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Apple Watch Vs. The Specialists




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Jeff Williams, Apple's chief operating officer, speaks about the Apple Watch Series 4 at the Steve Jobs Theater during an event to announce new Apple products Wednesday, Sept. 1

2 , 2018, Cupertino, Calif. (AP Photo / Marcio Jose Sanchez)

As someone who teaches innovation, I am naturally interested in the response to new products, and the launch of the Apple Watch 4 and its heart monitoring functions provides Een goed gevalstudie over het voorspellen en modelleren van reacties onder specialisten, evenals hun waarde in de middellange tot lange termijn. In het kort, hoe intensief werken over een onderwerp voor een lange tijd verdraagt ​​de standpunten over wat positief of negatief is over een innovatie, as well as innovation in a particular context or subjected to processes of social adoption.

How could we classify such responses? To begin with, doubts can be raised in an open format, as did Ethan Weiss which I mentioned in My previous article on the subject who during the Apple Watch presentation commented on Twitter: "I can not work out whether this is the best day in the history of cardiology or the worst." His doubts are laid out clearly en in neutrale termen, anticiperen de kind van scenario's die men zou kunnen verwachten van een ervaren cardioloog: niet-intrusieve monitoring in staat om problemen te identificeren voordat ze kritisch worden en hun potentieel om uiteindelijk te redden van levensverzekering tegen cardiologen 's wachtkamers gevuld met mensen overreacting to data they do not understand.

The Washington Post raised similar concerns the following day, after talking to several cardiologists, in an article called " What cardiologists think about the Apple Watch's heart-tracking feature ": making these types of measurements in such a high-popular product could generate unjustified anxiety and unnecessary visits to the GP. Interpreting an electrocardiogram requires a certain degree of familiarity with the technique and the metrics used, which could lead the untrained, in the face of natural variations in their heart rate, to become alarmed or feed their hypochondria. Undoubtedly, this is a minor problem in the context of the potential benefits of a technology that could alert people to possible heart problems early on. De muligheden for at personer uden tilstrækkelig grad af forberedelse rutinemæssigt har adgang til et diagnostisk værktøj som f.eks. Et elektrocardiogram rutinemæssigt kan være årsag til nogle alarm for fagfolk, der er ansvarlige for at træffe beslutninger med disse samme værktøjer. sommige onnodige bezoeken aan de cardioloog of voor mensen om oninformed te zijn over hun gezondheid.

 

A different question all together is the reliability of the device used to capture and process the data. An article in Quartz, "" The new heart-monitoring capabilities on the Apple Watch are not all that impressive ", points out that the electrocardiogram obtained by Apple Watch provides a much more imperfect and rudimentary result than a hospital would , where twelve electrodes are attached to different areas of the chest, arms and legs. The clinical device offers much higher precision, but in exchange for a much lower level of convenience. Selv om det var muligt for Apple Watch at være hooked up på denne måde, var det tanken at et stort antal mennesker ville bruge det rutinemæssigt eller dagligt er latterligt. The clinical device provides very reliable and rigorous measures in a hospital environment, while the Apple Watch provides fewer indicators with a much lower level of accuracy, but at any time and under any circumstances. Kan dette bidra til noe for patienters sundhed med for eksempel forhold som ikke manifesterer sig når de er i deres doktors kontor? Jeg er sikker på at vi vil se kardiologer som ser på de plater som er oppnådd ved Apple Watch av noen av deres pasienter. Það þýðir ekki að það sé að sjálfsögðu nauðsynlegt eða réttlætt í öllum tilvikum, eða að við þurfum að reyna að þrýsta læknum til að gera það.

Þessi spurningar hafa verið gefin upp af framleiðendum annarra notenda, svo sem WIWE which I also mentioned in my previous article about the Apple Watch 4. The company has worked for years to produce a device the size of a credit card which works by holding both thumbs on, making sure your hands do not touch, that gives an electrocardiogram with complete data and graphs recording arrhythmia, atrial fibrillation, ventricular heterogeneity and oxygen saturation in the blood stream and then Apple comes along with a device that provides similar data using … a watch. No wonder WIWE is skeptical:

While we have not tested it thoroughly yet, there are already a few concerns just by looking at the hardware setup of the watch which can significantly affect signal quality when recording ECG. Selv om det er et fælles designelement i en lednings ECG, kan brugerne placere deres fingre på sensorer for at opnå fuld kontakt og et stærkt signal. Klokken ser naturligvis ikke sådan ud.

A very common problem could arise fra en enkel ting: den brugers hårede wrist kan komme i vejen for sensoren som er ment å hente signaler fra den kanalen og så blir den begrenset i sin kapasitet. Let's see the other channel. Den brukerens rettpunktingfinger trenger å holde hold i position for lang nok, så risikoen for at det kommer til at tremble, følespenning osv. I andre ord beveger seg så støt og fredelig kontakten er vanskelig å oppnå. If you compare, you can place WIWE on a flat surface and rest your fingers steadily on the sensors for the duration of the measurement.

