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The medical health industry is entering a new era and technology will play a great role in this area. Equipment in hospitals is in many cases strictly dependent on technology that works. However, technology in the medical health industry will maybe become a bigger part of our private lifestyle. This lifestyle includes digital health apps, wearables and devices that track your daily physical routines with “Internet of things”. These ways of keeping track of your health can be used for private purposes, but also to complement medical studies with clinical results. This thesis will focus on how wearables can complement a medical study where patients with severe heart failure will use the smartwatch Apple Watch. This smartwatch will collect data on patients daily physical activity pattern and thereafter analyze this data in order to find activity patterns. This thesis intends to answer the questions How can wearables such as the Apple Watch benefit medical heart research? and what makes the Apple Watch a suitable wearable for the medical study at Lund’s University Hospital? Interviews were therefore held with medical heart researchers and addressed the purpose of the medical study and their choice of wearable. Thereafter, a examination of the Apple Watch was conducted and it together with the interview indicated that the Apple Watch in fact is a suitable wearable. Finally, an exportation process where data from the Apple Watch was done where the exported data then was decoded in Microsoft Excel. The purpose of this was to examine statements that were revealed in the interview. That being said, the thesis came to the conclusion that the Apple Watch contributes a lot when mixing complementing data from wearables with clinical records. Another conclusion was that this tracking device was suitable for the medical study. In what extension the Apple Watch is suitable, is yet unclear since the medical study is in need of further patients and research where one compares wearables against each other.

A tool allowing the prediction of the risk of bleeding in patients with hemophilia would be relevant for patients, stakeholders, and policymakers. We performed a systematic review of the literature searching for available risk assessment models to predict the risk of bleeding in people living with hemophilia, and to determine the key risk factors that the ideal model should include. We also systematically review the literature to determine the acceptability and accuracy of wrist-wearable devices to measure physical activity in the general population. Finally, we validated the performance of a risk assessment model for the prediction of the risk for bleeding in people living with hemophilia. We identified the following risk factors for bleeding in people living with hemophilia: plasma factor levels, history of bleeds, physical activity, antithrombotic treatment, and obesity. The FitBit Charge and FitBit Charge HR are the most accurate devices for measuring steps, and the Apple Watch is the most accurate for measuring heart rate. No device proved to be accurate in measuring energy expenditure. The predictive accuracy of the risk assessment model that we validated does not endorse its use to drive decision making on treatment strategies based on the predicted number of bleeds. This might in part be explained by the methods used in the derivation phase. The need for an accurate risk assessment model to predict the risk of bleeding in people living with hemophilia is still unmet. This should be done by including the relevant risk factors identified through our work, with data on physical activity possibly collected using an accurate wrist-wearable device, and through the application of rigorous methods in the derivation and validation phases. / Thesis / Doctor of Philosophy (PhD) / People living with hemophilia lack a coagulation factor and tend to experience spontaneous bleeds, with frequency and intensity that vary between individuals. Predicting who will experience more bleeds would allow for changing the treatment strategies and directing the best resources to the persons that can benefit more. Through this project, we identified the variables that should be considered to estimate the risk for bleeding in people living with hemophilia, namely the blood levels of the lacking coagulation factor, the bleeding history, the physical activity levels, the concomitant treatment with blood thinners, and the presence of obesity. We determined that Fitbit Charge and Charge HR are the most accurate devices for measuring steps and Apple Watch for heart rate. Lastly, we found that an existing tool for predicting the risk of bleeding is not accurate enough to be used in this setting, and a new model should be produced.

As a college student, there is a risk of spending a large part of the day with sedentary studies, which can have negative effects on students' health. With the intention of counteracting this and devoting more time to physical activity, Wearable fitness tracker (WFT) is an increasingly common technical aid for students. The most sought-after option on the market among students is Apple's smartwatch called the Apple Watch. In previous studies conducted on wearable fitness trackers, it was shown that the use of WFTs resulted in the perception of health having positive changes. Similarly, studies concerning the integrated social functions showed that the use of these significantly increases the individual's intention to continue exercising and to continue using the service that provided the functions. Therefore, this study examined whether the usability of the exercise-related features of the Apple Watch has an impact on the attitude toward physical activity of college students. This quantitative study used a digital survey with a variety of questions for participants to answer. The System Usability Scale was used as the basis for some of the questions that would measure usability, and the Exercise Motives and Gains Index (EMGI) was used to measure attitudes towards training. The results of the study showed that the usability for mainly two categories of functions, Gaming and Sharing, was of great importance for whether the attitude towards physical activity changed. In addition, 3% of participants claim to not meet the health recommendations after owning the Apple Watch, which is a decrease compared to the 29% before the smartwatch was acquired. Despite the reported numbers that the vast majority claim to be more physically active since acquiring the Apple Watch, no connection between a change in attitude and the increase could be established. / Universitetsstudenter riskerar att tillbringa en stor del av dagen åt stillasittande studier, vilket kan ha negativa effekter på deras hälsa. Med avsikt att motverka detta och ägna mer tid åt fysisk aktivitet är Wearable Fitness Trackers (WFT) ett allt vanligare tekniskt hjälpmedel för studenter. Ett av de mest efterfrågade alternativen på marknaden bland studenter är smartklockan Apple Watch. I tidigare studier utförda på Wearable Fitness Trackers visades att fortsatt användning av WFTs hade en positiv relation med upplevda hälsoförbättringar. Andra studier som rörde spelifierade och sociala funktioner i hälsoappar och WFTs, visade att användning av de funktionerna ökar intentionen att fortsätta använda tjänsterna eller tekniken, samt att fortsätta träna. I denna studie undersöktes huruvida användbarheten av de träningsrelaterade funktionerna i Apple Watch har en påverkan på inställningen till fysisk aktivitet hos universitetsstudenter. Denna kvantitativa studie använde en digital enkät med ett flertal frågor för deltagarna att besvara. System Usability Scale användes för att mäta användbarhet, och Exercise Motives and Gains Index (EMGI) användes för mätning av inställning till fysisk aktivitet. Resultatet av studien visade att användbarheten för två funktionskategorier, Gaming och Sharing, hade stor betydelse för om inställningen till fysisk aktivitet förändrats. Dessutom uppgav 3% av deltagarna att de inte uppfyllde hälsorekommendationerna efter ägandet av Apple Watch, vilket är en minskning jämfört med 29 procent innan smartklockan införskaffades. Trots att en överväldigande majoritet av deltagarna uppgett att de utövar mer fysisk aktivitet idag, kunde ingen koppling mellan en förändring i attityd och den ökning som uppgavs etableras.

