Acceptable nudge strategies to incentivize the use of wearables and physiolytics at work: A Q-methodology examination

The Covid-19 pandemic has increased the pressure on organizations to ensure health and safety in the workplace. An increasing number of organizations are considering wearables and physiolytics devices as part of their safe return to work programs so as to comply with governments' accountability rules. As with other technologies with ambivalent use (i.e., simultaneously beneficial and harmful), the introduction of these devices in work settings is met with skepticism. In this context, nudging strategies as a way of using design, information, and other ways to manipulate behaviors (system 1 nudge) and choices (system 2 nudge) has gained traction and is often applied alongside the introduction of ambivalent technologies with the aim to "nudge” their use. While the feasibility of different nudge strategies is often studied from only a managerial perspective, where employees' volitional autonomy and dignity is often treated as secondary, we explore which nudges are acceptable from the perspectives of ordinary workers. Using Q-methodology as a more evolutionary and participatory way to design nudges, we describe five basic strategies that are (to varying degrees) acceptable to them: (a) positive reinforcement and fun, (b) controlling the organizational environment, (c) self-responsibility, (d) collective responsibility, and (e) adapting the individual environment. Our findings show that there is a wide range of viewpoints on what is being considered an acceptable nudge and stress the importance of a transparent, equal dialogue between those who design nudges and potential nudgees. © Association for Information Technology Trust 2023.

The Pi-CON Methodology Applied: Operator Errors and Preference Tracking of a Novel Ubiquitous Vital Signs Sensor and Its User Interface

Remote Patient Monitoring has enjoyed strong growth to new heights driven by several factors, such as the COVID-19 pandemic or advances in technology, allowing consumers and patients to continuously record health data by themselves. This does not come without its challenges, however. A literature review was completed and highlights usability gaps when using wearables or home use medical devices in a virtual environment. Based on these findings, the Pi-CON methodology was applied to close these gaps by utilizing a novel sensor that allows the acquisition of vital signs at a distance, without any sensors touching the patient. Pi-CON stands for passive, continuous and non-contact, and describes the ability to acquire vital signs continuously and passively, with limited user interaction. The preference of vital sign acquisition with a newly developed sensor was tested and compared to vital sign tests taken with patient generated health-data devices (ear thermometer, pulse oximeter) measuring heart rate, respiratory rate and body temperature. In addition, the amount of operator errors and the user interfaces were tested and compared. Results show that participants preferred vital signs acquisition with the novel sensor and the developed user interface of the sensor. Results also revealed that participants had a mean error of .85 per vital sign measurement with the patient-generated health data devices and .33 with the developed sensor, confirming the beneficial impact available when using the developed sensor based on the Pi-CON methodology.

Smartwatch-based ecological momentary assessments for occupant wellness and privacy in buildings

This paper describes the adaptation of an open-source ecological momentary assessment smartwatch platform with three sets of micro-survey wellness-related questions focused on i) infectious disease (COVID-19) risk perception, ii) privacy and distraction in an office context, and iii) triggers of various movement-related behaviors in buildings. This platform was previously used to collect data for thermal comfort, and this work extends its use to other domains. Several research participants took part in a proof-of-concept experiment by wearing a smartwatch to collect their micro-survey question preferences and perception responses for two of the question sets. Participants were also asked to install an indoor localization app on their phone to detect where precisely in the building they completed the survey. The experiment identified occupant information such as the tendencies for the research participants to prefer privacy in certain spaces and the difference between infectious disease risk perception in naturally versus mechanically ventilated spaces. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.

Use of digital technologies for public health surveillance during the COVID-19 pandemic: A scoping review.

