Study on the Suitability of Activity Trackers in Health Care

19 August 2016

The health and fitness market is being flooded with activity trackers. These wristbands and smartwatches were developed to monitor physical activity, but some also offer other great features in addition to fantastic and functional design. Which of these trackers are reliable enough for use in the healthcare sector? I'm currently busy researching this topic and will tell you a bit more about it in this blog post.

The health and fitness market is being flooded with activity trackers. These wristbands and smartwatches were developed to monitor physical activity, but some also offer other great features in addition to fantastic and functional design. Which of these trackers are reliable enough for use in the healthcare sector? I'm currently busy researching this topic and will tell you a bit more about it in this blog post. ''Tracking physical activity doesn't sound sexy, does it?"

Well, that's not necessarily true and I'll explain why. These values can actually tell tell us a lot; the trick is choosing the right one.

What Makes Activity Tracking So Interesting?

By now, most people know that physical activity plays an important role in preventing and treating many chronic diseases. In addition, health care providers are increasingly using the degree of a patient's physical activity as a guide for improving or personalizing patient treatment plans.

In my opinion, activity tracking has two important functions:

  1. Identifying deterioration;
  2. Providing patients with feedback and encouraging them to achieve certain activity goals.

Allow me to illustrate: If a COPD patient is unable to walk for three days due to shortness of breath, this inactivity could indicate an exacerbation of their condition. And of course that's something you want to avoid! 

To give you another example, a heart patient agreed to take 8,000 steps a day and is exceeding this goal regularly thanks to notifications on her smartwatch.

"Tracking physical activity makes it easier to interpret other vital signs"Monitoring someone's physical activity also makes it easier to interpret other vital signs, as it provides more contextual information. One of my my first blogs included an example of a patient who was alerted to his rapid heart rate and breathing. At the time of the alert, however, this patient was vacuuming the house. Taken out of context, this system is of course doomed to fail! But if the patient's increased activity had been taken into consideration, it would have been clear that the baseline values for an alert had not been exceeded.

Me with the activity trackers.

Incorporating Physical Activity Into Daily Care

The University Medical Center Utrecht recently launched a home monitoring program for patients with hard-to-treat hypertension. The health care providers wanted to monitor the amount of physical activity this patient population gets. "We regularly see a discrepancy between the amount of physical activity patients claim they get on the questionnaires and how many steps they actually take based on their activity trackers."

So what's the best treatment option for patients and what's the best way to provide feedback? In this case, there's no easy answer.

"Simply linking an activity tracker to a phone or tablet isn't enough"How can we translate the needs of different health care providers into concrete home monitoring solutions for patients? Simply linking an activity tracker to a phone or tablet isn't enough. What values do we want to monitor and what activity trackers do we want to use?

After all, we're not working with athletes interested in tracking their fitness, we're trying to bring about real changes in a patient's health care trajectory. To do so, it's extremely important to determine the reliability of the activity trackers available to consumers.

Scientific Research on Activity Trackers

That's why I'm currently working on what is called a validation study. As part of this study, I'm researching different activity trackers and comparing them to a proven reference standard. This will help me determine the reliability of the devices.

During this study, thirty healthy participants simultaneously wear five activity trackers for three days. At the time of writing, participants 13, 14, and 15 are currently tracking their activity! 

My colleague Pim is also part of the study.

The activity trackers used in this study were chosen carefully. They all have to meet a checklist of criteria, such as a relevant CE marking or the option of linking the device to a platform.

But even this is no guarantee for success. In order to determine usability, I asked ten patients and ten health care providers to test the usability of these devices for one month, before the validation study began, and record their experiences. 

"We quickly got rid of the Misfit Flash"We quickly got rid of the Misfit Flash. One participant told us, "The attachment was so flimsy, I lost the device in the yard." 
And another said, "The band was ugly and cheap-looking and the device itself had an extremely short battery life." Those were certainly clear reasons for us to decide not to use this tracker.

Which Activity Trackers Provide Reliable Information?

The main question I hoped to answer was whether the number of daily steps corresponded to the reference standard. But with that in mind, the number of steps doesn't tell us everything because it doesn't give us an accurate impression of someone's daily activities. For example, these devices don't track swimming or biking, despite these being healthy activities according to the norm! 

That's why I'd also like to track the number of minutes participants are engaged in moderate to intense physical activity. Unfortunately, this is a little trickier for most of the consumer devices on the market today. We therefore plan to research this for some of the activity trackers in our validation study.

Bags with the activity trackers for the test subjects.

Waiting for Results

While the results of this study cannot be directly applied to a specific patient population, they will give us an idea of which consumer activity trackers are reliable enough to use and test on patients.

I'm extremely interested to find out which activity tracker comes out on top. So clearly, there's nothing boring about monitoring patient activity levels.

Are you interested in hearing about the initial results of this validation study? We plan to round things off in the months to come and analyze the initial results to determine which activity tracker scores the highest. I'll keep you posted!