As for AF detection: we have not seen information about the accuracy of it. % accuracy when tested against 10000 clinical samples – our certificate is available on request) and whether they examine atrial activation (by examining the "P" wave as WIWE does), or do they do the assessment based on heart rate alone? As far as it can be seen from the published information, they do not perform wave analysis, so they can not provide ECG specific information such as QRS, QTc, PQ, while WIWE offers all these to clinicians. Hvis de bare rely på hjertefrekvens, kan vurderingsresultatet være forvirrende når det er registrert. AF og det er bekreftet ved deres uttalelse fra FDA: "The ECG-appen er ikke beregnet til at blive anvendt til mennesker yngre end 22, og det er ikke anbefalet for mennesker med andre kendte hjerteforhold som kan forstyrre din hjerterytme. '

Efter at ha sagt det, er det en stor prestasjon at de fikk AHA-støtten og fikk FDA-klaring, så vi åpenbart ikke sier at klokken er

Endnu en gang: Det ser ut til at det inden for kategorien forbrukerprodukter, den nøyaktighet av en enhet som er designet specifikt for at opnå et elektrokardiogram, med to sensorer og en reasonably ergonomic configuration that allows you to keep your thumbs on them for a minute without problems will get more reliable results than a watch designed for a wide variety of functions, including telling the time. Men den modpart, igen, er tydelig: med WIWE-apparatet. Jeg overvåker min hjertefrekvens når jeg husker og, vanligvis, ikke en gang på daglig basis. With the watch, I monitor myself at all times and under all kinds of circumstances.

Are the responses to innovation by physicians and designers of competing products justified? There are certainly within reasonable grounds. Men de ignorerer et annet problem i deres analyse: de målinger, men mindre stringente, kan tages på ethvert tidspunkt af dagen. At the same time, we still do not know what Apple or other developers will be able to do with the right algorithms when they have measurements obtained regularly or in different contexts – we should remember that the Apple Watch is

Kan den udvikling af sådanne anordninger udgøre en konkret forbedring i medieperioden for forskning eller til praksis af kardiologi og for medicin i almindelighed? All things considered, I have to say that I'm convinced they will.

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Jeff Williams, Apple's chief operating officer, speaks about the Apple Watch Series 4 at the Steve Jobs Theater during an event to announce new Apple products Wednesday, September 12, 2018, in Cupertino, Calif. AP Photo / Marcio Jose Sanchez)

As someone who teaches innovation, I am naturally interested in the response to new products, and the launch of the Apple Watch 4 and its heart monitoring functions provides a good case study on predicting and modeling reactions tussen specialisten, evenals hun waarde in de middellange tot lange termijn. In het kort, hoe werkt intensief over een onderwerp voor een lange tijd verdraaide standpunten als wat positief of negatief is over een innovatie, evenals innovatie in een bepaalde context of subjected to processes of social adoption.

How could we classify such responses? To begin with, doubts can be raised in an open format, as did Ethan Weiss which I mentioned in my previous article on the subject, who d uring the Apple Watch presentation commented on Twitter: "I can not work out whether this is the best day in the history of cardiology or the worst." His doubts are laid out clearly and in neutral terms, foreseeing the kind of scenarios one might expect from an experienced cardiologist: non-intrusive monitoring able to identify problems before they become critical and its potential to ultimately save lives offset against cardiologists' waiting rooms filled with people overreacting to data they do not understand.

The Washington Post raised Similar concerns the next day, after talking to several cardiologists, in an article called "What cardiologists think about the Apple Watch's heart-tracking feature": making these types of measurements in such a high-popular product could generate unjustified anxiety and unnecessary visits to the GP. Interpreting an electrocardiogram requires a certain degree of familiarity with the technique and the metrics used, which could lead the untrained, in the face of natural variations in their heart rate, to become alarmed or feed their hypochondria. Undoubtedly, this is a minor problem in the context of the potential benefits of a technology that could alert people to possible heart problems early on. De muligheden for at personer uden tilstrækkelig grad af forberedelse rutinemæssigt har adgang til et diagnostisk værktøj som f.eks. Et elektrocardiogram rutinemæssigt kan være årsag til nogle alarm for fagfolk, der er ansvarlige for at træffe beslutninger med disse samme værktøjer. sommige onnodige bezoeken aan de cardioloog of mensen om zich te informeren over hun gezondheid.