Throughout the COVID-19 pandemic, a variety of digital technologies have been leveraged for public health surveillance worldwide. However, concerns remain around the rapid development and deployment of digital technologies, how these technologies have been used, and their efficacy in supporting public health goals. Following the five-stage scoping review framework, we conducted a scoping review of the peer-reviewed and grey literature to identify the types and nature of digital technologies used for surveillance during the COVID-19 pandemic and the success of these measures. We conducted a search of the peer-reviewed and grey literature published between 1 December 2019 and 31 December 2020 to provide a snapshot of questions, concerns, discussions, and findings emerging at this pivotal time. A total of 147 peer-reviewed and 79 grey literature publications reporting on digital technology use for surveillance across 90 countries and regions were retained for analysis. The most frequently used technologies included mobile phone devices and applications, location tracking technologies, drones, temperature scanning technologies, and wearable devices. The utility of digital technologies for public health surveillance was impacted by factors including uptake of digital technologies across targeted populations, technological capacity and errors, scope, validity and accuracy of data, guiding legal frameworks, and infrastructure to support technology use. Our findings raise important questions around the value of digital surveillance for public health and how to ensure successful use of technologies while mitigating potential harms not only in the context of the COVID-19 pandemic, but also during other infectious disease outbreaks, epidemics, and pandemics.

Bringing rehabilitation home with an e-health platform to treat stroke patients: study protocol of a randomized clinical trial (RGS@home).

BACKGROUND: There is a pressing need for scalable healthcare solutions and a shift in the rehabilitation paradigm from hospitals to homes to tackle the increase in stroke incidence while reducing the practical and economic burden for patients, hospitals, and society. Digital health technologies can contribute to addressing this challenge; however, little is known about their effectiveness in at-home settings. In response, we have designed the RGS@home study to investigate the effectiveness, acceptance, and cost of a deep tech solution called the Rehabilitation Gaming System (RGS). RGS is a cloud-based system for delivering AI-enhanced rehabilitation using virtual reality, motion capture, and wearables that can be used in the hospital and at home. The core principles of the brain theory-based RGS intervention are to deliver rehabilitation exercises in the form of embodied, goal-oriented, and task-specific action. METHODS: The RGS@home study is a randomized longitudinal clinical trial designed to assess whether the combination of the RGS intervention with standard care is superior to standard care alone for the functional recovery of stroke patients at the hospital and at home. The study is conducted in collaboration with hospitals in Spain, Sweden, and France and includes inpatients and outpatients at subacute and chronic stages post-stroke. The intervention duration is 3 months with assessment at baseline and after 3, 6, and 12 months. The impact of RGS is evaluated in terms of quality of life measurements, usability, and acceptance using standardized clinical scales, together with health economic analysis. So far, one-third of the patients expected to participate in the study have been recruited (N = 90, mean age 60, days after stroke ≥ 30 days). The trial will end in July 2023. DISCUSSION: We predict an improvement in the patients' recovery, high acceptance, and reduced costs due to a soft landing from the clinic to home rehabilitation. In addition, the data provided will allow us to assess whether the prescription of therapy at home can counteract deterioration and improve quality of life while also identifying new standards for online and remote assessment, diagnostics, and intervention across European hospitals. TRIAL REGISTRATION: C linicalTrials.gov NCT04620707. Registered on November 3, 2020.

Digital Health and Rheumatology: The Indian Context

India as a country of contrast and diversity has witnessed digital evolution in different waves and stages. The technology is already an integral part of lives of millions in India;however, its application in the health management remains limited unlike developed economies. COVID-19 pandemic has plunged the country into universal, regional, or local lockdowns repeatedly since the last year. An unexpected and unforeseen impact of this has been the usage of technology for doctor-patient interactions through telemedicine. Hitherto limited to certain pockets, virtual interactions with doctors, ordering laboratory investigations through an application or procuring medicines through internet, are now part of mainstream patient behavior. This is a crucial change in the mindset but requires a lot more to be done at various levels to tap its full potential with rheumatologists being at the forefront and leading the change in their specialty. The pool of rheumatologists is very small and mostly concentrated in few urban areas, leading to diagnostic delay, suboptimal treatment, and poor outcomes. Technology could, therefore, become a catalyst for change and harbinger for greater clinician access. There are plenty of discussions about the impact and potential of deep learning, artificial intelligence, remote monitoring with wearables, etc., but plenty of them may not be relevant to Indian patients in the current scenario. Hence, the context, relevance, and applicability are the key for rheumatologists when making a judgment.

Using Wearables to Optimize Learning at Home

During the COVID-19 pandemic, there has been a shift from learning in classrooms to learning at home. However, currently applied learning methods are not optimized for learning at home. Therefore, we explore how the unique benefits of a home environment could be used to inform the design of learning experiences. In particular, we explore the applicability of wearables and IoT devices as flexible and affordable learning tools. Based on our findings, we present our prototype of an NFC-based learning application for mobile devices.

