Wearing Your Heart on Your Sleeve

Say you want to know what the weather will be like tomorrow. You turn on the weather channel, and the broadcaster says, “It’ll be an average of 75 degrees in the United States this year.” Not the most helpful for planning out your day. This is not dissimilar from the way we currently practice preventative medicine. We visit our doctor annually, get a few labs drawn, and try to predict our current health status and trajectory–but it’s all based on population averages, meaning how you compare to the average person. Here’s a little secret–the average person doesn’t exist! Now Imagine you look at the weather app on your phone and learn it is currently 72 degrees at your location, has a 49% chance of rain, humidity of 68%, and will be cloudy for your 11:00am patio-brunch reservation. This information provides a precise and personalized picture of your day, allowing you to adapt accordingly. The use of wearable technology integrates this type of personalization into your medical care. These devices enable us to passively understand how our body functions continuously—in real-time. From this trove of data, we can make robust predictions and recommendations to maintain wellness and prevent disease, all while better understanding our biological identity.

9,823 steps, average resting heart rate of 65 bpm, 4.4 miles walked, and a sleep score of 67; these are all the data types you are likely familiar with if you have worn one of the popular health trackers. While these provide an interesting daily snapshot, the value lies in the dynamics of these variables across our life–how they change over time. Fitness trackers are just the tip of the iceberg regarding wearable health insight. Some devices, such as continuous glucose monitors and indirect calorimetry masks, measure our internal physiology. ECG, blood pressure, and oxygen saturation have typically been restricted to the clinical setting but are becoming common in smartwatches and other devices. New devices are developing that use optical and electronic sensors to see non-invasively into our bodies’ blood chemistry, enriching our ability to track our health and wellness trajectory. 

Our biological identity or “phenome” is the product of our genetics, behavior, and environment. By leveraging wearable data, we witness day-to-day changes in our phenome, reflecting our current health status and forecasting our transition to health or disease. By analyzing wearable data with personal measurements like genomics, diet, and health history, we can develop a computerized model of our phenome. These “models” may provide a visual representation of our phenome, analyze our risk of disease, and provide recommendations to optimize our progress toward health.  

Scientists have already started to track changes across the lifespan using wearables. When looking at these data using large populations, patterns emerge, allowing researchers to connect the dots among behavior, personal measurements, wellness, and transition to disease. In conjunction with phenomic research, wearables will be instrumental in shifting healthcare from disease focus and comparison to population averages to one oriented around prevention and personalization. 

Noah Levine
Research Associate, Phenome Health