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Wearable Devices Useful for Predicting Patient Health Outcomes

Wearable devices and accelerometers can be used to estimate health status and death risks in older patients more accurately than other methods used by physicians, experts say.

Source: Thinkstock  

By Samantha McGrail

October 30, 2019 – Wearable devices and accelerometers worn like a watch, belt, or bracelet to track movement are a more reliable measure of physical activity and better for assessing five-year risk of death in older adults than more traditional methods, according to a new study by Johns Hopkins Medicine. Researchers say that an objective accounting of physical activity outperforms traditional predictors of mortality within five years, such as age, smoking, diabetes, alcohol use, or history of cancer or heart disease.

“We’ve been interested in studying physical activity and how accumulating it in spurts throughout the day could predict mortality because activity is a factor that can be changed, unlike age or genetics,” says Ciprian Crainicanu, PhD, professor of biostatistics at the Johns Hopkins Bloomberg School of Public Health, who is also a member of the research team. 

Using data from the National Health and Nutrition Examination Survey (NHANES) conducted by the Centers for Disease Control and Prevention (CDC), researchers looked at 33 predictors of five-year all-cause mortality, including 30 objective measures of physical activity, such as total activity, amount of time not moving, or amount of time doing moderate to vigorous activity. 

“People can overestimate on surveys how much and when they move, but wearable devices provide accurate data that cuts through bias and guesswork,” explained Jacek Urbanek, PhD, assistant professor of medicine at Johns Hopkins Medicine and a member of the research team. 

All 3,000 adult participants between 50 and 85 years old wore an accelerometer device at the hip for seven consecutive days to track physical activity. Individual data came from responses to demographic, socioeconomic, and health-related survey questions, along with information accessed from medical records and clinical laboratory test results. 

With a focus on fragmented activity, researchers also collected data for two-hour spans throughout the day, and their analysis showed that physical activity, or lack thereof, between noon and two in the afternoon was the highest predictor of mortality risk. 

“The most surprising finding was that a simple summary of measures of activity derived from a hip-worn accelerometer over a week outperformed well-established mortality risk factors such as age, cancer, diabetes and smoking,” says Ekaterina Smirnova, MS, PhD, assistant professor of biostatistics at Virginia Commonwealth University and the lead author on the paper. 

While gender proportion was even, men made up 51 percent, and 65 percent of the men died within five years of the study’s follow up efforts.

When comparing the data of those who died within five years and those who survived, researchers said they were able to correctly rank the mortality risk using accelerometers 30 percent more accurately than using information about smoking status, and 40 percent better than using information about whether a person suffered a stroke or had cancer. 

As a result, physicians feel confident that these devices could be used as fitness profiles to help patients change unhealthy behaviors, increase physical activity, and potentially extend healthy lifespan. However, using wearable technology it does not guarantee that one’s risk of mortality is going to be lower with more physical activity.

Consumer-grade mHealth wearables are finally beginning to make their mark in remote patient monitoring programs. 

For example, the extremely popular and user-friendly Fitbit tracker can be used in some RPM programs and also used to identify trends that call for clinical intervention.

A study done by the researchers at Cedars-Sinai Medical Center and UCLA in May of 2018 recruited 200 patients with ischemic heart disease (IHD) and had them wear Fitbit Charge 2 trackers for 90 days. 

The average number of steps recorded per day correlated with the patient’s self-reported overall health, physical function, fatigue, and the results that the study found. The findings suggested relationships between physical activity and health, as well as physical function. 

“Our study used a single device with high unity, which simplifies the task of remote monitoring for both researchers and patients,” the researchers reported. “The ability of the device to simultaneously record multiple variables such as heart rate and accelerometer data, also allowed us to more accurately determine the patient’s state, whether he/she is active, sedentary, asleep, or not currently using the device.” 

Because researchers were able to easily access activity data, clinicians monitoring these patients through their Fitbits can get a real-time glimpse of their health and physical function, enough to spot dangerous trends and intervene. 

Wearables to track patient health has a significant correlation, according to the evidence found in recent research.

“An accurate measure of physical activity is a more reliable way for doctors and patients to assess physical activity and intervene to increase it as a potential way to improve health,” noted Andrew Leroux, a PhD candidate at Johns Hopkins and co-author of the study report.

Source: https://mhealthintelligence.com/news/wearable-devices-useful-for-predicting-patient-health-outcomes

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Five rehab hospitals across the country will soon be testing a digital therapeutic platform that combines music with AI and mHealth sensors to help stroke survivors with walking problems.

• Hospitals will be testing a digital therapeutic device developed by Portland, ME-based MedRhythms, which is seeking US Food and Drug Administration approval for the service.
• The program will study the mHealth device’s impact on walking among a group of patients who have walking impairments as a result of a stroke

By Eric Wicklund

October 29, 2019 – Five rehabilitation hospitals will be testing a telehealth platform for stroke treatment that integrates music with AI and mHealth sensors for guided therapy.

The hospitals will be testing a digital therapeutic device developed by Portland, ME-based MedRhythms, which is seeking US Food and Drug Administration approval for the service. The program will study the mHealth device’s impact on walking among a group of patients who have walking impairments as a result of a stroke.

“Right now, the MedRhythms digital therapeutic technology is a novel treatment for a subset of individuals that have few, if any, effective treatment options,” David Putrino, director of the Abilities Research Center (ARC) for the Department of Rehabilitation and Human Performance at the Mount Sinai Health System, said in a press release. “The mission of the ARC is to identify and validate novel technologies that have the potential to significantly enhance the rehabilitation of people who are recovering from brain injuries and neurological conditions, including chronic stroke.”

Putrino will lead the research project at New York-based Mount Sinai. Also participating in the study are the Shirley Ryan AbilityLab in Chicago, the Kessler Foundation in New Jersey and Spauld ing Rehabilitation Hospital and the Boston University Neuromotor Recovery Laboratory, both in Boston.

“The digital therapeutics industry has the potential to transform rehabilitation and disrupt healthcare, and it is imperative for companies in this space to run full-scale, multisite RCTs like MedRhythms is doing,” Putrino added.

MedRhytms began as a digital therapy program launched out of Spaulding Rehab, part of the Partners HealthCare network, and has been building a portfolio of digital therapeutic treatments for treatment of neurological injury and disease, including Parkinson’s Disease and Multiple Sclerosis. The company is also looking to apply the treatment to senior care and fall prevention programs.

The company’s first and signature product is MedRhythms Stride, a digital health platform for stroke rehabilitation that focuses on Rhythmic Auditory Simulation (RAS). mHealth sensors attached to a patient’s feet gather gait parameters, which are then analyzed by a smartphone app that pairs the patient’s gait with music.

“Rhythm is the main driver of the interventions we have,” Owen McCarthy, the company’s president and founder, told mHealthIntelligence in a 2018 interview. “And it’s the type of thing we’re going to see more and more of in healthcare.”

This past June, the company announced a partnership with Health Catalyst’s new life sciences business to make its platform available to payers and providers looking for new ways to enhance stroke rehabilitation programs.

“This partnership comes at a crucial time in the digital therapeutics industry,” Carlos Rodarte, senior vice president of strategy and business development for the life sciences at Health Catalyst, said in a press release. “Several companies in this field have completed or are completing important trials demonstrating the significant clinical impact of true, validated and regulated digital therapeutics, paving the way for an entire new industry in digital health which has disruptive potential globally to deliver rapid, efficient therapies for patients with unmet needs.”

Source: https://mhealthintelligence.com/news/hospitals-to-test-music-based-mhealth-platform-for-stroke-treatment