Smartwatches in childhood: a mixed blessing?-a scoping review

Area of Science:

• Pediatric cardiology
• Digital health technology
• Consumer health informatics

Background:

• Smartwatches are increasingly popular among children and adolescents.
• These devices monitor heart rate and generate electrocardiographic (ECG) traces.
• Cardiac data from smartwatches has potential benefits and risks, including inappropriate clinical interventions.

Purpose of the Study:

• To evaluate the literature on smartwatch use in children and adolescents.
• To assess the prevalence, perception, and interpretation of cardiac data from smartwatches.
• To understand the impact on children, adolescents, and their parents.

Main Methods:

• A scoping review was conducted.
• The review followed Arksey and O'Malley's principles.
• The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist was used.

Main Results:

• Smartwatch usage in children ranges from 15% to 40% globally.
• Increased presentations with smartwatch-related heart concerns, often false positives.
• Accurate heart rate measurement but poor heart rhythm classification algorithms for pediatrics.
• Some pediatric users experienced anxiety due to smartwatch-generated data.

Conclusions:

• Smartwatch use in pediatric populations is increasing.
• Misinterpretation of cardiac data due to flawed algorithms leads to healthcare visits and anxiety.
• There is a need for better algorithms and education on heart rate variability in children.
• Medicolegal, privacy, and cybersecurity issues require resolution.