How to leverage intelligent agents and complex event processing to improve patient monitoring

This paper describes an intelligent ecosystem that can continuously monitor patients' health conditions, whether at home, at work or during recreational activities, by leveraging a creative blend of wearable medical devices, intelligent agents (IA) and complex event processing (CEP). With the help of a smart application, linking wearable devices and the power of IA and CEP, patients will be constantly and actively supervised during their daily activities. This can even save their lives in case they experience sudden or gradual problems. Thanks to our system, patients with chronic illnesses that are not serious but potentially unstable will no longer overburden first aid services. This is also helpful in containing the spread of COVID-19. Specifically, in this paper, we focus on automatic monitoring of vital parameters, electrocardiogram analysis and psoriasis detection. Experimental results conducted on real patients show how promising our approach is.

Wearables, Telemedicine and the Future of Health in Brazil: New Trends in Health Technologies to Face Pandemics

This paper aims to reflect on the future of the right to healthcare access in Brazil under the influence of new technologies. To this end, it examines the effectiveness of using specific modalities of health technology - telemedicine and wearables - in pandemic contexts. By proposing the use of these health technologies, in compliance with constitutional legislation, it investigates the fulfillment of the duty of the State to guarantee the right to healthcare access and to ensure economic balance. The study is supported by descriptive research with bibliographic and documental basis, theoretically grounded on scientific articles published in journals, as well as economic and sanitation data on the pandemics publicized by national and international agencies, and interpreted from a critical approach. The scarcity of publications on the subject, as well as the absence of specific regulations and the continuation of the pandemic represent a limitation of the research. The innovation of the subject may be a contribution of this article to science, as it encourages new research. Based on the Economic Analysis of Law, the interpretation of the collected data has shown that new health technologies are effective mechanisms in the implementation of the right to healthcare access and in guaranteeing the economic order in pandemic contexts, since remote care, without physical contact, reduces the risk of both health system collapse and economic recession.

Multi-Omics Profiling for Health.

The world has witnessed a steady rise in both non-infectious and infectious chronic diseases, prompting a cross-disciplinary approach to understand and treating disease. Current medical care focuses on treating people after they become patients rather than preventing illness, leading to high costs in treating chronic and late-stage diseases. Additionally, a "one-size-fits all" approach to health care does not take into account individual differences in genetics, environment, or lifestyle factors, decreasing the number of people benefiting from interventions. Rapid advances in omics technologies and progress in computational capabilities have led to the development of multi-omics deep phenotyping, which profiles the interaction of multiple levels of biology over time and empowers precision health approaches. This review highlights current and emerging multi-omics modalities for precision health and discusses applications in the following areas: genetic variation, cardio-metabolic diseases, cancer, infectious diseases, organ transplantation, pregnancy, and longevity/aging. We will briefly discuss the potential of multi-omics approaches in disentangling host-microbe and host-environmental interactions. We will touch on emerging areas of electronic health record and clinical imaging integration with muti-omics for precision health. Finally, we will briefly discuss the challenges in the clinical implementation of multi-omics and its future prospects.

The scope and vulnerabilities of the internet of medical things (IoMT)

The year 2020 witnessed a major shift in our society and the global economy due to the onset of COVID-19. Many newer trends are expected to surface as people grow more digitally savvy and embrace technology while working from home. This has also impacted the medical industry worldwide and has made healthcare preventive, predictive, and personalized. In healthcare, the Internet of Things (IoT) refers to a network of connected medical devices that can generate, collect, and store data as well as connect to a network, analyze data, and transmit data of various types such as medical images, physiological and vital body signatures, and genomics data. Real-time monitoring, improved diagnostics, robotic surgical interventions, and other medical IoT applications can all help improve outcomes in healthcare. Medical IoT refers to IoT devices and applications tailored to healthcare demands and environments. It includes sensors and apps for monitoring healthcare remotely, telemedicine consultation, and delivery. Medical IoT also uses AI and machine learning to assist life-transforming advancements in existent medical devices, such as the smart inhaler for asthma sufferers. IoT devices offer a lot of new opportunities for patient monitoring, both by the doctors and by the patients themselves. This is made possible by a variety of wearable IoT devices that promise an array of benefits but also pose challenges for all stakeholders in the healthcare industry. Medical IoT devices enable the collection of patient data in real-time, which is processed and evaluated thereafter. The information gathered is centralized for computing, processing, and storage. Centralization can be hazardous as it is vulnerable to multiple threats: failure at one point, mistrust, manipulation, tampering of data, and privacy evasion. Blockchain can address such critical issues by offering decentralized computation and storage for IoT data. COVID-19 brought out the benefits of technology and has reinforced the need to develop and secure more advanced applications including Medical IoT. We have advanced much, but there is a huge scope to explore, expand, and establish. © 2022 Nova Science Publishers, Inc. All rights reserved.

