As a paramedic, not a physician, atrial fibrillation is not a life threatening event. Many people happily live with it for decades, unmedicated. It is more problematic if you are diabetic or hypertensive, but still not an acute medical event.
As a doctor, the proliferation of apple (and other) watch ECGs has done nothing positive but lead to a massive proliferation of severe health anxiety. Go take a look at /r/askdocs for anyone curious - dozens of apple and Samsung ECG questions, people sure they’re about to die. They have nothing.
I remain entirely unconvinced that putting ‘more’ health information at increased temporal frequency to consumers leads to any health benefit, and instead causes significant health anxiety and drain on health resources with false and misleading presentations for bad signals.
How do you reconcile your views on “nothing positive” when there are multiple reported accounts of it leading to early diagnosis events for serious issues?
It can be easily reconciled if there are far more instances of false positives than true positives.
Remember that a 99% accuracy for a condition that 0.1% of the population has still means 10 false positives for each 1 early diagnosis.
I don't what the numbers are for the conditions that the Apple Watch can detect, just discussing the general principle. Whether it's more useful or more harmful depends crucially on the real numbers.
There's some amount of luck and marginal effects that need to be discounted, otherwise you couldn't say "nothing positive" about a diagnostic that always says "you are dying", and you couldn't say "nothing positive" about a strategy that has you pick the opposite route and then repeat as many times as you want. And I think such a conclusion would be very dumb.
I'm not making a statement on whether the apple watch in particular is close enough to that line.
Maybe - I am unconvinced, my sister who is a Cardiologist (and so actually deals with this more day to day) certainly has changed her tune from 2-3 years ago to the point where she and the cardiologists she works with see it as a pestilence.
I think the commenter you replied to gives a good reason why. The false positive rate is so high, and the flow on effect to resourcing so great, that I find it hard to say anything positive about what is being presented as a diagnostic miracle. You've got trillion dollar companies behind these devices, that by themselves have annual turnovers for the product in question at the level of small countries' GDPs. You don't think their marketing teams ham it up a bit whenever there's the slightest story that one of their devices was involved in someone that was treated?
here's a nice pop-sci-feel-good article I found within seconds [0].
The first couple are completely unrelated. the A-Fib ones, which are the main ones that apple goes hard at (at least during initial marketing, and which all the promo was focused on) - are basically irrelevant. They sound impressive to the layperson, but AFib is very common, often intermittent in the initial stages (but very rarely causes any harm when intermittent) and very frequently symptomatic when it sets in which leads to presentations, which leads to prompt diagnosis and management.
As a counterpoint, my cardiologist suggested I get an Apple watch so I could keep a better eye on things and send him any questionable ECGs. At least some doctors seem to think there are positives.
The very important point is that you probably have a known heart condition, if your doctor recommended this. The problem with many of these devices is false positives.
As a paramedic, not a physician, atrial fibrillation is not a life threatening event. Many people happily live with it for decades, unmedicated. It is more problematic if you are diabetic or hypertensive, but still not an acute medical event.