Accuracy and role of consumer facing wearable technology for continuous monitoring during endoscopic procedures

Consumer facing wearable devices capture significant amounts of biometric data. The primary aim of this study is to determine the accuracy of consumer-facing wearable technology for continuous monitoring compared to standard anesthesia monitoring during endoscopic procedures. Secondary aims were to assess patient and provider perceptions of these devices in clinical settings.

Patients undergoing endoscopy with anesthesia support from June 2021 to June 2022 were provided a smartwatch (Apple Watch Series 7, Apple Inc., Cupertino, CA) and accessories including continuous ECG monitor and pulse oximeter (Qardio Inc., San Francisco, CA) for the duration of their procedure. Vital sign data from the wearable devices was compared to in-room anesthesia monitors. Concordance with anesthesia monitoring was assessed with interclass correlation coefficients (ICC). Surveys were then distributed to patients and clinicians to assess patient and provider preferences regarding the use of the wearable devices during procedures.

292 unique procedures were enrolled with a median anesthesia duration of 34 min (IQR 25-47). High fidelity readings were successfully recorded with wearable devices for heart rate in 279 (95.5%) cases, oxygen in 203 (69.5%), and respiratory rate in 154 (52.7%). ICCs for watch and accessories were 0.54 (95% CI 0.46-0.62) for tachycardia, 0.03 (95% CI 0-0.14) for bradycardia, and 0.33 (0.22-0.43) for oxygen desaturation. Patients generally felt the devices were more accurate (56.3% vs. 20.0% agree, p < 0.001) and more permissible (53.9% vs. 33.3% agree, p < 0.001) to wear during a procedure than providers.

Smartwatches perform poorly for continuous data collection compared to gold standard anesthesia monitoring. Refinement in software development is required if these devices are to be used for continuous, intensive vital sign monitoring.