints (max premium rations and guaranteed coverage for everyone). It’s no different than offering a lower car insurance premium to someone that doesn’t drive drunk.


These are so American problems... It already reads like a dystopia.


I completely agree with your sentiment. Sadly given the state of privacy, healthcare, lobbying, etc in the US, it is something I am very worried about.


Insurance companies are already doing this. My friend gets $5 discount on his monthly premium for wearing a garmin wristband.


It'll probably be more like auto insurance companies where they offer a voluntary tracking program and if you're better than average you get a discount


We're already headed in that direction, for sure. The company I currently work for doesn't run a program through the insurance company directly, but they do make the company contribution to your HSA dependent on you participating in their wellness program. Bonus points if you have a smartwatch that can feed data back. Supposedly none of that info gets back to the company or insurance, but I wouldn't bet on it.


The health insurers have been relatively "smart" (more accurately, subtle) about this by this separation of the tracking/privacy implications into separate "Wellness" programs. In many cases these Wellness programs do seem to be firewalled from insurers with the only information passing between Wellness and Insurance being the simple abstracted metrics of "Level" or "Points", and that by way of presumably only the Benefits coordination aspects of corporate HR.

Though there are still questions of how strong the firewall is in cases where the Wellness programs and Insurance providers share parent companies or even just C-Suite members. Arguably, the separation allows corporate plan buyers to pick and choose Insurance and Wellness program separately, allowing for some competition between them on things like privacy. Yet, being employer-driven "benefits" first and foremost, it's hard to say how much the end consumer/user/employer's privacy is always prioritized, as it is an indirect need of the market.

(Also, every employer I've seen the Wellness program didn't define HSA contributions but rather "discounts" on Insurance premiums, which does seem to indicate that Insurance companies are probably using the Wellness program for risk pools, even with what little data they supposedly are being fed across the firewalls.)


The real issue is how this is implemented. Will they just require that you wear the watch (and act on the data when it shows you have an issue), or share all the health data collected with the insurer?


I can see a future where Apple charges your doctor 30% of her fees for access to the heart data in their walled garden


It's already happening. Some insurers are giving lower rates to people who wear this stuff and allows the insurer to see the data for better pricing premiums for each individual. I also had purchased stock in a small cap company that makes tech to allow telemedicine to be possible.


Like with any medical test: if you do more tests you will find more incidence.

The same thing happened with various forms of cancer screening. If we were to test everybody for everything very few people would be found to be 100% and a lot of unnecessary procedures would be the result.

Given the obesity problem this result should not be a surprising finding anyway.


Ok, so what? Shouldn’t we be cheering the fact that a consumer device can potentially detect this without ever requiring a much costlier visit to the ER or doctors office?

My Apple Watch was a few hundred bucks. My latest ER visit for tachycardia (idle heart rate over 100) came to over $3000, with health insurance. And all they did was tests.


I can't fathom how anyone would pay this.

For less than three grand, you could fly to Europe for a weekend, stay in a five star hotel, and have all the tests done while you're there.


An acquaintance did this for knee surgery, I believe, to Spain. It was cheaper, and pintxos are much better recovery food than hospital jello.


I'm kind of surprised no insurance company has started offering medical tourism yet... go to US hospital for this treatment or get a holiday and treatment in one of these destinations.

(edit: I'm not in the US so no idea what is typical outside the stories I see in the media)


Not really an option in this case. When you feel like you’re having a heart attack you don’t go to the airport for a European trip :)

That $3k out-of-pocket cost was ECG, blood tests, urine tests, chest x-rays and talking to a doctor for 5 minutes. I wish I was kidding. Healthcare in America is an abomination.

I should, add, too, that the $3k cost was because I had insurance. The total bill came out to around $23,000 and I would have had to pay that if I didn't have insurance.

Seeing a cardiologist is a totally separate visit/bill.


I understand, and I in no way mean to trivialise what emergency patients go through. But in many cases, for many people, otherwise expensive medical procedures can be planned.


Yep, definitely. I tell everyone I know about it as a possibility if they are facing it, as insane as it feels to even make that proposal within the borders of the richest country in the world, that spends more on healthcare than any other nation (almost 20% of our GDP). It's shameful.


If your insurance pays for it, you probably wouldn't.


My insurance didn’t pay the $3k, that was my out of pocket cost. And higher deductible plans are on the rise in America.

Medical tourism might become a more common thing.


That can't be true, if you're not a citizen of a certain country, you don't get subsidies for its services.


It is true, because people do it all the time.

Medical tourism is a thing that people do. All the time.

You can pay top private clinics for medical services, and it can cost far less than the equivalent would cost in the US, even after insurance.


It’s more that private clinics in Europe are i) competing with free and ii) don’t have the same incentives to have crazy out of pocket prices which insurance companies negotiate down. So just turning up and paying for private care is a lot cheaper.


Are you advocating that we shouldn't bother testing instead? I'd imagine that many people would be quite interested in knowing the ways they're not 100% that might actually kill them... like cancer.