The Apple Watch is capable of recording single-lead electrocardiograms (ECGs). To incorporate such devices in routine medical care, the reliability of such devices to obtain precordial leads needs to be validated. The purpose of this study was to assess the feasibility and reliability of a smartwatch (SW) to obtain precordial leads compared to standard ECGs. We included 100 participants (62 male, aged 62.8 ± 13.1 years) with sinus rhythm and recorded a standard 12-lead ECG and the precordial leads with the Apple Watch. The ECGs were quantitively compared. A total of 98 patients were able to record precordial leads without assistance. A strong correlation was observed between the amplitude of the standard and SW-ECGs’ waves, in terms of P waves, QRS-complexes, and T waves (all p-values < 0.01). A significant correlation was observed between the two methods regarding the duration of the ECG waves (all p-values < 0.01). Assessment of polarity showed a significant and a strong concordance between the ECGs’ waves in all six leads (91–100%, all p-values < 0.001). In conclusion, 98% of patients were able to record precordial leads using a SW without assistance. The SW is feasible and reliable for obtaining valid precordial-lead ECG recordings as a validated alternative to a standard ECG.

Some of the recently released smartwatch products feature a single-lead electrocardiogram (ECG) recording capability. The reliability of obtaining 3-lead ECG with smartwatches is yet to be confirmed in a large study. This study aimed to assess the feasibility and reliability of smartwatch to obtain 3-lead ECG recordings, the classical Einthoven ECG leads I-III compared to standard ECG. To record lead I, the watch was worn on the left wrist and the right index finger was placed on the digital crown for 30 s. For lead II, the watch was placed on the lower abdomen and the right index finger was placed on the digital crown for 30 s. For lead III, the same process was repeated with the left index finger. Spearman correlation and Bland-Altman tests were used for data analysis. A total of 300 smartwatch ECG tracings were successfully obtained. ECG waves’ characteristics of all three leads obtained from the smartwatch had a similar duration, amplitude, and polarity compared to standard ECG. The results of this study suggested that the examined smartwatch (Apple Watch Series 4) could obtain 3-lead ECG tracings, including Einthoven leads I, II, and III by placing the smartwatch on the described positions.

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Over the past 10 years, smartwatches have become increasingly popular for commercial use. Their ever-increasing capabilities, accuracy, and sophistication of smartwatches is making them increasingly appealing to physical activity researchers as a valuable research tool. The non-invasive nature, prevalence, and versatility of smartwatches is being utilized to track heart rate, blood-oxygen levels, activity and movement, and sleep. However, the current state of the art lacks a uniform method to extract, organize, and analyze data collected from these devices. The objective of this research was to develop a Python software library that is widely available, highly capable, and easy to use with the data collected by the Apple Watch. The library was designed to offer data science, visualization, and mining features that help physical activity research find and communicate patterns in the Apple Health data. The custom-built caching system of the library provides near-instant runtime to parse and analyze large files without trading off on memory usage. The Wanjara Smartwatch Library has significantly better performance, proven reliability and robustness, and improved usability than the alternatives discovered in the review of the literature. / Master of Science / Over the past 10 years, smartwatches have become increasingly popular for commercial use. Their ever-increasing capabilities, accuracy, and sophistication of smartwatches is making them increasingly appealing to physical activity researchers as a valuable research tool. The non-invasive nature, prevalence, and versatility of smartwatches is being utilized to track heart rate, blood-oxygen levels, activity and movement, and sleep. However, the current state of the art lacks a uniform method to extract, organize, and analyze data collected from these devices. The objective of this research was to develop a Python software library that is widely available, highly capable, and easy to use with the data collected by the Apple Watch. The library was designed to offer data science, visualization, and mining features that help physical activity research find and communicate patterns in the Apple Health data. The custom-built caching system of the library provides near-instant runtime to parse and analyze large files without trading off on memory usage. The Wanjara Smartwatch Library has significantly better performance, proven reliability and robustness, and improved usability than the alternatives discovered in the review of the literature.

The project explores an alternative timekeeping device that without a digital screen and use of electrical light displays five distinct shades representing each stage of light a day consists of. The thesis presents a design proposal for an alternative watch that through unconventional methods uses natural light to gradually reveal the passage of time. Furthermore, design research includes observations of and interactions with other-than humans (such as the Calathea plant and a Spiral Grained Tree) and their relation to time and light. Underlying the two main themes is the topic of mental health and stress-related illness that has rapidly increased in Sweden over the past few years.

En même temps: Diss. phil.-hist. Bern, 2001. / Index. Bibliogr.