The widespread public adoption of new technologies to measure behavior and health characteristics outside the clinic have enabled a high resolution, stream of information with important known links to health and medical outcomes. This includes data from consumer grade wearable devices (e.g. Fitbit, Apple watch, etc.), but also home-based health devices (glucose monitors, blood pressure cuffs, scales, etc.) and online self-report surveys.
Building an institutional resource around collecting, organizing, and providing these data to VUMC users will enable substantial advances in translating digital health data into clinical utility. Work using a similar resource from our team has shown that increasing step counts from Fitbit devices is associated with numerous health conditions (published in Nature Medicine) and that the number of steps needed to mitigate risk of obesity is dependent on genetic background. These results represent just two of many opportunities to leverage these data that when linked to other VUMC resources (RD/SD, BioVU) aligns with the VICTR’s mission to transform the way ideas and research discoveries make their way from origin to patient care.
Examples of a few scientific questions that could be addressed with this type of infrastructure.
- Understanding the causal impact of behavior (e.g. changes in activity or sleep) on clinical outcomes and medical utilization.
- Targeted recruitment and provision of specific device for patients with risk of disease (e.g. Fitbit for patients with high risk of atrial fibrillation, or glucose monitor for those at risk for type 2 diabetes).
- RCT to test value of automated identification of functional drift (i.e. a digital prodrome) that may herald an impending admission (e.g. heart failure).
- RCT for value of monitoring patients after serious medical event or intervention (e.g. recovery from MI, transplant, discharge from ICU).