06Jun

As if clinical researchers and managers didn’t already have enough to worry about, now add activity trackers to the list.

Smartwatches, Fitbits and similar trackers have the potential to influence behavior, which matters in studies where physical activity is a study endpoint. (An endpoint in a clinical study is an event used to objectively measure the effect of a drug or other intervention.)

If the level of activity is an endpoint in a study of, say, a drug to improve fatigue, researchers need to be able to say that it is the drug that has made the difference. But anyone who has ever used a Fitbit or other activity tracker know how engaging – addicting, even – they can be. They prod you to get in that 10,000 steps with encouraging messages like, “Only 789 steps to reach your goal.”

As an article on the Clinical Research News website says, “Use of the devices could result in ‘activity peaks’ and ‘activity plateaus’ driven not by drug efficacy but as a response to the smartwatch/fitness tracker targets.”

In other words, who’s to say the increased physical activity was the result of the drug or the tracker prodding?

Before commercial trackers became so ubiquitous, researchers gave study volunteers devices that accumulated the data, but without making it visible to them. Commercial trackers make everything visible.

Besides simply counting steps, sophisticated wearables measure all sorts of activity related variables like heart rate, duration, intensity, distance, sleep and more. Because participants in studies of physical activity are able to see this data they can skew the results by working to reach targets and earn badges.

The authors of the article – “The Potential Of Activity Trackers To Bias Study Results” – suggest a number of measures researchers can take to mitigate the influence of these devices including prohibiting participants from wearing them, establishing baseline physical activity levels and choosing endpoints less likely to be influenced by the trackers.

Ultimately, the writers say, “Additional research is needed in this arena… More certain is that the unblinding of study data could have far-reaching if unintended consequences by introducing bias into the data analysis process.”

Photo by Andres Urena on Unsplash

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Jun 6, 2023

Chronic Pain Patients Find Telehealth Cost Effective

Telehealth continues to demonstrate its popularity, this time among people suffering with chronic pain.

At their annual meeting this month, itself held online, anesthesiologists heard that patients who met with their pain specialist remotely were overwhelmingly satisfied with the experience.

Conducted by the UCLA Comprehensive Pain Center in Los Angeles, the survey period began in August 2019, long before the COVID-19 pandemic. Patients at the pain center were given the option of in-office or remote appointments by video or phone. The 1,398 patients who chose the remote options had a cumulative 2,948 virtual appointments.

According to an account of the study by Healthcare Finance the virtual meetings saved patients both time and money. Half saved at least 69 minutes commuting and a roundtrip of 26 miles or more. They also saved a median $22 in gas and parking fees for each virtual visit.

Initial visits for new patients or existing patients with new conditions were best served by in-person office appointments, the report said. Thereafter, follow-up appointments could be conducted remotely. Anesthesiologists participating in the conference estimated that up to 50% of visits could be virtual.

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