為什麼醫生對穿戴裝置持謹慎態度？

Wearable technology, especially smart rings and watches, is becoming increasingly popular for tracking health. These devices can monitor various health metrics, including heart rate, sleep patterns, and body temperature. The wearable tech industry is worth billions of dollars and is focused on helping people manage their health. Recently, the Health Secretary in England proposed a plan to allow millions of NHS patients to use wearables to track their health from home, particularly to monitor symptoms related to cancer treatments. However, many doctors and tech experts are cautious about the reliability of the data collected by these devices. I personally tried a smart ring from a company called Ultrahuman, and it alerted me that I might be getting sick before I even realized it. It indicated that my temperature was slightly elevated and that my sleep was restless. I dismissed the warning, thinking it was related to perimenopause, but two days later, I was bedridden with gastric flu. This experience made me wonder if the data from my wearable could have been useful to healthcare professionals if I had needed medical assistance. Some wearable brands, like Oura, allow users to download their health data in a report format to share with their doctors. Dr. Jake Deutsch, a clinician in the US who advises Oura, believes that wearable data can help him assess a patient's overall health more accurately. However, not all doctors share this view. Dr. Helen Salisbury, a general practitioner in Oxford, has noticed an increase in patients bringing their wearables to appointments, which concerns her. She believes that while there are instances when the data is helpful, there are likely more occasions when it is not. Dr. Salisbury worries that society is becoming overly focused on monitoring health, leading to unnecessary anxiety and hypochondria. She points out that many factors can cause temporary abnormal data, such as an increased heart rate, which may not require further investigation. She fears that people will start to visit their doctors every time their device indicates a problem, rather than when they genuinely feel unwell. Additionally, Dr. Salisbury raises a valid point about the psychological impact of using wearable data as a safety net against unexpected health issues. Serious conditions, like cancer, may not be detected by a smartwatch or app. While wearables can promote healthy habits, the fundamental advice for maintaining good health remains unchanged: exercise regularly, limit alcohol consumption, and maintain a healthy weight. The Apple Watch is known to be the best-selling smartwatch globally, although its sales have recently slowed. Apple has not commented on this trend, but the company often shares stories of individuals whose lives were saved due to the heart tracking feature in their marketing campaigns. Anecdotal evidence suggests that many people have benefited from these features, but there is little information on how often wearables produce false positives. When patients present their data to healthcare professionals, many clinicians prefer to verify the information using their own equipment rather than relying solely on the wearable's data. Dr. Yang Wei, an associate professor in wearable technologies at Nottingham Trent University, explains that there are practical reasons for this preference. In a hospital setting, machines can be plugged in and do not have to worry about battery life, while wearables must conserve power. Additionally, movement—both of the device and the person wearing it—can introduce noise into the data collected, making it less reliable. Dr. Wei emphasizes that the most accurate way to measure heart rate is directly from the wrist or heart, rather than from the finger, which sacrifices accuracy. Software is intended to fill in data gaps, but there is currently no international standard for wearables, including the sensors and software that power these devices. The more consistently a device is worn, the more accurate its data is likely to be. However, there are cautionary tales regarding false alarms. For instance, Ben Wood received alarming notifications from his Apple Watch indicating that he had been in a car crash, but he was actually at a racetrack driving fast cars. He felt safe and was not in any danger. In a blog post, he expressed the need for careful management of the boundaries between incidents and alerts. Pritesh Mistry, a digital technologies fellow at the Kings Fund, agrees that there are significant challenges in integrating patient-generated data into healthcare systems. He notes that discussions about this topic have been ongoing in the UK for several years without a clear resolution. Mistry believes there is a strong case for using wearables in the UK government's efforts to shift care from hospitals to community settings. However, he warns that without a solid technological foundation and a workforce equipped with the necessary skills and knowledge, it will be challenging to implement these changes effectively.