The use of wearables in the sleep clinic and at home

As consumer sleep technology becomes ubiquitous, sleep clinicians are tasked with navigating these new technologies and must decide if and how to incorporate these technologies into a typical sleep clinical visit. We explore the potential applications of wearables, nearables, and apps in sleep medicine and consider how our acceptance of technology has changed since the COVID-19 pandemic. © 2023 Elsevier Inc. All rights reserved

Internet of Things in the Global Impacts of COVID-19: A Systematic Study

COVID-19 is highly contagious in nature. It marked a grievous impact on the world's social and economic status and disrupted the other related domains as well. Global mental health is debatable in present scenario. Travel and Tourism industry is one of the hardly hit sectors which clearly and badly influenced the aviation industry. In this article, we highlight some of the major global sectors which are highly affected by the pandemic, including social and financial turmoil caused by COVID-19, healthcare front, environment, education, and travel. A reasonable weightage is given to situation in India while discussing about the different impacts. Since the outbreak, researchers have been working feverishly to leverage a broad range of technologies to tackle the global threat. The Internet of Things (IoT) is one of the forerunners in this field. The Internet of Things (IoT) has gained popularity as a new research field in a variety of academic and industry fields in recent years, particularly in healthcare. This article investigates and highlights the overall applications of the well-proven IoT tools and technologies in all the COVID-19 impacted domains by providing a perspective roadmap to combat this global threat. Various myths or misconceptions regarding COVID-19 have also been discussed and explained logically. © 2023 Scrivener Publishing LLC.

Evidence for the Efficacy of Commercially Available Wearable Biofeedback Gait Devices: Consumer-Centered Review.

BACKGROUND: The number of wearable technological devices or sensors that are commercially available for gait training is increasing. These devices can fill a gap by extending therapy outside the clinical setting. This was shown to be important during the COVID-19 pandemic when people could not access one-on-one treatment. These devices vary widely in terms of mechanisms of therapeutic effect, as well as targeted gait parameters, availability, and strength of the evidence supporting the claims. OBJECTIVE: This study aimed to create an inventory of devices targeting improvement in gait pattern and walking behavior and identify the strength of the evidence underlying the claims of effectiveness for devices that are commercially available to the public. METHODS: As there is no systematic or reproducible way to identify gait training technologies available to the public, we used a pragmatic, iterative approach using both the gray and published literature. Four approaches were used: simple words, including some suggested by laypersons; devices endorsed by condition-specific organizations or charities; impairment-specific search terms; and systematic reviews. A findable list of technological devices targeting walking was extracted separately by 3 authors. For each device identified, the evidence for efficacy was extracted from material displayed on the websites, and full-text articles were obtained from the scientific databases PubMed, Ovid MEDLINE, Scopus, or Google Scholar. Additional information on the target population, mechanism of feedback, evidence for efficacy or effectiveness, and commercial availability was obtained from the published material or websites. A level of evidence was assigned to each study involving the device using the Oxford Centre for Evidence-Based Medicine classification. We also proposed reporting guidelines for the clinical appraisal of devices targeting movement and mobility. RESULTS: The search strategy for this consumer-centered review yielded 17 biofeedback devices that claim to target gait quality improvement through various sensory feedback mechanisms. Of these 17 devices, 11 (65%) are commercially available, and 6 (35%) are at various stages of research and development. Of the 11 commercially available devices, 4 (36%) had findable evidence for efficacy potential supporting the claims. Most of these devices were targeted to people living with Parkinson disease. The reporting of key information about the devices was inconsistent; in addition, there was no summary of research findings in layperson's language. CONCLUSIONS: The amount of information that is currently available to the general public to help them make an informed choice is insufficient, and, at times, the information presented is misleading. The evidence supporting the effectiveness does not cover all aspects of technology uptake. Commercially available technologies help to provide continuity of therapy outside the clinical setting, but there is a need to demonstrate effectiveness to support claims made by the technologies.