It's a question of false positives and false negatives. Most medical tests have a decent percentage of both.

> Screening test results may appear to be abnormal even though no cancer is present. A false-positive test result (one that shows there is cancer when there really isn't) can cause anxiety and is usually followed by more tests (such as biopsy), which also have risks. [1]

[1] https://www.cancer.gov/types/colorectal/patient/colorectal-s...


It's complicated... Not all instances of cancer are harmful, more men die with prostate cancer then die because of of it and thyroid cancer is found as an incidental in ~30% of autopsies. More detection can cause more harm than good, as what happened in South Korea with thyroid cancer screening, a huge increase in detection and treatment without any decrease in survival rates.

Here's a good overview:

https://sciencebasedmedicine.org/a-skeptical-look-at-screeni...

Info about thyroid cancer over diagnosis:

https://www.npr.org/sections/health-shots/2017/05/09/5275692...


Under-rated opinion - if you're not feeling ill, there's probably no reason to perform any medical diagnostics. If you're wearing a medical diagnostic bracelet, and it tells you that you have some issue, you might end up getting more anxcious and stressed (which can cause real harm), despite the fact that there's nothing "wrong" really.


There's evidence that the following are beneficial on an asymptomatic population level:

Obesity screening

Blood pressure screening

Cervical cancer screening (pap test) though most medical providers test at the wrong intervals.


If you simply go looking, you'll find a lot of abnormalities associated with various conditions that turn out to be false positives and, for that person, fairly normal.

Here's a piece on the subject; http://www.journalgazette.net/features/20180604/anomalies-in...


Nothing specific to this article, but this comes up often in medicine. Sure, you can pay to run more tests, find some things earlier (along with some false positives), but the outcomes and treatment aren't any different than if you waited for more obvious symptoms and could take a more accurate test.


What? An ounce of prevention and a pound of cure and all that. Early detection is key in a lot of situations, so how could earlier not be better? Why wait unnecessarily?


The cure may statistically be worse than doing nothing.

For example, prostate cancer can kill, but more people die with prostate cancer than of prostate cancer, in the latter case often with minor symptoms.

Detecting it before it bothers people helps those it would kill, but subjects lots of others to testing, and those tests will initially have false positives that unnecessarily stress those it wouldn’t kill.

Worse, the side effects of treatment can include incontinence and erectile dysfunction that can significantly affect quality of life for those were follow-up tests also produce false positives.

Thats’s why there is discussion on whether screening for prostate cancer makes sense, and if so, for whom. See for example https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD....


So don't ignore symptoms, but don't go looking for them if you're otherwise healthy. Early detection of many things is important... but you don't want everyone getting screened for every disease. You'll just end up with a bunch of false positives, which will cause emotional stress and backup an already overworked medical system.

By all means, don't ignore symptoms! Just don't go looking for them.


Just imagine all the stress and suffering caused by the misdiagnosis and unnecessary visits to the doctor and unnecessary tests and imagine that on a grand scale (to say nothing of wasted resources).

I’m not saying that to automatically disqualify and increase in the availability of testing – but it does have to be implemented with the proper care and caution.


That is precisely the beauty of something like an Apple Watch. Everybody can be screened without wasting resources and the device can alert if it is really something that needs a specialist. Of course, we are on the early stages of something like that and the devices are not really capable of diagnosing on their own, thus you end up with a spike in consultations. But given some time it should be way more accurate and helpful.


It's entirely possible that a test which was net positive when applied "with probable cause", can even become a net negative if applied without. Because testing the whole population will produce many more false positives.

I doubt the tests they are running here will actually go that far. But pervasive testing does need different trade-offs to targeted testing. At least we may have more complete data from which to understand this.


> Because testing the whole population will produce many more false positives.

That is the issue that should get resolved with time. The watch will receive a lot of feedback from medical professionals to adjust its reporting because now we'll know so much more about what symptoms are really worth paying attention. But of course, there will be an adjustment period like what we are seeing now. This has always been true of new technologies introduced in medicine.


> That is the issue that should get resolved with time.

Bear in mind that this hasn't happened for the other major overdiagnosis issue (cancer screening), and the best solution found so far there is to screen less. This really isn't the sort of thing where natural technological progress is enough to be comfortable saying things like "it'll get resolved with time". There are already counterexamples to what you're saying, it's not a matter of an "adjustment period".


If I understand right, one of the problems in the case of cancer is that we don't have great data about the people without symptoms who wider screening would catch. Once we catch them, we treat them, and many recover. But to say how many of those would have been fine anyway, we'd have to know more about the un-screened rest of the population.

The hope with widespread cheap screening would be that it might avoid this. If heart-rate smartwatches become as common as smartphones, we could train our treatment model on everyone, and do better. Or at least this sounds mathematically plausible to me (not an expert).

Whether it will come to pass, or whether doctors will continue to treat as now (anything which an eyeball test says looks like an early stage of a known disease) I don't know.


