by Larry Magid
This post first appeared in the Mercury News
For the past few weeks I’ve been testing three different devices designed — in part — to measure health and fitness. Two of them — the Apple Watch 4 and Fitbit Charge 3 are watches. The other, called Kardia Mobile, is a tiny $99 device that can easily fit into a pocket that you pair with a smartphone.
The Apple Watch, which starts at $399, is a full-featured smartwatch. It not only has lots of features built in but also supports third party apps, similar to the iPhone.
The Fitbit Charge 3, which sells for $149, is billed as a fitness band, but also has essential smartwatch features including text, email, calendar notifications, timers, alarms, weather information and an app designed to help you relax.
The Kardia Mobile works with nearly all smartphones. The Apple Watch requires an iPhone 5 or newer.
What the Kardia Mobile and the Apple Watch have in common is the ability to record electrocardiograms and measure for atrial fibrillation (AFib), a potentially dangerous heart condition that can be a precursor to a stroke. Apple announced that it would be adding the feature to its Apple Watch 4, which reportedly is part of an update rolling out right now.
Before I get into my review of these devices, I think it’s important to shed some light on the issue of who should be using devices like this to monitor their condition.
I’m not a doctor and clearly not qualified to give medical advice, but I did speak at length with Dr. Dave Albert, the founder and chief medical officer at AliveCor — the company that makes Kardia Mobile.
I confessed that I’m nervous about doing my own medical evaluations because I tend to worry about the results, especially if the device gives me a reading that is cause for concern. He said that I’m not alone and acknowledged that any such consumer device, whether from his company, Apple or anyone else, is prone to false positives. He added, “false positives have a cost: a financial cost, an emotional cost, and a resource utilization cost.” And they can lead to interventions, which in some cases, can be risky.
He said that the “average Apple Watch user is 41 years old, not 61” (he was close: a study from Wristly puts the average Apple Watch user at 40) and that the odds of an abnormal ECG or A at that age are extremely low. He said that his device is mostly aimed at people who have already been determined to be at risk for heart problems — not the general public.
Still, there is the possibility that a device such as Karida Mobile or the Apple Watch could detect a real abnormality in someone who has no symptoms and may not even be part of any known risk group.
ZDNET journalist Jason Perlow, is an example. In his late 40s, he’s not in a high-risk group, but when participating in a Stanford study using an older Apple Watch, he was informed of a possible AFib condition after the study’s cloud-based analysis discovered an abnormal pattern, which was later confirmed to be AFib. He was treated for the condition and wrote a ZDNET post titled, “How Apple Watch saved my life.”
Testing both ECG devices
As per Kardia Mobile, I overcame my fear of the unknown and took the test. The process was very easy. I installed the app on my phone and simply pressed two fingers from each hand on the small Kardia Mobile band. In about 30 seconds the test was complete. Because I am a new user, the results were sent to a cardiologist who analyzed the data and got back to me the next day to say that my results are normal (whew!). Now that that’s done, I will be able to view my own ECG results, though if I have no indications of a problem, I don’t plan to use this on a regular basis.
Apple’s ECG feature is also very quick and easy to use. Once you’ve updated the Watch app on your phone and the Apple Watch 4 itself, you simply launch the app and place a finger from your opposite hand on the watch’s crown and hold it there for 30 seconds. You’ll then see a report on the watch and a more detailed report in your iPhone’s Health app. The app will create a PDF that you can email to your doctor. I tried the ECG app 5 times. The first four readings were “inconclusive,” which caused me some anxiety until I finally got a normal reading. I subsequently learned that “inconclusive” could be a result of your watch not being tight enough on the wrist or your arm moving, as in nervous shaking when you’re stressed out till you get the test results.
Albert said that people who have been diagnosed with an issue should use it on a more regular basis but cautioned that if you have any symptoms, you should first call 911 and then use the device while waiting for medics. The device is also useful as a diagnostic tool in areas where there is no access to professional medical ECGs.
The Apple Watch 4 also has fall detection. I haven’t fallen but I have dropped my watch and reports “that it looks like you’ve taken a fall,” and then vibrates and sounds an alarm. If you don’t respond, Apple says that it will “call emergency services.” Even though this feature can save lives, I worry about too many false alarms from people who drop their watch and don’t dismiss the warning notice.
Health issues aside, the Apple Watch 4 is the most attractive and useful smartwatch I’ve tested. I don’t always wear it (too often I forget to charge it daily as required) but I do enjoy the look, the feel and the data it provides.
The Fitbit Charge 3 is a much more modest device than the Apple Watch but it has dutifully been recording my footsteps, tracking my heart rate and letting me know of incoming calls and text messages — the very things I mostly care about in any smartwatch.
I love the fact that it only needs to be charged about once every five days or so and don’t mind that the screen is in black and white. In addition to measuring footsteps, you can also configure it to track runs, bike rides, swims and other activities. Unfortunately, it doesn’t automatically detect those activities. If you forget to tell it you’re on a bike ride, it might falsely report increased footsteps. It does continuous heart-rate monitoring and reports the results on the screen and on the app along with your exercise data and estimated calories burned.
If you have an iPhone, can afford $399 or more and don’t mind charging your watch daily, an Apple Watch is a great luxury item and potentially a life-saver for those who need to monitor their heart regularly.
A $149 Fitbit Charge 3 is a great alternative for basic fitness data and a handful of essential smartwatch features.
The $99 Kardia Mobile is an excellent and affordable device for those who need it, but I’d consult with a doctor before getting any device to closely monitor your heart and possibly increase your anxiety