Use of Health-Related Apps and Telehealth in Adults with Epilepsy in Germany: A Multicenter Cohort Study.

Background: Telehealth can improve the treatment of chronic disorders, such as epilepsy. Telehealth prevalence and use increased during the coronavirus disease 2019 (COVID-19) pandemic. However, familiarity with and use of telehealth and health-related mobile applications (apps) by persons with epilepsy remain unknown. Methods: We investigated telehealth use, demographics, and clinical variables within the multicenter Epi2020 cross-sectional study. Between October and December 2020, adults with epilepsy completed a validated questionnaire, including individual questions regarding knowledge and use of apps and telehealth. Results: Of 476 included individuals (58.2% women; mean age 40.2 ± 15.4 years), 41.6% reported using health-related apps. Health apps were used more frequently (pedometer 32.1%, exercise app 17.6%) than medical apps (health insurance 15.1%, menstrual apps 12.2%) or apps designed for epilepsy (medication reminders 10.3%, seizure calendars 4.6%). Few used seizure detectors (i.e., apps as medical devices 1.9%) or mobile health devices (fitness bracelet 11.3%). A majority (60.9%) had heard the term telehealth, 78.6% of whom had a positive view. However, only 28.6% had a concrete idea of telehealth, and only 16.6% reported personal experience with telehealth. A majority (55%) would attend a teleconsultation follow-up, and 41.2% would in a medical emergency. Data privacy and availability were considered equally important by 50.8%, 21.8% considered data privacy more important, and 20.2% considered data availability more important. Current health-related app use was independently associated with younger age (p = 0.003), higher education (p < 0.001), and subjective COVID-19-related challenges (p = 0.002). Persistent seizure occurrence (vs. seizure freedom ≥12 months) did not affect willingness to use teleconsultations on multivariable logistic regression analysis. Conclusions: Despite positive telehealth views, few persons with epilepsy in Germany are familiar with specific apps or services. Socioeconomic factors influence telehealth use more than baseline epilepsy characteristics. Telehealth education and services should target socioeconomically disadvantaged individuals to reduce the digital care gap. German Clinical Trials Register (DRKS00022024; Universal Trial Number: U1111-1252-5331).

IoT-Based Wearable and Smart Health Device Solutions for Capnography: Analysis and Perspectives

The potential of the Internet of Health Things (IoHT), also identified in the literature as the Internet of Medical Things (IoMT), is enormous, since it can generate expressive impacts on healthcare devices, such as the capnograph. When applied to mechanical ventilation, it provides essential healthcare to the patient and helps save lives. This survey elaborates on a deep review of related literature about the most robust and effective innovative healthcare solutions using modern technologies, such as the Internet of Things (IoT), cloud computing, Blynk, Bluetooth Low Energy, Robotics, and embedded systems. It emphasizes that IoT-based wearable and smart devices that work as integrated systems can be a faster response to other pandemic crises, respiratory diseases, and other problems that may occur in the future. It may also extend the performance of e-Health platforms used as monitoring systems. Therefore, this paper considers the state of the art to substantiate research about sensors, highlighting the relevance of new studies, strategies, approaches, and novelties in the field.

Wireless and Multi‐Person Respiration Monitoring using Facemask‐Integrated Flexible Meta‐Antennas

Respiration monitoring of a large population is important in containing the spread of viral respiratory infections such as the coronavirus disease 2019 (COVID‐19). Current technologies, however, lack the ability in respiration monitoring of multiple human subjects in a long‐term, robust, and low‐cost manner. Herein, wireless respiration monitoring of multiple human subjects using facemask‐integrated flexible meta‐antennas is demonstrated. The flexible meta‐antenna has an architecture of multi‐layered anisotropic hole‐array, which is optimized by theory and simulations to achieve high performances including good antenna gain, robustness against body interferences, and high air permeability favorable for facemask integration. A person's respiration patterns and respiration rates are wirelessly obtained by the meta‐antenna integrated with a temperature‐sensor‐embedded chip. Respiration monitoring of multiple subjects in long range and long term during daily activities is simultaneously demonstrated. In addition, a real‐time data processing system is introduced in which a local server, a cloud server, and an application layer are implemented for the real‐time display of respiration patterns and automatic recognition of abnormal status. The design of flexible meta‐antennas may lead to a distinct class of physiological sensors over a large population for applications in pandemic control and personalized healthcare. [ABSTRACT FROM AUTHOR] Copyright of Advanced Materials Technologies is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Use of wearable and health applications in insurance industry using internet of things and big data