Not when everyone is wearing one of these watches. That's the point behind one of the parent comments. The traditional way of looking at medical screening is that you only go looking for something if there is a rationale.

So, for a heart monitor, you'd only have the test run if you had another symptom, such as shortness of breath, an irregular heart beat, etc... Otherwise, you will end up with many more false positives, which can be dangerous in and of itself. What if someone who legitimately has a heart condition had an Apple watch and ran the test. But what if that person then ignored the watch because all of their friends tried the same thing, and went to the doctor only to find out it wasn't anything to worry about. Their false positives could have a real impact on someone who had a true positive result.

The more you test, the more you'll find. Now, it's perfectly possible that many of the subjects in this study bought the watch specifically because they suspected that they had a heart condition. In which case, the study pool could be skewed away from the general population.

There is no way to adjust for this. The more people you screen, the more you'll find. Whether or not it's a true positive or false positive is another question. And I'd argue that Apple would need to skew their reporting towards removing false negatives instead of removing false positives, just from a liability point of view. You're much more likely to see Apple sued over this than a typical medical device manufacturer.


When the ratio of true to false positives is at greater than 5:1, it's hard to imagine the false positives causing net harm.


Where do you get 5:1? Maybe I don't know enough about heart disease but the numbers in the article seem pretty hard to parse.

It sounds like many of those who got a bleep from their iWatch subsequently had some effect detected by standard tests. But that isn't the right number. We don't necessarily know that we should treat everyone who fails standard tests. Especially if our previous knowledge about such tests was limited to patients where there was other evidence.


> Where do you get 5:1?

At least 84% of the positives were correct.

> It sounds like many of those who got a bleep from their iWatch subsequently had some effect detected by standard tests. But that isn't the right number. We don't necessarily know that we should treat everyone who fails standard tests. Especially if our previous knowledge about such tests was limited to patients where there was other evidence.

I agree, but there is a very important distinction to make here. When we don't know what to do with the results of a test, it can be wasteful and negative even when the results of the test are completely accurate.

That is the much bigger risk here. That the true positives are a waste of time and net negative all by themselves. They have the real potential for issues here, not the false positives.

Because the true positives outweigh the false positives by so much, for there to be net harm because of false positives, each one would have to do more damage than the effect of five true positives. I doubt that's the case. I'm pretty confident that either the test is an overall good thing, or the test is a bad thing because of true positives.


OK, I think we're fully in agreement here, modulo terminology. You are using "true positive" to mean that the watch correctly predicted a positive score on the medical test. And these are the people who may be treated, some of them unnecessarily.


Not just that it matches the medical test, I'm saying that the watch is objectively correct in detecting an irregular heartbeat. The problem is that we don't know what to do with that data, which is different from the test making a mistake.

There are other situations where it actually is a huge problem that the test makes a mistake some percent of the time. It's important to distinguish the two problems.


Given the choice between

A) Everyone is told nothing.

B) 5% of people are told “Here’s something. It’s serious.” And, 45% of people are told “Here’s something. But, it’s not serious.”

Option B sounds greatly preferable.


Depends... does "Here’s something. But, it’s not serious" take expensive, risky, and invasive medical tests to get to the "not serious" part?


Exactly -- for those 45% with the false positive, you will be doing emotional harm to many of them, even without an invasive followup test.

And then, if you knew that 45% of people got a false positive, how likely is the 5% (the true positives who really need it) going to believe their initial result and even get the followup?


EULA and UI should emphasize that this is not a sure thing, please see a doctor to be sure. Why would anyone get mad at that? My grandpa noticed my dad losing a ton of weight. He told my dad there might be something wrong with him, go check it out. Turns out it was cancer, saved my dad's life. Should my dad be upset at my grandpa for causing emotional stress if it was nothing?


Of course your dad shouldn’t be upset - your grand father did exactly what he should have done. When you notice a symptom like that, you get it checked out. (I’m happy for you and your dad, btw). The problem is when you have people getting checked out without any underlying symptoms.

When you have a ton of people getting their hearts checked because their watch told them to (and only for that reason), you’re going to get a lot of false positives. There are many reasons better explained in these comments for why that’s not a good thing.

One major reason is the extra stress on the medical system that can’t handle it. There has been much talk about medical genetics clinics having issues dealing with people calling in about 24 and me (etc) test results. It’s a major load for these clinics.

Now, an easy test like this — in the presence of other symptoms — is a great thing to have. I just worry about all the people getting needlessly checked out. But for those who already have a concern or family history, this type of test can be great.


Getting tests when you have symptoms is a completely and totally different topic than widescale testing of asymptomatic individuals without specific risk factors, which is what we are talking about here.


For now, I'd prefer option C) "Here's something. Go ask your doctor if it's serious."


> Like with any medical test: if you do more tests you will find more incidence.

I've heard this line parroted a lot but a robust Bayesian analysis should mitigate this.

