The Apple Watch Heart Monitor Sends Too Many People To the Doctor 43
The heart monitoring feature on the Apple Watch may lead to unnecessary health care visits, according to a new study published this week. The Verge reports: Only around 10 percent of people who saw a doctor at the Mayo Clinic after noticing an abnormal pulse reading on their watch were eventually diagnosed with a cardiac condition. The finding shows that at-home health monitoring devices can lead to over-utilization of the health care system, said study author Heather Heaton, an assistant professor of emergency medicine at the Mayo Clinic College of Medicine, in an email to The Verge. That may be expensive for patients and for the system as a whole, and it may take up doctor and patient time unnecessarily.
Heaton and the study team scanned patient health records at every Mayo Clinic site, including offices in Arizona, Florida, Wisconsin, and Iowa, for mentions of the term "Apple Watch" over a six-month period from December 2018 to April 2019. The window came just after Apple introduced a feature to detect abnormal heart rhythms and after publication of a study tracking how well the watches could detect atrial fibrillation. They found records of 264 patients who said their Apple Watches flagged a concerning heart rhythm. Of that group, 41 explicitly mentioned getting an alert from their watch (others may have had an alert, but it wasn't mentioned specifically in their health record). Half of the patients already had a cardiac diagnosis, including 58 who'd been previously diagnosed with atrial fibrillation. About two-thirds had symptoms, including lightheadedness or chest pain. Only 30 patients in the study got a cardiac diagnosis after their doctors visit. Most of the concerning heart monitor data, then, were probably false positives, the study concluded.
Heaton and the study team scanned patient health records at every Mayo Clinic site, including offices in Arizona, Florida, Wisconsin, and Iowa, for mentions of the term "Apple Watch" over a six-month period from December 2018 to April 2019. The window came just after Apple introduced a feature to detect abnormal heart rhythms and after publication of a study tracking how well the watches could detect atrial fibrillation. They found records of 264 patients who said their Apple Watches flagged a concerning heart rhythm. Of that group, 41 explicitly mentioned getting an alert from their watch (others may have had an alert, but it wasn't mentioned specifically in their health record). Half of the patients already had a cardiac diagnosis, including 58 who'd been previously diagnosed with atrial fibrillation. About two-thirds had symptoms, including lightheadedness or chest pain. Only 30 patients in the study got a cardiac diagnosis after their doctors visit. Most of the concerning heart monitor data, then, were probably false positives, the study concluded.
Hey wait a second (Score:1)
Did Trump have one?
Re: (Score:2)
Probably not, but he would be surrounded by hi-tech medical equipment and personnel trained to use them correctly.
Failing that, he has a helicopter on stand-by.
Would be nice if everyone had those.
Not Bad (Score:5, Insightful)
10% is significant. It sounds fairly successful to me.
Re: Not Bad (Score:2)
Re: (Score:2)
10% is significant. It sounds fairly successful to me.
If a 90% false positive rate is success, at what point does the watch become a failure? With similar thinking, a 99% false positive rate could also be considered to be successful. Also consider that this 90% false positive rate is likely a low estimate, since some non-zero number of people received alarms from their watch and ignored them without going to the doctor.
And the huge unknown is what the false negative rate is. For a 90% false positive rate to be considered anywhere close to successful, the fa
Re:Not Bad (Score:4, Insightful)
If these patients are using their apple watch in addition to anything else (or nothing) that they would have been doing anyway... Then these 10% of people are people who wouldn't have been diagnosed at all otherwise.
A false negative simply results in the condition not being detected, which is the same result that not using an apple watch at all would generate.
Generally with a medical problem, earlier diagnosis leads to better outcomes. Increasing the chance of early diagnosis, even with a 90% false positive rate will save lives.
Re: (Score:2)
We do not have all the numbers. It is quite possible that the watch successfully filtered out 90% of the false tests - assuming the overall positive rate is actually equal to 1% of the sample population.
Those performing the tests will see an increase in work needed to be performed. I can see why those individuals / offices would be complaining. But overall, it is not that bad. The additional investment into early detection will reduce costs for other health care workers. Preventative medicine is typ
Re: (Score:2)
We do not have all the numbers. It is quite possible that the watch successfully filtered out 90% of the false tests - assuming the overall positive rate is actually equal to 1% of the sample population.
