Apple Watch detects irregular heart beat in large U.S. study • Hacker News Board

Re: Apple Watch detects irregular heart beat in large U.S. study

#211

Post by imglorp » Sun, Mar 17, 2019, 12:19 PM UTC

brandonb wrote: post #82

I work at a related company (Cardiogram), and there's a surprising amount of signal locked in the humble heart rate sensor -- we've run multiple studies with UCSF showing accurate detection of sleep apnea, high blood pressure, and even diabetes using off-the-shelf heart rate sensors and a deep neural network, DeepHeart: https://blog.cardiogr.am/screening-with-wearables-what-do-th... If you're an engineer or payer rel…

Payer relations?

Does this mean insurance companies are interested in this heart rate data stream, and are making inferences from it? Are they already collecting it? Do any of these wearables provide this data to these companies without the user's express permission?

Is this a good thing?

Re: Apple Watch detects irregular heart beat in large U.S. study

#212

Post by Brakenshire » Sun, Mar 17, 2019, 12:24 PM UTC

deburo wrote: post #157

yakshaving_jgt wrote: post #142

Earlier quoted context omitted.

I can't fathom how anyone would pay this. For less than three grand, you could fly to Europe for a weekend, stay in a five star hotel, and have all the tests done while you're there.

That can't be true, if you're not a citizen of a certain country, you don't get subsidies for its services.

It’s more that private clinics in Europe are i) competing with free and ii) don’t have the same incentives to have crazy out of pocket prices which insurance companies negotiate down. So just turning up and paying for private care is a lot cheaper.

Re: Apple Watch detects irregular heart beat in large U.S. study

#213

Post by iguy » Sun, Mar 17, 2019, 12:30 PM UTC

Dylan16807 wrote: post #198

iguy wrote: post #44

Earlier quoted context omitted.

It's entirely possible that a test which was net positive when applied "with probable cause", can even become a net negative if applied without. Because testing the whole population will produce many more false positives. I doubt the tests they are running here will actually go that far. But pervasive testing does need different trade-offs to targeted testing. At least we may have more complete data from which to und…

When the ratio of true to false positives is at greater than 5:1, it's hard to imagine the false positives causing net harm.

Where do you get 5:1? Maybe I don't know enough about heart disease but the numbers in the article seem pretty hard to parse.

It sounds like many of those who got a bleep from their iWatch subsequently had some effect detected by standard tests. But that isn't the right number. We don't necessarily know that we should treat everyone who fails standard tests. Especially if our previous knowledge about such tests was limited to patients where there was other evidence.

Re: Apple Watch detects irregular heart beat in large U.S. study

#214

Post by eeeeeeeeeeeee » Sun, Mar 17, 2019, 1:04 PM UTC

yakshaving_jgt wrote: post #142

eeeeeeeeeeeee wrote: post #88

Earlier quoted context omitted.

Ok, so what? Shouldn’t we be cheering the fact that a consumer device can potentially detect this without ever requiring a much costlier visit to the ER or doctors office? My Apple Watch was a few hundred bucks. My latest ER visit for tachycardia (idle heart rate over 100) came to over $3000, with health insurance. And all they did was tests.

I can't fathom how anyone would pay this. For less than three grand, you could fly to Europe for a weekend, stay in a five star hotel, and have all the tests done while you're there.

Not really an option in this case. When you feel like you’re having a heart attack you don’t go to the airport for a European trip :)

That $3k out-of-pocket cost was ECG, blood tests, urine tests, chest x-rays and talking to a doctor for 5 minutes. I wish I was kidding. Healthcare in America is an abomination.

I should, add, too, that the $3k cost was because I had insurance. The total bill came out to around $23,000 and I would have had to pay that if I didn't have insurance.

Seeing a cardiologist is a totally separate visit/bill.

Re: Apple Watch detects irregular heart beat in large U.S. study

#215

Post by astura » Sun, Mar 17, 2019, 1:34 PM UTC

PakG1 wrote: post #148

mbreese wrote: post #85

Earlier quoted context omitted.

Exactly -- for those 45% with the false positive, you will be doing emotional harm to many of them, even without an invasive followup test. And then, if you knew that 45% of people got a false positive, how likely is the 5% (the true positives who really need it) going to believe their initial result and even get the followup?

EULA and UI should emphasize that this is not a sure thing, please see a doctor to be sure. Why would anyone get mad at that? My grandpa noticed my dad losing a ton of weight. He told my dad there might be something wrong with him, go check it out. Turns out it was cancer, saved my dad's life. Should my dad be upset at my grandpa for causing emotional stress if it was nothing?

Getting tests when you have symptoms is a completely and totally different topic than widescale testing of asymptomatic individuals without specific risk factors, which is what we are talking about here.

