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Preface
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On November 30, Stephen and others published an editorial article in New England Medicine, which introduced the series of wearable devices. The article discussed the development status and future possibilities of this field.
**"Wearable device"** is a term used to refer to a form of technology that is used on the body, such as a smart watch or an adhesive patch that contains sensors and provides useful functionality to the wearer or caregiver. Common examples include devices that track physical activity and sleep or provide physiological data about the wearer, such as heart rate and rhythm or blood sugar levels. Medical professionals are increasingly using wearable devices to provide clinical data about their patients and patients. This Digital Health Technology (DHT) is worn by patients and connected through a mobile app or personal digital assistant, and can be used for disease monitoring, diagnosis, alerts or other clinical care services. We call this particular category of technology “wearable DHTs.”
Will wearable DHT improve patient outcomes and clinical practice? Or is it just a trend that will pass, like many consumer devices and their health claims?
Wearable technology has always been the focus of engineering technicians and doctors, and is considered the technological starting point for subverting traditional medical care. /Image source: Nature Electronics
NEJM | Editorial
The first article in a series of articles on the clinical application of wearable DHT [1] appears in this issue of the Wall Street Journal. Now, wearable DHT is at the tipping point between proof of concept and practical applications that are being integrated into health monitoring, clinical diagnostics, and new therapies. Just 5 years ago, almost all discussions about wearable DHT placed it in the future, but now we can reasonably assume that before the end of this decade (before 2030 ), the use of wearable DHT will become mainstream and become the basis for many aspects of healthcare assessment and decision-making by patients and clinicians.
As of 2020, approximately 840,000 people in the United States have used apps containing health and wellness-related content[2]. It is estimated that as of April 2022, there are more than 200 million smartwatches providing health information worldwide, with 45% of Americans wearing some form of smartwatch [3]. About 92% of smartwatch users report that they use these devices to monitor and manage their health. As for other wearable devices, more than 70,000 smart rings have been sold as of 2022, and more than 760,000 continuous glucose sensors will be sold this year. As for the wearable medical device market, Bloomberg estimates that it will grow to $7.6 billion by 2028[4]. At the same time, these devices are collecting increasingly reliable data, and programmers are developing more powerful algorithms to process it. NEJM’s goal in this series is to raise awareness of emerging forms of wearable DHT that are impacting medical research and clinical care, in the context of general awareness or consensus of their benefits and risks. Until then, it is worthwhile for clinicians and medical researchers to develop a framework.
Wearable DHT and artificial intelligence and machine learning (AI-ML) are closely related fields, but each has its own unique focus and applications. Wearable DHT encompasses a broad range of tools, platforms, technologies, and devices used to monitor physiological and health conditions, enable remote care delivery, and potentially improve health outcomes. On the other hand, the field of AI-ML focuses on developing algorithms and models that can learn from data, including a wide range of DHT-derived data, to make predictions or make better decisions based on that learning . AI-ML can be used to analyze images, diagnose disease, identify risk factors and develop personalized treatment plans. Wearable forms of DHT often incorporate AI-ML, but they differ in their broader focus on using technology to remotely monitor a patient's physiology or symptoms, thereby reducing the need for in-person visits and, where appropriate, empowering patients through self-care and Engage patients with their health data. Clinicians can use wearable DHTs with or without AI-ML algorithms for personalized treatment planning and early detection of disease.
This series of articles focuses on wearable DHT, which although has been integrated into clinical care, is currently in limited use. They have been written to provide practitioners, researchers, and academics wishing to practice clinical practice with a better understanding of how wearable DHTs may impact their work following adoption. This series aims to provide real-world examples of how wearable DHTs are increasingly being used in today’s clinical situations, and how this use may be expanded or limited until they are fully Can be implemented into the healthcare system and reimbursed by health insurance plans.
Each article begins with one or more clinical questions based on actual clinical cases that describe patient and clinical challenges that are more easily solved today using one or more types of wearable DHT. The first article in this series focuses on wearable DHT for the treatment of diabetes, as well as the emerging use of continuous glucose monitors and active insulin delivery devices in patients with type 1 or type 2 diabetes and in hospital settings [1]. The series will also feature articles on wearable DHT in other clinical areas such as psychiatry and cardiology, as well as in epilepsy treatment.
In the final article in this series, the cross-cutting challenges of these emerging clinical technologies will be discussed, such as: What overarching barriers must be overcome to move patients and clinicians from these Getting the most out of new forms of technology? What evidence is needed for a wearable DHT to make the medical claim that it improves patient outcomes? Could wearable DHT improve patient care while reducing clinician burden? Should manufacturers of wearable DHT be careful not to overpromise or overburden patients and providers? How can technologists, data scientists, and clinicians collaborate to deliver the promise of personalized and revolutionary new medical insights in a world already overloaded with data and new discoveries?
Stephen wrote at the end:The purpose of this series is to use these articles as a basis to inspire researchersin the daily care of patients< /span>Explore and deploy proven wearable DHTs. By accelerating the appropriate adoption of wearable DHT, the focus of patient assessment and care is no longer limited to hospitals and offices, but instead provides effective “anytime, anywhere care” to patients.
▼Scan the QR code below to read the full text
N Engl J Med 2023; 389:2100-2101
DOI: 10.1056/NEJMe2303219
*The Chinese interpretation is for reference only, and all content shall be subject to the original English text. If there are copyright issues, please contact us to delete.
▼References
[1] Hughes MS, Addala A, Buckingham B. Digital technology for diabetes. N Engl J Med 2023;389:2076-2086.
[2] Phaneuf A. The number of health and fitness app users increased 27% from last year. Insider Intelligence. July 20, 2020
[3] Ruby D. Smartwatch statistics 2023: how many people use smartwatches? Demandsage. March 6, 2023
[4] Wearable medical devices market to grow US$ 76,479.8 mn by end of 2028, says Coherent Market Insights. Bloomberg. October 20, 2021
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