Image: Vivametrica Activity trackers such as the various Fitbit and Jawbone UP models or the recently released Microsoft Band remain popular, but usage often declines or ceases altogether after an initial burst of engagement.
A major missing element, according to healthcare analytics startup Vivametrica, is context for the data generated and presented by these devices: what's needed is a comparison of an individual's activity pattern with the relevant sector of the general population, an assessment of the relative risks of different diseases based on these patterns, and personalised interventions designed to reduce those risks.
Vivametrica has been researching lower back pain caused by lumbar spinal stenosis (LSS), which, according to cofounder and chief operating officer Dr Christy Lane, "is the top reason for orthopaedic surgery in North America; it's a huge, costly problem, and what's happening is that people are getting thrown into surgery, which is often very successful, but there also are a lot of people who could avoid surgery through something like this".
Vivametrica's pilot study, released today, finds that body mass index is the best predictor of daily function in people with LSS, suggesting that weight loss and increased physical activity may improve the condition. The study also finds that objective activity measures from wearable devices eliminate the guesswork inherent in patient feedback such as questionnaires, allowing more targeted treatment. The use of wearable devices also empowers LSS patients to be more involved in their own health and encourages them to change their behaviour.
Would you make use of a fitness wearable and consent to sharing that data with employers and insurers if that meant cheaper health insurance premiums?
"We're aiming at the person as a whole - lifestyle change," says Lane. "What we're seeing is that people are losing weight and becoming more active - but they're also having less pain, which is huge."
Lane says that "80 percent of people will have lower back pain at some point in their life" and that the cost to the economy runs into billions of dollars. Combating 'diseases of inactivity' with a combination of wearable devices, comparative analytics, and personalised e-health interventions could be very big business indeed.
Vivametrica is currently conducting a follow-up randomised controlled trial with a larger sample of LSS patients. Lane expects to complete an interim analysis in spring next year, and to complete the study by the end of 2015.
Other work underway at Vivametrica involves comparing consumer-grade activity trackers to the research-grade ActiGraph, and working out which ones to recommend to study participants.
"What we're finding is that they're all fairly accurate for general activity levels, so I'm comfortable with all of them," says Lane. "It's mainly a question of which other features patients will appreciate," she adds. "But when you want really granular measurements - small changes in activity levels, which is what Vivametrica wants to look at - that's when you need the ActiGraph."
Another goal is access to the raw data from consumer-grade activity trackers: "They all have accelerometers, but every vendor filters their raw data in a different way. Once a few of the big names release their raw data, and consumers see what analytics are able to do with that, I think the other companies are going to have to follow suit."
In the meantime, Vivametrica is working to standardise the input and analysis of these different devices so that, as Lane puts it, "If you have a Fitbit and your friend has a Jawbone, you can both access the same analysis from Vivametrica and it will mean the same thing, and you'll get the information back in the appropriate format for your device."
In other company news, Lane says that Vivametrica is "holding off on our consumer SaaS rollout" - originally planned for December - as new partnership opportunities are explored. The company also plans e-health services targeted at enterprises, various verticals, and public health researchers. We can expect more news on this front in "early 2015," says Lane.