With the announcement of the newest Apple phone and Watch iteration on the 12th came the news that Apple was further stepping into healthcare. The Apple Watch Series 4 will come equipped with a heart monitor, that Apple claims will be able to diagnose Atrial Fibrillation and perform an ECG.
AHA President Ivor Benjamin made an appearance on stage to endorse the Watch, which didn’t sit well with one user:
Was anyone else uncomfortable with Apple trotting out Ivor Benjamin, the AHA president, to spew meaningless blather implying the AHA supported the cardiology features of the new Watch? How much money did that take @Apple ?— Skeptical Cardio (@skepcard) September 13, 2018
Others wanted to know how useful an ECG would be if the data wasn’t taken into consideration with the full patient.
Hey @American_Heart , can you explique me how the #AppleWatchSeries4 can help me to treat a condition (patient with low risk, asymptomatic, with atrial fibrillation) for the which you don’t known if is really a problem?— Abraham E. Gracia R. (@Abraham_RMI) September 15, 2018
And while others wondered how the features could replace tools and physicians….
…others were critical of its accuracy.
My critical comments on the #AppleWatchSeries4 ECG #AI abnormal heart rhythm detection announced at #AppleEvent— Eric Topol (@EricTopol) September 13, 2018
—@NPR https://t.co/6fvfPQ2Su3 by @heyavie
—@WSJ https://t.co/xx7QQZcLqw by @Loftus
w/ @drjohnm pic.twitter.com/qgqoWWAaz3
No objections to @Apple watch ECG from my end.— Sek Kathiresan MD (@skathire) September 14, 2018
Just trying to educate that
Test can have 98% sensitivity/99% specificity (eg Apple Watch ECG per submission to @US_FDA, see __)
Can give wrong diagnosis (false positive) most of the time. https://t.co/7FEdo4FKMb
Apple watch afib detection testing characteristics: sensitivity 98%, specificity 99.6% (N=580, 1:1 AFib : no AFib). As pointed out by several, more likely to observe false (vs true) positives among groups with a low prevalence of Afib @statnews https://t.co/hxhxSk0iWF— Pradeep Natarajan (@pnatarajanmd) September 13, 2018
I'd love to see the study on the accuracy of the ECG touted by Apple Watch today. The work on Afib was based in part on this study from UCSF. Small sample, but promising. https://t.co/jWh8Xq7ISO— Kishore Hari (@sciencequiche) September 12, 2018
Some were hopeful that the increased awareness for heart conditions would be beneficial, while others thought the probability of getting a false positive would lead to more crowded hospitals.
Hmm. Cardiologist says Apple Watch's new ECG functionality could be "unbelievably helpful" for AFib patients, but expresses "shock" at FDA clearance since "I haven't seen any data on it." Could revolutionize care -- or clog ERs with false alarms. https://t.co/hAxNRWXoov— Matt Arnold (@MattArnoldRx) September 13, 2018
As a whole, medicine is dealing with a huge problem of overdiagnosis (a bunch of true positives for whom detection means medicalization not better health). And here comes a tool perfected to make the problem worse. Urggg— Victor Montori, MD (@vmontori) September 13, 2018
Seems misleading to label #AppleWatchSeries4 as capable of performing an electrocardiogram. A rhythm strip is more like it. Not a substitute for a 12-lead. And then I am wondering… when will we know what to do w/the results. Lots of people might have a little #afib. @drjohnm— Harlan Krumholz (@hmkyale) September 15, 2018
Are you interested in understanding just how bad @Apple watch's false positive rate might be?— Venk Murthy MD PhD (@venkmurthy) September 18, 2018
2. No, it's AHA endorsed and cool
Looking forward to the new Apple Watch features I but think this will unfortunately happen too often #applewatch #apple #ekg #watch #scottsdale #phoenix #medical #doctor #physician #heart #smartwatch #arizona https://t.co/n4n00Kbpt7 pic.twitter.com/q5gwfVNz8l— DoctorPrimack (@doctorprimack) September 19, 2018
What do you think: is the new Apple Watch ECG feature helpful or harmful?