Re: Apple Watch detects irregular heart beat in large U.S. study

#216

Post by astura » Sun, Mar 17, 2019, 1:53 PM UTC

chii wrote: post #105

astura wrote: post #71

Earlier quoted context omitted.

It's complicated... Not all instances of cancer are harmful, more men die with prostate cancer then die because of of it and thyroid cancer is found as an incidental in ~30% of autopsies. More detection can cause more harm than good, as what happened in South Korea with thyroid cancer screening, a huge increase in detection and treatment without any decrease in survival rates. Here's a good overview: https://scienceb…

Under-rated opinion - if you're not feeling ill, there's probably no reason to perform any medical diagnostics. If you're wearing a medical diagnostic bracelet, and it tells you that you have some issue, you might end up getting more anxcious and stressed (which can cause real harm), despite the fact that there's nothing "wrong" really.

There's evidence that the following are beneficial on an asymptomatic population level:

Obesity screening

Blood pressure screening

Cervical cancer screening (pap test) though most medical providers test at the wrong intervals.

Re: Apple Watch detects irregular heart beat in large U.S. study

#217

Post by hatsunearu » Sun, Mar 17, 2019, 2:05 PM UTC

lucb1e wrote: post #194

hatsunearu wrote: post #173

https://www.youtube.com/watch?v=s0sv3Kuurhw Super underrated channel (British humor, anyone)--shows how the Apple Watch's ECG feature can be actually bad for overall health. edit: though the amount of positive outcomes (the reddit thread) makes me reassess this...

Edit: reading further in the thread, this comment said it better than I did (though they aren't speaking about the video, it makes the same argument): https://news.ycombinator.com/item?id=19409734 > It should be noted though that this study does not say that an Apple Watch will overall provide medical benefits. It also doesn't follow automatically from the fact that it detects things with a certain reliability. The i…

I'd definitely buy this for my gramps or something like that, and I'd buy it myself if I had an iPhone, just because I like smartwatches.

But what I am concerned about is that this kind of stuff is a Pandora's box that can cause some undeserved panic...

Re: Apple Watch detects irregular heart beat in large U.S. study

#218

Post by yakshaving_jgt » Sun, Mar 17, 2019, 2:27 PM UTC

eeeeeeeeeeeee wrote: post #214

yakshaving_jgt wrote: post #142

Earlier quoted context omitted.

I can't fathom how anyone would pay this. For less than three grand, you could fly to Europe for a weekend, stay in a five star hotel, and have all the tests done while you're there.

Not really an option in this case. When you feel like you’re having a heart attack you don’t go to the airport for a European trip :) That $3k out-of-pocket cost was ECG, blood tests, urine tests, chest x-rays and talking to a doctor for 5 minutes. I wish I was kidding. Healthcare in America is an abomination. I should, add, too, that the $3k cost was because I had insurance. The total bill came out to around $23,000…

I understand, and I in no way mean to trivialise what emergency patients go through. But in many cases, for many people, otherwise expensive medical procedures can be planned.

Re: Apple Watch detects irregular heart beat in large U.S. study

#219

Post by eeeeeeeeeeeee » Sun, Mar 17, 2019, 2:38 PM UTC

yakshaving_jgt wrote: post #218

eeeeeeeeeeeee wrote: post #214

Earlier quoted context omitted.

Not really an option in this case. When you feel like you’re having a heart attack you don’t go to the airport for a European trip :) That $3k out-of-pocket cost was ECG, blood tests, urine tests, chest x-rays and talking to a doctor for 5 minutes. I wish I was kidding. Healthcare in America is an abomination. I should, add, too, that the $3k cost was because I had insurance. The total bill came out to around $23,000…

I understand, and I in no way mean to trivialise what emergency patients go through. But in many cases, for many people, otherwise expensive medical procedures can be planned.

Yep, definitely. I tell everyone I know about it as a possibility if they are facing it, as insane as it feels to even make that proposal within the borders of the richest country in the world, that spends more on healthcare than any other nation (almost 20% of our GDP). It's shameful.

Re: Apple Watch detects irregular heart beat in large U.S. study

#220

Post by eeeeeeeeeeeee » Sun, Mar 17, 2019, 2:41 PM UTC

PakG1 wrote: post #147

yakshaving_jgt wrote: post #142

Earlier quoted context omitted.

I can't fathom how anyone would pay this. For less than three grand, you could fly to Europe for a weekend, stay in a five star hotel, and have all the tests done while you're there.

If your insurance pays for it, you probably wouldn't.

My insurance didn’t pay the $3k, that was my out of pocket cost. And higher deductible plans are on the rise in America.

Medical tourism might become a more common thing.