Exploring the Use of Wearable Data in the Congenital Heart Disease Population Using the All of Us Research Program

Wearable devices, such as smart watches, smart rings, accelerometer-based step counters, compact blood pressure monitors, and continuous glucose sensors have enabled the continuous measurement of physiological signals. Studies have demonstrated that wearable health technologies can provide valuable physiological feedback to subjects and clinicians about health trajectories and can aid in the detection of health anomalies. Wearable devices have the potential to provide more frequent remote physiologic measurements for congenital heart disease (CHD) patients - people who are born with a range of structural and functional cardiovascular abnormalities. In this paper, differences in activity levels, defined by step count and activity minutes, between patients diagnosed with congenital heart diseases and those without were evaluated within relevant subgroups (age range, sex at birth, race, ethnicity, BMI status, state) using the All of Us Research Program. A cohort of 537 patients diagnosed with some form of CHD was created. Fitbit metrics like the average number of steps and activity minutes (lightly active, fairly active, very active, and sedentary) between January 2015 to December 2019 were compared across a CHD and non-CHD cohort (36,071 people). Using factorial ANOVA, the results demonstrate a statistically significant difference in the number of steps walked by CHD and non-CHD subjects. In addition, sex assigned at birth and BMI have the highest contribution (when compared to CHD diagnosis and various subgroups) to the difference in steps counted, followed by geographic location, age range, and then CHD diagnosis. The implications of these findings are that the number of steps, which are a surrogate for the amount of physical activity achieved by a subject, are much smaller for CHD patients than for non-CHD subjects.Clinical relevance- The population of people with congenital heart disease (CHD) is expected to increase over the next 25 years and routine monitoring for these individuals is crucial for their health trajectories. Wearable devices represent supplemental devices that can help clinicians track the health status of CHD patients.