Like by setting appropriate thresholds you should be able to either

* do the same amount of interventions with more of them being helpful

* maintain the rate of helpfulness but doing more procedurees.

or even a mix of the two. Testing all the things all the time on all the people would be a boon if we just did it correctly.


The magic here is that this is baked into an otherwise useful, relatively cheap non-medical device. That device (and this test) are also entirely self-service, and the cost for both is borne by the consumer, effectively elective.

Also: The heart beat monitoring features account for some portion of the Apple Watch's price, surely, but I suspect for most people this feels like a "free" benefit.


https://www.youtube.com/watch?v=s0sv3Kuurhw

Super underrated channel (British humor, anyone)--shows how the Apple Watch's ECG feature can be actually bad for overall health.

edit: though the amount of positive outcomes (the reddit thread) makes me reassess this...


Edit: reading further in the thread, this comment said it better than I did (though they aren't speaking about the video, it makes the same argument): https://news.ycombinator.com/item?id=19409734

> It should be noted though that this study does not say that an Apple Watch will overall provide medical benefits. It also doesn't follow automatically from the fact that it detects things with a certain reliability. The interactions of early detection and medical benefits and downsides are complicated and it will require a lot more science to figure out whether a device like an Apple Watch can provide benefit.

The only thing I would add is the last thing I mentioned in this comment, namely that you might consider buying one for a higher risk person like your grandpa rather than yourself.

--- (original comment) ---

Watched the whole thing, basically the argument is that overdiagnosis leads to people worrying (increasing stress) when the doctor says "based on this I can't give you drugs since the drugs aren't completely harmless", or the doc might recommend follow up tests that give ambiguous results and escalate (in the example) to an operation to test a certain thing where the patient has a 1 in 3k chance of dying from the procedure itself. Additionally, experiments where they strap a bunch of such devices to healthy patients (basically what apple's watch does as well, especially the young and modern people will buy it) and while it lead to more diagnoses, it didn't decrease the chance of stroke or heart attacks in that group.

I don't think any of this is a significant reason not to buy it. I'm not going to buy one for various reasons, but this isn't one of them. It is good to be aware of the arguments, though: it might lead to someone buying one for their grandma rather than healthy and young(ish) self.


I'd definitely buy this for my gramps or something like that, and I'd buy it myself if I had an iPhone, just because I like smartwatches.

But what I am concerned about is that this kind of stuff is a Pandora's box that can cause some undeserved panic...


Yeah, it's good at spotting issues... but man, health monitoring creeps me out.

I don't want to live in a world where insurance companies and employers force us to hand over this data.

Just feels really creepy to me. Like way over the line.


I don't want to live in a world where insurance companies or employers have any need or incentive to have this data. Like most developed nations outside the U.S. for example.


I'm from the US, but I live in a country with "national health care" and... look it sucks. You know what I miss? 1990s era health care for tech workers in the US. When you went in and everything was covered for a $20 co-pay.

You want a specific medication, or a non-generic medication in Australia? Too bad. It's not that it costs more, you just can't get it. Things like Wellbutrin are as illegal as crack. And if you do something like tell your doctor that you tried a bunch of medications and Vyvanse is what works best... they'll literally treat you like someone trying to score opiates. They don't like it when you have an opinion on medications, and you get all sorts of lectures about how bad drug advertising is. It's a very dated, "I'm the doctor, you have to do what I say..." mentality.

And the wait times... "Oh, did you need back surgery? Because you're under 65 and you are over weight, that means you're now bottom on the list... and you'll have to wait for 1-2 years to have this done." A co-worker of mine here is a larger woman, but she just paid out of pocket rather than go on a 2-year wait list. Oh, and the recovery room... there were like 4 people crammed in one room sharing one bathroom. Doctors came in and were talking about care and medical details, in front of total strangers and her visiting guests. No privacy at all. The government would absolutely use health / fitness data to prioritize care... it's not that everyone gets unlimited treatment, they still have budgets.

What else? Remember those classes in college where you couldn't understand the professor because he had such a thick accent? Yeah, that's pretty much every doctor here now. You go to the ER and you need stitches, you end up waiting for a few hours and when you're finally seen the doctor is like, "Why weren't you escalated faster?" "I couldn't understand what your triage nurse was saying, she doesn't speak English... and I haven't got a clue if she understood me... she just told me to sit and wait..." My friend needed 14 stitches and waited over 3 hours in the ER holding a bloody towel on her hand. Only got someone to do something when she started dripping blood on the floor after it had soaked through the towel.

Anyway I know health care sucks in the US, and I do want to get to a point where governments pick up the bill... but holy hell, if the choices at present are what we have in the US or what they have in Australia... man, they both really suck. If you're someone with a job, and with any money, the US model works slightly better.


That is most certainly not the experience I've had with nationalized health care in Europe. Sounds like an implementation problem more than anything.


thats kind of the issue though. If or when the implementation goes wrong you wont have any other options. In one case the UK's NHS even prevented parents from going abroad for treatments for their terminally ill child.