At the point of the hospitals, the false positive rate is 90%. However, because Apple devices tend to be owned by more affluent and likely more healthy people, some of those individuals will decide to ignore alarms, so the true false positive rate is higher. If that rate of self-filtering is significant, it would be interesting to see the extent to which the Apple Watch alarm is better than a random alarm with self-filtering. The key is the self-filtering which would tend to constrict the population to t
Re: (Score:2)
It depends if they would have been diagnosed anyway or not. If they were already being investigated for heart issues and bought an Apple Watch as a result of that then it may have had no effect on the outcome of the diagnosis.
The Apple Watch seems to occupy that awkward space where it's potentially useful but not good enough to make an accurate diagnosis. Maybe in a few generations it will get there.
Re: (Score:3)
10% is significant. It sounds fairly successful to me.
You're under the assumption that those 10% wouldn't have been treated in another way after showing other symptoms. Right now all we really have shown is the watch sent 90% of people to the doctor unnecessarily. No data on if it actually made a difference to anyone's life.
Re: (Score:2)
Sure, but those "other symptoms" might include things like atrial fibrillation, heart attack and death.
Just What We Need (Score:1, Troll)
More paranoid people making decisions based on useless information.
The death rate is holding steady at 100%. That stupid watch ain't going to do anything for you but die sooner from the stress of your nosiness about things one doesn't understand anyway.
Corporations taking advantage of imperfect humans for the win!!!
Oooops, almost forgot. FUCK APPLE!
A Universal Truth (Score:3)
It’s always the other guy that uses too much healthcare.
Re: (Score:2)
Bingo.
Better those 10% of lives were saved and money was lost (?) on the 90%.
Re: (Score:2)
Better those 10% of lives were saved and money was lost (?) on the 90%.
Do we know those 10% would have died? Nothing about this study says that those 10% wouldn't have ended up at the doctor anyway and it's a stretch to say that we saved 10% of people for a 90% false positive.
The only conclusion you can draw right now is that 90% of people went to the doctor unnecessarily, and that 10% went to the doctor. That's it. No claims of mortality. No claims of what happens if the watch didn't exist.
Don't read into data what isn't there.
counterpoint (Score:2)
way too many americans need to go to the doctor
and apple get's 30% of the docker bill in full! (Score:5, Funny)
and apple get's 30% of the docker bill in full!
False negatives better? (Score:5, Insightful)
I don't own an Apple watch and probably never will because I am not interested in monitoring my heartbeat 24/7 and because I am not willing to pay several hundred bucks for a plastic watch from the evil Apple. But I am bemused by the learned doctor's comments. After years of hearing every doctor speaking publicly about some condition tell us we should definitely see our doctor if we are concerned about something, this ER doctor now says that we are bothering doctors with too many unwarranted inquiries. She seems to be implying that it would be better for her if we all just waited until we keeled over before bothering her in her ER. Perhaps it would be better if the stupid watch missed the condition entirely.
Re: (Score:3)
There's a difference between visiting your doctor regularly and going to the ER. Too many people going to the ER needlessly screws up the ER for people who need it, whereas going to your own doctor unnecessarilly is not a bad thing. ("as long as you're here, let's talk about your blood pressure readings")
Re: (Score:3)
You're not wrong, but the heart is one organ you don't screw around with.
Going to your local GP when you suspect you have a heart emergency is a gamble.
If it turns out you are indeed having a cardiac event do you really want to be delaying your ER visit by 15 - 20 mins?
If you think you have skin cancer, or a hairline fracture, etc etc ... sure. But the heart is a somewhat important organ.
Usual disclaimer: I am not a doctor.
Re: (Score:2)
If you're having a cardiac arrest or a stroke, well, visit the ER. Thing is, it's pre
Re: (Score:2)
After years of hearing every doctor speaking publicly about some condition tell us we should definitely see our doctor if we are concerned about something, this ER doctor now says that we are bothering doctors with too many unwarranted inquiries.
There's a difference between going to the doctor because you have symptoms or concerns and going to the doctor because some piece of software told you to when you were in fact otherwise completely healthy.
The advice remains very much the same, if you're concerned see a doctor. The critique here is on a device causing false concerns. This is really no different to complaints about WebMD or the internet in general.
I have a headache. *Googles*. I just self diagnosed cancer, oh god!!!
Why is this a surprise? (Score:3)
Medlife Crisis (Score:3)
Big fan of Medlife Crisis (on youtube). He has done a number of really good videos on over diagnosis and testing, including one on the apple watch in particular.
His focus is usually more on the harm to the patient then any harm to the hospital or finances. If I wasn't on mobile I'd dig up a direct link because he makes some really good and by his own admission non-intuitive points.
