Why researchers are flocking to Fitbit in the fight against disease

The best-selling tracker is also a hit with scientists
Fitbit's clinical studies takeover

The go-to wearable tech brand for millions of hardcore gym bunnies, part-time fitness lovers and well, anyone seeking the exercise holy grail of 10,000 steps a day, Fitbit now has another key fan base in the form of the medical research community. The people in white coats can't seem to get enough of its devices.

A survey published last month that polled members of the influential Association of Clinical Research Organizations (ACRO) – basically the world's top medical researchers – reported a rapid increase in the use of wearable technology in medical trials. According to those surveyed, "wearables represent a huge opportunity to gather additional data, and make clinical trials more efficient and more convenient for participants."

Researchers have been falling over themselves to incorporate wearables in their studies, with Fitbit the brand of choice. The Clinical Trials.gov database lists 104 completed, current and pending clinical studies that feature Fitbit devices. The studies cover a variety of health conditions, from obesity and diabetes to cancer, testing either the Fitbit device itself or using it as a tool to gather data.

The researcher's favourite

This is in stark contrast to the mere handful of studies listed that use competing devices such as the Jawbone UP, Garmin VivoFit 2 or Misfit Shine. And while Apple has its very own open source ResearchKit framework that allows researchers to "gather robust data for studies", there's only one clinical study listed on ClinicalTrials.gov that features the Apple Watch. Presumably research institutions are put off by the device's high cost per unit.

Like Apple, Fitbit has been actively encouraging the use of its devices in clinical studies, marking an expansion for the company from consumer activity tracking to more medical-focussed digital health monitoring.

Fitbit recently launched Fitbit Group Health, a service aimed at healthcare professionals and corporate wellness schemes. The latest announcement is a study by the Dana-Farber Cancer Institute at Harvard University looking at the impact of physical activity and weight loss on breast cancer recurrence. Participants will use Fitbit Charge HRs, Aria smart scales and a subscription to FitStar.

"Partnering with researchers is a core component of our work as we continue to scale our health efforts," says Amy McDonough, vice president of Fitbit Group Health.

And it doesn't take a scientist to work out why Fitbit is so keen to hook up with the medical community. Soreon Research estimates that the smart wearable healthcare market will grow from $2 billion in 2014 to more than $41 billion by 2020.

Savvy partnerships

Fitbit has set up strategic partnerships with leading health record system providers, meaning that researchers can access user data via their existing systems – a major factor in the take-up of Fitbit devices.

Dr Michael Horst, director of the Lancaster General Research Institute at Penn Medicine, Pennsylvania, is recruiting for a study that will examine whether Fitbits can improve health outcomes in patients who have undergone gastric sleeve surgery. "We selected Fitbit because the company has an interface with our electronic health record system vendor," he told us. "The user sets up permission for their Fitbit account to automatically take the step data and transfer to our health record server."

Outshining the competition

The out and out user-friendliness and popularity of Fitbit devices with consumers also explains their popularity with researchers. "For our trial, we were interested in the Fitbit Surge because of its ability to easily display heart rate and activity data, and because of its ease of use and familiarity to our patient population," says Dr Michael Wood of the Lineberger Comprehensive Cancer Center, at the University of North Carolina, which is using the device to monitor fitness levels in patients who are awaiting stem cell transplant ops.

Claire Bentley, a research assistant at the University of Sheffield in the UK, is part of a team looking at whether the Fitbit Charge can encourage physical activity in patients with a collection of lung diseases known as chronic obstructive pulmonary disease (COPD). The team's initial usability tests found that people with COPD preferred the Fitbit Charge over competing devices and thought it looked more stylish than the rest.

Accuracy issues

The accuracy of Fitbit devices is obviously another big draw. "We found that the Fitbit models were more accurate for tracking activity compared to the smartphones and other activity monitors," says Bentley.

Questions have been raised however about the devices' accuracy in terms of measuring heart rate. A small study by Indiana's Ball State University and journalists at TV station WTHR which was published in February found the Fitbit Charge HR had an average error rate of 14% on this metric.

On top of defending the credibility of its devices, Fitbit is facing a class action lawsuit in the US, which claims the firm's heart rate monitors are inaccurate.

The plaintiffs' legal team even commissioned a study showing that the Fitbit Charge HR heart rate monitor, which is powered by PurePulse technology, was on average, 20 beats per minute off the true cardio rate. We spoke to the scientist involved who stands by the claims but Fitbit intends to fight the lawsuit every step of the way.

"What the plaintiffs' attorneys call a 'study' is biased, baseless, and nothing more than an attempt to extract a payout from Fitbit," says McDonough.


A medical future?

In a conversation with the MIT Technology Review in January, Fitbit CEO James Park hinted that the company's devices could be used in the future to diagnose disorders such as sleep apnea and high blood pressure. Yet Fitbit has no major plans to market its products as medical devices per se.

"Fitbit trackers are designed to provide meaningful data to our users to help them reach their health and fitness goals, and are not intended to be scientific or medical devices," says McDonough. "Our primary focus is on building consumer devices that harness the power of data and software to help people live healthier, more active lives."

Going down the medical device route would involve jumping over some tricky regulatory hurdles, so understandably Fitbit is cagey about whether it will seek FDA approval for upcoming wearable devices in the US, or try to get through the relevant medical regulatory bodies elsewhere. Data security and patient privacy are other potential issues that could present problems for the company in the future – the recent ACRO survey warns of a lack of guidance in these areas.

Caveats aside, the current lack of FDA approval for Fitbits and potential data security and privacy issues certainly haven't deterred the medical research community from embracing the brand in a big, big way. Those clinical studies just keep on coming.

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