And there won't be any transparency because the people administering the system have all the power and don't like being embarrassed. Meanwhile then public schools and public broadcasts will bang the drum for that system on a daily basis making sure most citizens feel dependent on it, no matter how bad it really is.

And just to make it real, I personally know someone who was told to wait half a year for an appointment. They personally knew a doctor who told them "you can't wait that long, I am going to pull some strings". Turns out it was cancer. This is in Germany, btw, and it's not an isolated case.


Happy you've been happy.

I'll add another thing to my experience in Australia. As an immigrant, I'm not covered by national health care. Taxed at a higher rate, plus paying for a visa, and a small fortune if I apply for a PR... and they do nothing to cover me during this time period. Employers don't cover people here, so all I can get is private insurance.

But... private insurance doesn't really cover anything for a year after you pay for the tier you want. So you can get like just emergency coverage -- things like simple ER visits, but things like minor surgery, or anything they can deem is a "pre-existing" condition will take a least a year of paying premiums before you're eligible for benefits. Things like an appendicitis are not covered, there's a cap of like $5k or something on everything in the first year. Luckily I didn't need much coverage... but I'm the best plan I can find here, and if you get seriously ill the first year you're over here you're really just fucked. There's medical screening before your visa can be accepted, but they don't at all cover you if you get in trouble here.

An American friend needed hernia surgery, and he had to pay entirely out of pocket because his insurance wouldn't cover it. Health care... not like it's a regular service you can price compare when you need treatment. You just say, "Fix it!" and I think it cost him something like $18k to have the surgery. Mind you he had health insurance, but, again, it doesn't cover anything the first year you have it.

And it's next to impossible to get anything around mental health covered, even with the top tier private insurance here. Want to maintain your prescription of Adderall? Good luck finding a doctor here who will give you a script. It's all pretty shitty. On top of that... it's all a digitized system, where the government gets full access to your records. There's a question on the visa applications if you've ever seen a psychiatrist. The lawyers strongly caution you not to answer yes on it, as it supposedly makes it harder to get a visa approved... but since it's all data the state has access too... pretty hard to keep any of it a secret.

Anyway look, is the US perfect? No, and I've never been through immigration in the US. But the Australian system is pretty far from perfect. Take people, put them a billion miles away from their friend and family, and then penalize them for getting homesick and seeking mental health... that's insane. (=

I've ranted enough, but a lot of this strikes home for me. I've come to the other side of the world so I can score my long-term medication, medication that something like 10% of the people in the US are on, illegally from prep school kids. That's my experience with the Australian system.


Universal healthcare systems merely change the point of information demand based on who is responsible for the cost, from private companies to governments.

The notion that the authoritarian-creep and spy-on-everyone mentality that continues rapidly spreading in most developed nations, won't apply to this type of healthcare data, is obviously false. There is no entity that wants to track people more than governments (and in all possible regards), it's not even remotely close. It doesn't matter whether we're talking about the US, France, UK, Australia, South Korea, Japan or Germany.


You just invented this situation in your head.

No one is handing over health data to insurance companies or employers.


* Swiss Insurance Company Will Charge Higher Premiums For Lazy People | Popular Science || https://www.popsci.com/swiss-insurance-company-will-charge-h...


Yet.


Related https://cardio-cloud.ru

Dongle+app supports Android and iOS.

No prices on En page though, but the official price for the Russian market is 3500 RUB ~ $54



this is kind of a trivial question but is the apple watch HR monitor known to be better than that of FitBit? I got a Charge 3 for Christmas and I barely even wear it anymore, as it would say things like "95 bpm" when I'm working out and I'm clearly at around 135 bpm. you can say things like "oh wear it higher / lower / tighter" whatever but if it's that prone to being 40 bpm off the mark, what use is it.


In my experience, FitBit Charge HR 2 was useless. Same issue with you where it would 40 bpm off or provide no reading at all.

Apple Watch 3 was pretty bad too. It would give inaccurate often enough that I couldn't use it for training in a heart rate zone. For example, I'd be walking for warm up and it would give a reading of 160 at the beginning, then back down to 110, then 10 mins later back to 160. I can't imagine the Apple Watch being a medical device with lives depending on it.

Garmin 935 has been great. It has the most accurate HR and GPS readings.


this is the thing I wonder if the mechanism by which wrist-based HR monitors work (seems to be optical) is just not effective for some people, for some physiological reason.


An electrical engineering friend who did some hardware development work on these a few years back suggested that noise in the observations was a fairly significant challenge. Seems the devices use a lot of data smoothing to counteract this.


My cardiologist has looked at it when I'm hooked up to a full 12-lead EKG and has noted how pretty solid the measurements seem to be. If it's on a slightly looser setting, sometimes it initially catches only half the tempo for a second, but then locks in. This is on an Apple Watch 4.


my Apple Watch series 2 is quite accurate. I've hooked myself up to a cardiac monitor (I'm a paramedic, and sometimes do this as an equipment test anyway) and it was spot on.


