Setup of Consumer Wearable Devices for Exposure and Health Monitoring in Population Studies

Summary

Commercial smartwatches equipped with wearable sensors are increasingly being used in population studies. However, their utility is often constrained by their limited battery duration, memory capacity, and data quality. This report provides examples of cost-effective solutions to real-life technical challenges encountered during studies involving asthmatic children and elderly cardiac patients.

Abstract

Wearable sensors, which are often embedded in commercial smartwatches, allow for continuous and non-invasive health measurements and exposure assessments in clinical studies. Nevertheless, the real-life application of these technologies in studies involving a large number of participants for a significant observation period may be hindered by several practical challenges.

In this study, we present a modified protocol from a previous intervention study for the mitigation of health effects from desert dust storms. The study involved two distinct population groups: asthmatic children aged 6-11 years and elderly patients with atrial fibrillation (AF). Both groups were equipped with a smartwatch for the assessment of physical activity (using a heart rate monitor, pedometer, and accelerometer) and location (using GPS signals to locate individuals in indoor "at home" or outdoor microenvironments). The participants were required to wear the smartwatch equipped with a data collection application on a daily basis, and data were transmitted via a wireless network to a centrally administered data collection platform for the near real-time assessment of compliance.

Over a period of 26 months, more than 250 children and 50 patients with AF participated in the aforementioned study. The main technical challenges identified included restricting access to standard smartwatch features, such as gaming, internet browser, camera, and audio recording applications, technical issues, such as loss of GPS signal, especially in indoor environments, and the internal smartwatch settings interfering with the data collection application.

The aim of this protocol is to demonstrate how the use of publicly available application lockers and device automation applications made it possible to address most of these challenges in a simple and cost-effective way. In addition, the inclusion of a Wi-Fi received signal strength indicator significantly improved indoor localization and largely minimized GPS signal misclassification. The implementation of these protocols during the roll-out of this intervention study in the spring of 2020 led to significantly improved results in terms of data completeness and data quality.

Introduction

Digital health technology applications and wearable sensors enable non-invasive and cost-effective patient monitoring both in healthcare and home settings¹. At the same time, the large amount of data collected and the availability of wearable-based analytic platforms enable the development of algorithms for automated health event prediction, prevention, and intervention for a wide range of acute and chronic diseases². Commercially available wearable sensors, primarily used for fitness tracking, are also increasingly being used by medical professionals in public health research and represent a promising tool for multimoda....

Protocol

Administrative and ethics approvals were obtained from the Cyprus Ministry of Health (YY5.34.01.7.6E) and the Cyprus National Bioethics Committee (ΕΕΒΚ/ΕΠ/2016.01.23). Patients with atrial fibrillation and the guardians of the asthmatic children provided written informed consent prior to participation in the study.

1. Application lockers and device automation applications

NOTE: Freely available application lockers and dev.......

Discussion

Wearable sensors are useful tools that allow the continuous and non-invasive monitoring of health parameters and patient behavior. Commercial smartwatches, which are equipped with a variety of sensors, provide a promising alternative to traditional data collection methods, and their use in clinical and public health research is only expected to rise as a result of increased variety and quality of built-in sensors, stronger academic-industry partnerships, and reductions in retail prices¹⁴. In this .......

Materials

Name	Company	Catalog Number	Comments
APK Extractor	Meher	Version 4.21.08	Application
Charger/Adaptor with data cable	Jiangsu Chenyang Electron Co. Ltd	C-P17	Charger
Embrace application	EmbraceTech LTD	Version 1.5.4	Application
LEMFO LF25 Smartwatch	Shenzhen domino Times Technology Co. Ltd	DM368 Plus	Smartwatch
Lock App - Smart App Locker	ANUJ TENANI	Version 4.0	Application
Macrodroid-Device Automation	ArloSoft	Version 5.5.2	Application
Xiaomi Redmi 6A	Xiaomi	M1804C3CG	Smartphone