How is this news? (Score:5, Interesting)
OK, so the people involved in this study cannot verify whether all 264 cases involved an Apple watch, nor did they correlate the 41 they think involve the ECG or pulse monitoring of an Apple watch with the resulting diagnosis (or verification, for those already diagnosed), so how can they come up with 10%? If all of the cases of an Apple watch triggering a visit were for patients that already had a diagnosis of atrial fibrillation (58), then the number is 100% (all valid and potentially life saving).
If we assume that all 264 cases involved the watch, and 30 *new* diagnosis were issued, then (30 + 61)/264 or ~34.5% potentially involved atrial fibrillation or (30+132)/264 or ~61.4% involved some cardiac issue (including afib).
Regardless, the point of these monitoring features isn't to only detect new conditions, it is also to monitor ongoing symptoms and provide on-the-spot data that isn't always easy to collect in a doctor's office or while walking around with a monitor for several days to a month. Same as a car's onboard computers recording performance data that allows a mechanic to read it and more easily determine what is going wrong with the engine, etc.
Not just cardiac problems (Score:5, Insightful)
My Apple Watch kept detecting high heart rate while I was asleep. Went to the doctor and was diagnosed with severe sleep apnoea and am now on CPAP therapy. (The snoring was a hint too).
We should all be getting a checkup every now and then, so this doesn't really seem like a problem. Whatever money is spent looking at people without a problem is saved by early detection of the people who did have an issue. Study after study shows a massive return for preventative healthcare.
Apples and oranges (Score:2)
I would rather... (Score:2)
Ten percent? (Score:5, Insightful)
According to this site [healthline.com] 1/23 people develop colon cancer IN THEIR LIFETIME, yet colonoscopy is still recommended for most people at 50.
If they're getting 10% diagnosis of cardiac conditions from these relatively cheap devices, I'd say that's a huge diagnostic win, way better than colonoscopy which I'm sure they have no problems with.
Re: (Score:2)
Re: Ten percent? (Score:2)
You should see how much real medical devices and doctor visits cost.
We have a free market system, so you can just shop around and compare prices. Go ahead and call some of our heart doctors and ask for quotes.
I'm kidding, the real answer is you'll find out after you get the bill, and it depends on your insurance, and nobody knows how their insurance works other than you dump money into a hole and doctors reach around like they're playing a claw game for cash.
Re: (Score:1)
If they're getting 10% diagnosis of cardiac conditions from these relatively cheap devices, I'd say that's a huge diagnostic win, way better than colonoscopy which I'm sure they have no problems with.
It takes an American to call a $300 device that doesn't work "cheap".
What does a colonoscopy cost outside of the US? I assume your attention span is sufficient to make it to the end of a sentence and your reading comprehension is sufficient to recognize that the post you replied to said "relatively cheap" not "absolutely cheap" and that it is relative to a colonoscopy.
If I'm being to generous in my assumptions about your attention span and/or reading comprehension, please let me know. If $300 is cheap relative to a colonoscopy, please do enlighten us as to what you think a c
Re: (Score:1)
Thank-you. That. Precisely.
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Missing context (Score:2)
What percentage of all patients visiting their doctor are eventually diagnosed with some significant underlying condition?
Apple even makes money for cardiologists (Score:2)
Great!
What sort of rates do other things have? (Score:1)
Plenty of Slashdot old-timers are probably at least forty by now, maybe even fifty or sixty.
So:
At the age where all women are told they need to get a mammogram, what percent of them are found to have cancer?
At the age where all people are told they need to get a colonoscopy, what percent of them are found to have cancer, or even precancerous polyps?
Curious, since I don't know what the actual numbers are. But i have a feeling of 10% of women showing up for their first routine age-based mammogram were found
My Apple Watch Saved My Life (Score:5, Interesting)
Dangerously bad science. (Score:2)
These type of rhythms can be caused by many non-cardiac events such as caffeine, stress or medications. Making the ridiculous assumption that any detection of such rhythms that isnâ(TM)t followed by a cardiac diagnosis is a false positive is truly flawed logic.
PROBABLY False Positives? (Score:1)
Most of the concerning heart monitor data, then, were probably false positives, the study concluded.
What kind of bullshit equivocation is that???
At worst, you go to your doctor, and he does/schedules a more precise evaluation. BFD.
At best, you uncover a hard-to-capture intermittent arrhythmia (which are all-to-common, and often missed in a single ECG).
My personal rule of thumb would be (if no prior history of heart issues) :
One random Notification with no other symptoms: Ignore;
Three Notifications in a week or so (symptoms or not): Call the Dr. in the next day or so;
Five Notifications in a day: Go to the