My Apple 3 is dead on unless I'm very sweaty or wearing it loosely (it only needs to be snug). Confirmed with my BP monitor and my Garmin's chest strap (before I retired that system).

I'm a runner so it gets a bit upset when my resting heart rate gets below 50 but other than that ...


One-off comment, but the new band has really improved HR detection for me. I went from the rubber strap (with holes every centimeter or so) to the adjustable velcro strap and it's night & day. It went from being 100% useless on runs to _actually_ keeping accurate detection the entire run.


What do you mean by the velcro strap? Is it the "Sport loop" (https://store.storeimages.cdn-apple.com/4982/as-images.apple...)?


Exactly that.


Thanks for sharing. Just bought one :)


I haven’t had this experience. I can push my heart rate up to about 165 running uphill. Considering my age, that’s pretty close to what my maximum HR should be. Conversely, I can get it down to about 45 when sitting very still. Much lower and I’d be unconscious.

It’s possible yours was just faulty. Fitbit aren’t known for their quality control.


If anyone is interested, I’ve spent the last couple of years trying to break into the medical space from a consumer perspective. We are now ready to move to the next step and I’m looking for co-founder positions to fill important roles. Check out https://www.kb4e.com Would love to hear from you if our mission resonates with anyone.


In the future everyone will wear a smartwatch. My thesis was health and safety.

https://h4labs.wordpress.com/2015/07/28/in-the-future-everyo...


When tech companies are subject to the same level of data protection as health care providers, complete with with HIPAA penalties for failure, then I might trust them with medical data.


Would HIPAA not apply to tech companies when handling health data?


I don’t think so. HIPAA defines the “covered entities” — e.g. hospitals, health plans — that must follow its regulations. Being a company that handles health data does not automatically make you a covered entity.

https://www.hhs.gov/hipaa/for-professionals/faq/190/who-must...


This isn't 100% accurate. While I can't say much about the case of the apple watch, I can say that there are a ton of tech companies which are not covered entities but which do fall under HIPAA guidelines.

For example, the company I work at is not a covered entity because we do have access to PHI we have certain regulations we have to follow. Further, we have to sign BAAs with any covered entity we work with defining who is responsible for what.

Any company which deals with heathcare information should always assume they fall under HIPAA until they've hired lawyers who tell them otherwise.


If you are signing BAAs, you're probably a service provider for a covered entity and are contractually obligated to follow HIPAA. Which is different than what the original question was.

For example, what is Apple's exposure here? I doubt any... they keep your data private because it's good for business (and they can then advertise how privacy conscience they are and get people to buy more watches). They aren't doing it because they have to follow HIPAA regulations.

A more interesting question is -- if the Apple watch was purchased as a medical device (maybe even with insurance or a prescription), does Apple's data processing need to change at all? What about if people got a watch as part of a medical study (not people that already had the watch). Would that be different?


Do the examples you have in mind work with data that originates with HIPAA covered entities? That, and/or doing work on behalf of a CE would likely be a situation in which you’d have to comply: https://www.techhealthperspectives.com/2012/09/25/when-does-...

In a future where smartwatch companies integrate with a health plan/hospital’s medical records system, I would expect HIPAA to cover them. But in a case where a company is generating the data (via user consent/input), it might not be the case.


This is a common misconception and comes up a lot.

Rule of thumb is if it's not an insurance company or medical facility (hospital, doctor's office) HIPAA doesn't apply.


There are problems with HIPPA for sure. In fact I trust my doctor's patient portal less than most things I log into.


I was at a medical conference recently (within the last year) and there was an entire talk explaining to people that they couldn't send healthcare records or pictures over snapchat.

HIPAA is great- enforcement of it is not.


No they won’t.

The market for luxury watches is growing every year and despite the arrival of different technologies e.g. Quartz, Digital they are still around. I actually think this will be an emerging market as people start to revolt against technology being everywhere.

And for me smart watches are on whole detrimental to a person’s health since they raise stress levels through constant notifications.


I’ve turned off all notifications on my watch other than texts and phone calls - it’s nice to be able to walk outside without my phone, but still can call someone if we lose each other.


I don't have a smart watch, so I assumed it connects to your phone via Bluetooth. Is that not the case? Otherwise how can you leave the house without your phone also?


Several watches, including Apple Watch, have a version with built-in LTE. I use it all the time and leave my phone at home. Kinda liberating, actually.


The series 3 have cellular modems and virtual SIMs.


It's funny how a complex and intricate technology of mechanical watches ceases to be seen as technology in 300 years.


Hopefully in the future they’ll be slimmer, cheaper, and last more than a day without recharging.


If there are any MDs around, I'd be curious to know if there's some kind of data-driven baseline about there being a regular heart beat to begin with, or if there being one is an underlying assumption that's taken for granted.

(Either way, kudos to Apple for contributing to health science.)


Med Student here so I know just about nothing...

We’ve monitored hearts for a long time. It is common for a heart to skip a beat or maybe double a beat occasionally (a stethoscope on your own heart for 30 mins would demonstrate that).