Een andere vraag is alles dat de betrouwbaarheid van het apparaat gebruikt om de data te verwerken en te verwerken. An article in Quartz, "The new heart-monitoring capabilities on the Apple Watch are not all that impressive", points out that the electrocardiogram obtained by Apple Watch provides a much more imperfect and rudimentary result than a hospital would, where twelve electrodes are attached two different areas of the chest, arms and legs. The clinical device offers much higher precision, but in exchange for a much lower level of convenience. Selv om det var muligt for Apple Watch at være hooked up på denne måde, var det tanken at et stort antal mennesker ville bruge det rutinemæssigt eller dagligt er latterligt. The clinical device provides very reliable and rigorous measures in a hospital environment, while the Apple Watch provides fewer indicators with a much lower level of accuracy, but at any time and under any circumstances. Kan dette bidra til noe for patienters sundhed med for eksempel forhold som ikke manifesterer sig når de er i deres doktors kontor? Jeg er sikker på at vi vil se kardiologer som ser på de plater som er oppnådd ved Apple Watch av noen av deres pasienter. Það þýðir þó ekki að þetta sé nauðsynlegt eða réttlætanlegt í öllum tilvikum, eða að við þurfum að reyna að þrýsta læknum að gera það.

Þessi spurningar hafa verið gefin upp af framleiðendum annarra notenda, svo sem WIWE, som jeg også omtalte i min tidligere artikel om Apple Watch 4. Det firma har jobbet for mange år for at producere en enhed som størrelsen på et kreditkort, som fungerer ved at holde begge fingrene på, og sørg for at dine hænder ikke rører, det giver en elektrokardiogram with complete data and graphs recording arrhythmia, atrial fibrillation, ventricular heterogeneity and oxygen saturation in the blood stream, and then Apple comes along with a device that provides similar data using … a watch. No wonder WIWE is skeptical:

While we have not tested it thoroughly yet, there are already a few concerns just by looking at the hardware setup of the watch which can significantly affect signal quality when recording ECG. Selv om det er et fælles designelement i en lednings ECG, kan brugerne placere deres fingre på sensorer for at opnå fuld kontakt og et stærkt signal. Klokken ser naturligvis ikke sådan ud.

A very common problem could arise fra en enkel ting: den brugers hårede wrist kan komme i vejen for sensoren som er ment å hente signaler fra den kanalen og så blir den begrenset i sin kapasitet. Let's see the other channel. Den brukerens rettpunktingfinger trenger å holde hold i position for lang nok, så risikoen for at det kommer til at tremble, følespenning osv. I andre ord beveger seg så støt og fredelig kontakten er vanskelig å oppnå. If you compare, you can place WIWE on a flat surface and rest your fingers steadily on the sensors for the duration of the measurement.

As for AF detection: we have not seen information about the accuracy of it. % accuracy when tested against 10000 clinical samples – our certificate is available on request) and whether they examine atrial activation (by examining the "P" wave as WIWE does), or do they do the assessment based on heart rate alone? As far as it can be seen from the published information, they do not perform wave analysis, so they can not provide ECG specific information such as QRS, QTc, PQ, while WIWE offers all these to clinicians. Hvis de bare rely på hjertefrekvens, kan vurderingsresultatet være forvirrende når det er registrert. AF og det er bekreftet ved deres uttalelse fra FDA: "The ECG-appen er ikke beregnet til at blive anvendt til mennesker yngre end 22, og det er ikke anbefalet for mennesker med andre kendte hjerteforhold som kan forstyrre din hjerterytme. '

Efter at ha sagt det, er det en stor prestasjon at de fikk AHA-støtten og fikk FDA-klaring, så vi åpenbart ikke sier at klokken er

Endnu en gang: Det ser ut til at det inden for kategorien forbrukerprodukter, den nøyaktighet av en enhet som er designet specifikt for at opnå et elektrokardiogram, med to sensorer og en reasonably ergonomic configuration that allows you to keep your thumbs on them for a minute without problems will get more reliable results than a watch designed for a wide variety of functions, including telling the time. Men den modpart, igen, er tydelig: med WIWE-apparatet. Jeg overvåker min hjertefrekvens når jeg husker og, vanligvis, ikke en gang på daglig basis. With the watch, I monitor myself at all times and under all kinds of circumstances.

Are the responses to innovation by physicians and designers of competing products justified? There are certainly within reasonable grounds. Men de ignorerer et annet problem i deres analyse: de målinger, men mindre stringente, kan tages på ethvert tidspunkt af dagen. At the same time, we still do not know what Apple or other developers will be able to do with the right algorithms when they have measurements obtained regularly or in various contexts – we should remember that the Apple Watch is also used, for example, for regular monitoring of physical activity.

Could the development of such devices represent a tangible improvement in the medium term for research or for the practice of cardiology and for medicine in general? All things considered, I have to say that I'm convinced they will.


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