Journal
JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION
Volume 27, Issue 9, Pages 1359-1363Publisher
OXFORD UNIV PRESS
DOI: 10.1093/jamia/ocaa137
Keywords
wearable electronic devices; direct-to-consumer screening and testing; mass screening; fitness trackers; monitoring; ambulatory
Categories
Funding
- United States Food and Drug Administration [U01FD005938]
- National Institutes of Health [UL1TR002377]
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Objective: The study sought to characterize the evaluation of patients who present following detection of an abnormal pulse using Apple Watch. Materials and Methods: We conducted a retrospective review of patients evaluated for abnormal pulse detected using Apple Watch over a 4-month period. Results: Among 264 included patients, clinical documentation for 41 (15.5%) explicitly noted an abnormal pulse alert. Preexisting atrial fibrillation was noted in 58 (22.0%). Most commonly performed testing included 12-lead echocardiography (n = 158; 59.8%), Holter monitor (n = 77; 29.2%), and chest x-ray (n = 64; 24.2%). A clinically actionable cardiovascular diagnosis of interest was established in only 30 (11.4%) patients, including 6 of 41 (15%) patients who received an explicit alert. Discussion: False positive screening results may lead to overutilization of healthcare resources. Conclusions: The Food and Drug Administration and Apple should consider the unintended consequences of widespread screening for asymptomatic (silent) atrial fibrillation and use of the Apple Watch abnormal pulse detection functionality by populations in whom the device has not been adequately studied.
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