I don’t think Atrial Fibrillation is ever a normal sign.


I really like the humble attitude. When I was studying CS I was like "let me through, I know everything" (I don't). Good for you and thanks for the info.


i would like this in a watch that doesnt need charging every week. i dont care for touchscreens and games.


You may be interested in a Garmin smartwatch then. They are primarily designed for exercise, so have very good optical-based wrist heart rate sensors, and are designed to minimise battery usage - I can easily get a week and more out of mine (a Garmin Fenix 5), even whilst making heavy use of its GPS and other functionality.


It really depends on if you sleep with your watch or not.

If you don’t then battery life is really irrelevant because you can rest your watch on a pad and have it charge just like if it were a normal watch.


Although, this can matter if you are separated from a place to charge your watch, or somehow forget to charge it.


I use an Amazfit BiP which does steps+ heart rate + sleep and lasts a month on battery. Would highly recommend to you.


Withings are about to introduce something with this capability.


I have a watch with also an irregular heart beat detection (Garmin). It sometimes detects irregular heart rates when I play video games. Usually in a very intense scenario such as a top 3 in a battle royale game.


A lot of people are overlooking the ultimate consumers of this data or being the usual SV shills. This data and all PHI/PII can be resold to insurance packaged in slightly different ways. Have fun with your 20th century issues in the 21st.


While I think your fear is an important one to keep in mind, Apple doesn't share your data without your consent, and the data is encrypted.

https://www.apple.com/privacy/approach-to-privacy/


It's always seemed to me like accurate risk profiling is a positive thing. We don't mind that smokers pay higher rates, for example. After all their projected medical costs are more than double. Otherwise, nonsmokers would be forced to subsidize the choices of smokers.

Things like congenital issues should be protected (not a choice), but if someone leads an unhealthy lifestyle and actuaries can work out a good expected cost, why not? Is that so different from a risky driver?


Meanwhile WearOS is a joke both in hardware and software


I am pretty happy with mine (Fossil Sport). Lasts about 2 days on a charge while the display is always on, has all the sensors and most important, I can run my own software on it.


I understand qualms with the software, but what about the hardware is a joke?


The Qualcomm chips used are a few years old because there isn’t enough demand for Qualcomm to make faster ones.

So it’s WAY behind the chip in Apple watches in terms of performance.

Even if wear OS was better (never used it myself) it couldn’t compete.


This is pretty much true. Google doesn't seem to particularly care about Wear OS, Qualcomm can't make a decent chip for it, and manufactures aren't coming out with anything compelling. With wearables, it really does seem like it's mostly Apple Watch along with Fitbit, Garmin, and a few others.


Pretty cool. Although its early days yet. I still worry about back doors that would allow the watch to be used as a lie detector surreptitiously.


I'm more concerned with the data being sold/ leaked and it impacting insurance premiums.


When has Apple ever sold or leaked data to third parties ?


Not sure - never to my knowledge. I'm still allowed to be worried. This issue is also not really apple specific - Android has health monitoring features, and I trust OEMs a lot less.

I'm not stating that this has happened, but yeah, I worry.


Aren't lie detectors junk science?


Only if you think their purpose is to detect lies.


In the same way statistical spam filters are junk† science. They suffer from false positives/negatives issues, but they perform a lot better than coin toss.

† Granted spam filters literally deal with junk..


Not arguing either or but a coin toss is a very low bar.


>but they perform a lot better than coin toss

I'm curious how that was tested. And if there is a source for this.


They're based on the idea that if you're made to tell a lie, your body will react in some way (sweating, faster heartbeat etc) compared to a baseline measurement. There is a whole field of psychology around lying and additionally agents are ostensibly trained to detect visual cues that someone is telling a lie.

The premise isn't exactly junk - hardware lie detectors are basically trying to identify a fight or flight reaction, which some people will exhibit when lying. Have you ever been confronted with a fact (did you eat that cookie?), lied, and felt a rush or a feeling of panic? That's what lie detectors try to detect.

The problem is it's possible to fool a polygraph and it's prone to bias. For example some people get nervous when asked a question, even if innocent. It's theatre in some sense, and it shouldn't be assumed as 100% accurate, but there are plenty of people who will break out into a cold sweat when you ask them a question they don't want to answer truthfully.


It's borderline useless. And can do lots of harm if assumed that it's useful.


I wouldn't disagree with that. And a big problem is that innocent people tend to produce stress reactions when interrogated, leading to false positives. It would be appropriate to call a polygraph a "fear" detector, since that's basically what it's measuring. But still, the "science" isn't entirely bunk: some people do panic when they lie - though I read an anecdote that said this is a weirdly American trait (Europeans can cheat the polygraph more easily) - but it's virtually impossible to sift out the true positives from the noise.


It is not 'junk' as long as Federal Agencies use it!!


Public Service Announcement: You can just check your pulse manually for free. AFIB will be irregularly irregular.

