Wearable devices—addressing bias and inequity
Open accessAbstract
The increasing digitisation of health care has led to wearable devices becoming a frequent contributor to health-care decisions.1 Wearable devices are a developing group of health-care technologies that include smartwatches and fitness trackers. These technologies have a substantial number of users, with a fifth of adults in the USA now using a wearable device.2 These devices provide objective data that can enhance the doctor–patient relationship and improve the overall quality of clinical encounters.
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More recent research has highlighted the potential presence of skin pigmentation biases in research-grade and consumer PPG-based wearable devices.
“More recent research has also highlighted the potential presence of these biases in research-grade and consumer PPG-based wearable devices [4,27-29]”
From Impact of skin pigmentation on pulse oximetry blood oxygenation and wearable pulse rate accuracy: systematic review and meta-analysis (2024) · cites this paper as [27]
Cites
Large-Scale Assessment of a Smartwatch to Identify Atrial Fibrillation
Perez, M. V., Mahaffey, K. W., Hedlin, H., Rumsfeld, J. S., Garcia, A., Ferris, T., Balasubramanian, V., Russo, A. M., Rajmane, A., Cheung, L., et al. (2019) · New England Journal of Medicine · doi:10.1056/nejmoa1901183 · Cited by 1,917 · see citing works
Racial bias in pulse oximetry measurement
Sjoding, M. W., Dickson, R. P., Iwashyna, T. J., Gay, S. E., & Valley, T. S. (2020) · New England Journal of Medicine · doi:10.1056/nejmc2029240 · Cited by 1,114 · see citing works
Investigating sources of inaccuracy in wearable optical heart rate sensors
Bent, B., Goldstein, B. A., Kibbe, W. A., & Dunn, J. P. (2020) · npj Digital Medicine · doi:10.1038/s41746-020-0226-6 · Cited by 673 · see citing works
Holko, M., Litwin, T. R., Munoz, F., Theisz, K. I., Salgin, L., Jenks, N. P., Holmes, B. W., Watson-McGee, P., Winford, E., & Sharma, Y. (2022) · npj Digital Medicine · doi:10.1038/s41746-022-00593-x · Cited by 85 · see citing works
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Singh, S., Bennett, M. R., Chen, C., Shin, S., Ghanbari, H., & Nelson, B. W. (2024) · Journal of Medical Internet Research · doi:10.2196/62769 · Cited by 36 · see citing works
“More recent research has also highlighted the potential presence of these biases in research-grade and consumer PPG-based wearable devices [4,27-29], leading to calls to address inequity, bias, and discrimination in wearable health technology and clinical practice algorithms [30,31].”
- Authors
- Zinzuwadia, A., & Singh, J. P.
- Affiliations
- Harvard University (US)
- Massachusetts General Hospital (US)
- Corresponding author
- Singh, Jagmeet P
- Venue
- The Lancet Digital Health
- Publisher
- Elsevier BV
- Published
- 2022-12
- Volume
- 4
- Issue
- 12
- Pages
- e856-e857
- ISSN
- 2589-7500 (ISSN-L)
- OpenAlex
- W4307965115
- Cited by
- 58
- References
- 4
- Citations by year
- 2026: 10 · 2025: 22 · 2024: 16 · 2023: 10
- FWCI
- 13.90
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- The Lancet Digital Health (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Safety Research › Ethics and Social Impacts of AI
- Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- wearable devices, smartwatches, wearable activity trackers, algorithmic bias, health disparities, health technology, physician-patient relationship, clinical decision-making
- MeSH terms
- Wearable Electronic Devices, Bias
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