Introduction: There is a variety of wearables and health applications available in the market which allow the tracking of various health and lifestyle measures like blood sugar, calorie counter, number of steps, sleep patterns, etc. After the Covid-19 pandemic, people have become more aware of their health and use these wearables to maintain a healthy lifestyle. Insurance companies in India are also eyeing the potential usage of these wearables in life and health insurance. Purpose: This research aims to look at the emergence of wearables and health apps and their usage in India's life and health insurance industry. This study also focuses on how these devices might benefit insurers' business models and some of the pitfalls to consider. Methodology: The study used both primary and secondary data. A survey was conducted to understand the customer perception towards usage of wearables. The secondary research included the analysis of the integration of wearables by insurance companies. Findings: The research would be helpful to the insurance companies as it would help them to understand the customer's viewpoint for the usage of wearables in the insurance industry. This study would also allow insurers to understand new dimensions, such as where the wearables improve customer satisfaction and engagement. The study results would be helpful for the customers for the appropriate usage of wearables and the internet of things (IoT). Insurance companies can provide better pricing and make personalised insurance plans that ultimately help customers. © 2022 by Emerald Publishing Limited. All rights reserved.

‘The plural of silo is not ecosystem': Qualitative study on the role of innovation ecosystems in supporting ‘Internet of Things' applications in health and care

Background: Internet of Things (IoT) innovations such as wearables and sensors promise improved health outcomes and service efficiencies. Yet, most applications remain experimental with little routine use in health and care settings. We sought to examine the multiple interacting influences on IoT implementation, spread and scale-up, including the role of regional innovation ‘ecosystems' and the impact of the COVID-19 context. Methods: Qualitative study involving 20 participants with clinical, entrepreneurial and broader innovation experience in 18 in-depth interviews, focusing primarily on heart monitoring and assistive technology applications. Data analysis was informed by the NASSS (non-adoption, abandonment, scale-up, spread, sustainability) framework. Results: Interviewees discussed multiple tensions and trade-offs, including lack of organisational capacity for routine IoT use, limited ability to receive and interpret data, complex procurement and governance processes, and risk of health disparities and inequalities without system support and funding. Although the pandemic highlighted opportunities for IoT use, it was unclear whether these would be sustained, with framings of innovation as ‘disruption' coming at odds with immediate needs in healthcare settings. Even in an ‘ecosystem' with strong presence of academic and research institutions, support was viewed as limited, with impressions of siloed working, conflicting agendas, fragmentation and lack of collaboration opportunities. Conclusions: IoT development, implementation and roll-out require support from multiple ecosystem actors to be able to articulate a value proposition beyond experimental or small-scale applications. In contexts where clinical, academic and commercial worlds collide, sustained effort is needed to align needs, priorities and motives, and to strengthen potential for good value IoT innovation. © The Author(s) 2023.

Accuracy of the Apple Watch Oxygen Saturation Measurement in Adults: A Systematic Review.

The purpose of this review is to summarize the research on the accuracy of oxygen saturation (spO2) measurements using the Apple Watch (Apple Inc., Cupertino, California). The Medline and Google Scholar databases were searched for papers evaluating the spO2 measurements of the Apple Watch vs. any kind of ground truth and records were analyzed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The five publications with 973 total patients that met the inclusion criteria all used the Apple Watch Series 6 and described 95% limits of agreement of +/- 2.7 to 5.9% spO2. However, outliers of up to 15% spO2 were reported. Only one study had patient-level data uploaded to a public repository. The Apple Watch Series 6 does not show a strong systematic bias compared to conventional, medical-grade pulse oximeters. However, outliers do occur and should not cause concern in otherwise healthy individuals. The impact of race on measurement accuracy should be investigated.