As as comparing cancer to AFIB it's definitely not accurate to compare the two directly. A very common cause of AFIB in people younger than 60 for example is 'holiday heart' short-term AFIB related to binge drinking, it is generally self-resolving and transitory, and generally does not require treatment especially if asymptomatic. Cancer to my knowledge generally does not self-resolve.


I have AF and once you're aware of it it's pretty easy to tell when your heart's "gone out". Quick check of pulse confirms it as you say.

The trouble is really when you're first getting to grips with it. That's the scary time.

Everyone's AF is somewhat different though I imagine.


Thanks, apparently this has been one of my less popular comments. I saw quite a few people in the comments before i posted asking if their charge/apple/whatever monitor was accurate and it's likely better to manually check heart rate to see if it's accurate, as opposed to going off random internet data on whether a device is trustworthy.

Monitors tend to be potentially less accurate than manual apical pulse when there is an arrhythmia present, the gold standard for any cardiac is auscultation, aka stethoscope, for a full minute by trained professional.

Medicine is really complex is the short version. Also Sinus Arrythmia is not uncommon.


Actually most cancers do self-resolve in that your immune system kills them before they get large. This is one of the reasons being on immune suppression drugs leads to a significantly higher risk of developing cancer that gets large enough to be detected.


Yeah I should change the wording above to established cancer, thanks.


> Public Service Announcement: You can just check your pulse manually for free.

Not continuously throughout the day, you can't.


60 Beats Per Minute feels a lot different than 100 BPM, which feels different than 140+ BPM. Once you get a feeling for how different BPM's feel to you if you have an abnormal elevation, like rapid heart rate at rest that would be an indication to manually check your pulse.

I'm just trying to say if you want to buy one that's cool but the premise that's it some kind of must-have life-saving accessory is questionable to me for the majority of people.


Waiting for insurance providers to deny payments basis this data next.


I just want this kind of thing to finally hit consumer devices. I've been reading about this stuff for years now, and it's really great stuff, but it's all limited to the people who get to be in these studies.


So the Watch is no consumer device?


It's an iPhone accessory, not really a consumer product. It can't be used outside of the apple ecosystem without involving an iphone in the process and that stops it from being a widely adopted wearable product. Apple's marketshare is dropping with every yeah and they sell only roughly double the previous smartwatch incumbent, samsung despite apple having a generally more affluent userbase.

I hope this tech reaches more people with less restrictive hardware options.


When ECG in Canada?


Seems Apple is having problems getting the ECG feature approved outside the US. I've heard nothing for a few months from the EU about this passing over this side of the pond.


Yeah. My wife is actually looking to buy one(here in UK) but when we discovered in an Apple Store that it doesn't have ECG support we decided to hold off for now. Maybe at some point once it's enabled.


If they’re going to announce more countries I would expect it at WWDC.


Does it display systolic and diastolic numbers?


I stopped reading at "funded by Apple Inc."


Most medical studies are not publicly funded[1]. You just dismissed the majority of medical research done in the U.S. in at least the last ten years. There are potential problems with private funding compromising studies but without any specific complaint this is just a baseless dismissal.

1. https://hub.jhu.edu/2015/12/15/industry-funded-clinical-tria...


Plus, this study had 400k people in it. This isn’t exactly a small “well we tried it on 20 people” study, it’s much higher quality.


Do you think Apple and Stanford have a reason to falsify their results? Is it a sane, credible reason, based on actual history of those organizations falsifying medical research? Or, is it just an opposition related to malfunctioning tin-foil headgear? Is Stanford not a credible enough institution?


> Do you think Apple and Stanford have a reason to falsify their results?

Of course they do. It's just that if they did, there would likely be huge consequences for them, which makes one hope that they didn't do so in this case.


I don’t understand, even Reuters is giving random numbers:

A third of those whose watches detected an irregular pulse were confirmed to have atrial fibrillation using the ECG technology, researchers said.

Some 84 percent of the irregular pulse notifications were later confirmed to have been AF episodes, data showed.

What is it then, 1/3 or 4/5?


The ECG only confirmed 1/3, so they tried better tests and got it to 5/6.


Apple Watch is technically capable of detecting your heart rate. NSA is capable of enforcing Apple to feed this data to them, real time if needed. Never wear an Apple Watch during lying to powerful people, your heart rate will give you away.


That would be overkill considering they can extract your heart rate in real time from a video.


How is this possible? Honest question, I've never heard of this before.


This video from 2013 references to possible methods: imperceptible changes in skin color and imperceptible movement of the head. https://youtu.be/EhZXDgG9oSk


https://web.stanford.edu/class/cs231a/prev_projects_2016/fin... https://www.forbes.com/sites/robertglatter/2018/01/30/novel-...

Essentially, using appropriate image analysis, they can sense the pulse of blood moving through the skin


Skin color change or head motion:

https://www.youtube.com/watch?v=EhZXDgG9oSk


The other comments provided the academic sources, but the Cardiio app on my iPhone accurately takes my heart rate from my face with the selfie camera and that was released in 2012 I think.





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