Physician viewpoint: Apple Watch's use as AFib detector needs more study

Andrea Park - Print  | 

Though a recent study suggested the Apple Watch is capable of acting as a medical device by effectively detecting irregular heartbeats, the study is not nearly comprehensive enough, according to Aaron Carroll, MD, a professor of pediatrics at Indiana University School of Medicine.

Dr. Carroll pushed back on the claims of the Apple Heart Study, which was conducted in tandem with Stanford (Calif.) Medicine, in a recent article for The New York Times. Though the researchers concluded the smartwatch has a "positive predictive value" of 84 percent for an atrial fibrillation diagnosis, Dr. Carroll noted that the value was based on just 72 participants in the study who received an irregular pulse notification from the device and were ultimately diagnosed with the heart condition.

These topline results do not factor in the nearly 2,000 participants who received irregular pulse notifications and ignored them. According to the study, more than 2,100 participants received the notifications, but only 450 submitted their sensor patches for evaluation. Furthermore, only 86 received notifications while wearing a confirmatory patch, which is the sample size used to determine the aforementioned positive predictive value.

"This doesn't mean that the Apple device failed. It probably led some participants to be diagnosed sooner than they might have," Dr. Carroll wrote. "How many, and how much of a difference this made in their health, though, is debatable."

Many experts have concluded that regular electrocardiogram screenings for all patients at risk of atrial fibrillation are not recommended and could potentially result in false positives, misdiagnosis and unnecessary further testing. Additionally, while interventions are most recommended for older patients, they are less likely to utilize wearable devices like the Apple Watch.

"There are positive messages from this study. There's potential to use commercial devices to monitor and assess people outside of the clinical setting, and there's clearly an appetite for it as well," Dr. Carroll concluded. "But for now, and based on these results, while there may be reasons to own an Apple Watch, using it as a widespread screen for atrial fibrillation probably isn't one."

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