Off-the-shelf wearable trackers provide clinically-useful info for patients with heart disease

Monitoring using consumer wearable devices was found to have clinical value for comparing response to two treatments for atrial fibrillation and heart failure

Woman wearing smartwatch

Monitoring of heart rate and physical activity using consumer wearable devices was found to have clinical value for comparing the response to two treatments for atrial fibrillation and heart failure.

The study published in Nature Medicine examined if a commercially-available fitness tracker and smartphone could continuously monitor the response to medications, and provide clinical information similar to in-person hospital assessment.

The wearable devices, consisting of a wrist band and connected smartphone, collected a vast amount of data on the response to two different medications prescribed as part of a clinical trial called RATE-AF, funded by the National Institute for Health and Care Research (NIHR).

This study shows the potential to use this new technology to assess the response to treatment and make a positive contribution to the routine care of patients

Prof Dipak Kotecha

Led by researchers from the cardAIc group at the University of Birmingham, the team used artificial intelligence to help analyse over 140 million datapoints for heart rate in 53 individuals over 20 weeks. They found that digoxin and beta-blockers had a similar effect on heart rate, even after accounting for differences in physical activity. This was in contrast to previous studies that had only assessed the short-term impact of digoxin.

A neural network that took account of missing information was developed to avoid an over-optimistic view of the wearable data stream. Using this approach, the team found that the wearables were equivalent to standard tests often used in hospitals and clinical trials that require staff time and resources. The average age of participants in the study was 76 years, highlighting possible future value regardless of age or experience with technology.

Professor Dipak Kotecha from the Institute of Cardiovascular Sciences at the University of Birmingham and the lead author of the study said:

“People across the world are increasingly using wearable devices in their daily lives to help monitor their activity and health status. This study shows the potential to use this new technology to assess the response to treatment and make a positive contribution to the routine care of patients.”

“Heart conditions such as atrial fibrillation and heart failure are expected to double in prevalence over the next few decades, leading to a large burden on patients as well as substantial healthcare cost. This study is an exciting showcase for how artificial intelligence can support new ways to help treat patients better.”

The study was funded as part of the BigData@Heart consortium from the European Union’s Innovative Medicines Initiative. The RATE-AF trial was funded by the UK National Institute for Health and Care Research.

Notes for editors

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The University of Birmingham is ranked amongst the world’s top 100 institutions. Its work brings people from across the world to Birmingham, including researchers, teachers and more than 8,000 international students from over 150 countries.

  • The University of Birmingham is a founding member of Birmingham Health Partners (BHP), a strategic alliance which transcends organisational boundaries to rapidly translate healthcare research findings into new diagnostics, drugs and devices for patients. Birmingham Health Partners is a strategic alliance between seven organisations who collaborate to bring healthcare innovations through to clinical application:
    • University of Birmingham
    • University Hospitals Birmingham NHS Foundation Trust
    • Birmingham Women's and Children's Hospitals NHS Foundation Trust
    • Aston University
    • The Royal Orthopaedic Hospital NHS Foundation Trust
    • Sandwell and West Birmingham Hospitals NHS Trust
    • West Midlands Academic Health Science Network
    • Birmingham and Solihull Mental Health NHS Foundation Trust
  • The cardAIc group (Application of Artificial Intelligence to Routine Healthcare Data to Benefit Patients with Cardiovascular Disease) was set up to expand the use of new technologies that could contribute to routine clinical care of patients with heart conditions. The multidisciplinary group of clinical and data scientists are supported and directed in their efforts by a patient and public involvement team. Further information and results are available in the Lancet, the European Heart Journal, and the DaRe2THINK trial published in the European Heart Journal Digital Health.
  • The BigData@Heart project was part of the Innovative Medicines Initiative (IMI) Big Data for Better Outcomes programme. It brought together some of Europe’s leading experts in cardiovascular disease, as well as epidemiologists, big data scientists, doctors, industry representatives, patient representatives, and ethics and legal experts. The IMI is funded jointly by the European Union (represented by the European Commission) and the European pharmaceutical industry (represented by the European Federation of Pharmaceutical Industries and Associations). The IMI seeks to improve health by speeding up the development of, and patient access to, innovative medicines, particularly in areas where there is an unmet medical or social need.
  • The mission of the NIHR is to improve the health and wealth of the nation through research. We do this by:
    • Funding high quality, timely research that benefits the NHS, public health and social care;
    • Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services;
    • Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research;
    • Attracting, training and supporting the best researchers to tackle complex health and social care challenges;
    • Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system;
    • Funding applied global health research and training to meet the needs of the poorest people in low and middle income countries.

      NIHR is funded by the Department of Health and Social Care. Its work in low and middle income countries is principally funded through UK Aid from the UK government.
  • The RATE-AF trial (RAte control Therapy Evaluation in permanent Atrial Fibrillation) was co-developed by patients and researchers at the University of Birmingham and University Hospitals Birmingham NHS Foundation Trust to improve quality of life in patients with atrial fibrillation and heart failure. Further information and results are available at: JAMA, Cardiology, European Heart Journal, BMJ Journal Health, BMJ Open. The RATE-AF trial was funded by the National Institute for Health and Care Research (NIHR).