The widespread public adoption of new technologies to measure behavior and health characteristics outside the clinic has enabled a high-resolution stream of information with important links to health and medical outcomes. This includes data from consumer-grade wearable devices such as Fitbits and Apple watches, home-based health devices such as glucose monitors, blood pressure cuffs and scales, as well as online self-report surveys.
The Center for Digital Genomic Medicine is building an institutional resource around collecting, organizing, and providing these data to VUMC users, which will enable substantial advances in translating digital health data into clinical utility.
Prior work from our team using the All of Us resource has shown that increasing step counts from Fitbit devices is associated with numerous health conditions and that the number of steps needed to mitigate the risk of obesity is dependent on genetic background. These results represent just two of many opportunities to leverage these data, that when linked to clinical and genetic resources, can impact patient health and care.
Examples of a few scientific questions that could be addressed with this type of infrastructure:
- Understanding the causal impact of behavior (such as changes in activity or sleep) on clinical outcomes and medical utilization.
- Targeted recruitment and provision of specific device for patients with risk of disease, such as Fitbits for patients with high risk of atrial fibrillation, or glucose monitor for those at risk for type 2 diabetes.
- Randomized clinical trials (RCT) to test the value of automated identification of functional drift (i.e. a digital prodrome) that may herald an impending admission for conditions like heart failure.
- RCT for value of monitoring patients after serious medical event or intervention, such as recovery from MI, transplant, or discharge from ICU.