Could Wearables Capture Well-being?
Devices may be a means to monitor psychological states through effortless data collection using artificial intelligence
Applying machine learning models, a type of artificial intelligence (AI), to data collected passively from wearable devices can identify a patient’s degree of resilience and well-being, according to investigators at the Icahn School of Medicine at Mount Sinai in New York.
The findings, reported in the May 2nd issue of JAMIA Open, support wearable devices, such as the Apple Watch®, as a way to monitor and assess psychological states remotely without requiring the completion of mental health questionnaires.
The paper points out that resilience, or an individual’s ability to overcome difficulty, is an important stress mitigator, reduces morbidity, and improves chronic disease management.
“Wearables provide a means to continually collect information about an individual's physical state. Our results provide insight into the feasibility of assessing psychological characteristics from this passively collected data,” said first author Robert P. Hirten, MD, Clinical Director, Hasso Plattner Institute for Digital Health at Mount Sinai. “To our knowledge, this is the first study to evaluate whether resilience, a key mental health feature, can be evaluated from devices such as the Apple Watch.”
Mental health disorders are common, accounting for 13 percent of the burden of global disease, with a quarter of the population at some point experiencing psychological illness. Yet we have limited resources for their evaluation, say the researchers.
“There are wide disparities in access across geography and socioeconomic status, and the need for in-person assessment or the completion of validated mental health surveys is further limiting,” said senior author Zahi Fayad, PhD, Director of the BioMedical Engineering and Imaging Institute at Icahn Mount Sinai. “A better understanding of who is at psychological risk and an improved means of tracking the impact of psychological interventions is needed. The growth of digital technology presents an opportunity to improve access to mental health services for all people.”
To determine if machine learning models could be trained to distinguish an individual’s degree of resilience and psychological well-being using the data from wearable devices, the Icahn Mount Sinai researchers analyzed data from the Warrior Watch Study. Leveraged for the current digital observational study, the data set comprised 329 health care workers enrolled at seven hospitals in New York City.
Subjects wore an Apple Watch® Series 4 or 5 for the duration of their participation, measuring heart rate variability and resting heart rate throughout the follow-up period. Surveys were collected measuring resilience, optimism, and emotional support at baseline. The metrics collected were found to be predictive in identifying resilience or well-being states. Despite the Warrior Watch Study not being designed to evaluate this endpoint, the findings support the further assessment of psychological characteristics from passively collected wearable data.
“We hope that this approach will enable us to bring psychological assessment and care to a larger population, who may not have access at this time,” said Micol Zweig, MPH, co-author of the paper and Associate Director of Clinical Research, Hasso Plattner Institute for Digital Health at Mount Sinai. “We also intend to evaluate this technique in other patient populations to further refine the algorithm and improve its applicability.”
To that end, the research team plans to continue using wearable data to observe a range of physical and psychological disorders and diseases. The simultaneous development of sophisticated analytical tools, including artificial intelligence, say the investigators, can facilitate the analysis of data collected from these devices and apps to identify patterns associated with a given mental or physical disease condition.
The paper is titled “A machine learning approach to determine resilience utilizing wearable device data: analysis of an observational cohort.”
Additional co-authors are Robert P. Hirten, MD, Maria Suprun, PhD, Matteo Danieletto, PhD, Micol Zweig, MPH, Eddye Golden, Renata Pyzik, Sparshdeep Kaur, Drew Helmus, Anthony Biello, Kyle Landell, Jovita Rodrigues, Erwin P. Bottinger, Laurie Keefer, Dennis Charney, MD, PhD, Girish N. Nadkarni, PhD, Mayte Suarez-Farinas, and Zahi A. Fayad, PhD all from the Icahn School of Medicine at Mount Sinai.
Support for this study was provided by the Ehrenkranz Lab for Human Resilience, the BioMedical Engineering and Imaging Institute, the Hasso Plattner Institute for Digital Health, the Mount Sinai Clinical Intelligence Center, and the Dr. Henry D. Janowitz Division of Gastroenterology, all at Icahn Mount Sinai, and from the National Institutes of Health, grant number K23DK129835.
About the Icahn School of Medicine at Mount Sinai
The Icahn School of Medicine at Mount Sinai is internationally renowned for its outstanding research, educational, and clinical care programs. It is the sole academic partner for the eight- member hospitals* of the Mount Sinai Health System, one of the largest academic health systems in the United States, providing care to a large and diverse patient population.
Ranked 14th nationwide in National Institutes of Health (NIH) funding and among the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges, Icahn Mount Sinai has a talented, productive, and successful faculty. More than 3,000 full-time scientists, educators, and clinicians work within and across 34 academic departments and 35 multidisciplinary institutes, a structure that facilitates tremendous collaboration and synergy. Our emphasis on translational research and therapeutics is evident in such diverse areas as genomics/big data, virology, neuroscience, cardiology, geriatrics, as well as gastrointestinal and liver diseases.
Icahn Mount Sinai offers highly competitive MD, PhD, and Master’s degree programs, with current enrollment of approximately 1,300 students. It has the largest graduate medical education program in the country, with more than 2,000 clinical residents and fellows training throughout the Health System. In addition, more than 550 postdoctoral research fellows are in training within the Health System.
A culture of innovation and discovery permeates every Icahn Mount Sinai program. Mount Sinai’s technology transfer office, one of the largest in the country, partners with faculty and trainees to pursue optimal commercialization of intellectual property to ensure that Mount Sinai discoveries and innovations translate into healthcare products and services that benefit the public.
Icahn Mount Sinai’s commitment to breakthrough science and clinical care is enhanced by academic affiliations that supplement and complement the School’s programs.
Through the Mount Sinai Innovation Partners (MSIP), the Health System facilitates the real-world application and commercialization of medical breakthroughs made at Mount Sinai. Additionally, MSIP develops research partnerships with industry leaders such as Merck & Co., AstraZeneca, Novo Nordisk, and others.
The Icahn School of Medicine at Mount Sinai is located in New York City on the border between the Upper East Side and East Harlem, and classroom teaching takes place on a campus facing Central Park. Icahn Mount Sinai’s location offers many opportunities to interact with and care for diverse communities. Learning extends well beyond the borders of our physical campus, to the eight hospitals of the Mount Sinai Health System, our academic affiliates, and globally.
* Mount Sinai Health System member hospitals: The Mount Sinai Hospital; Mount Sinai Beth Israel; Mount Sinai Brooklyn; Mount Sinai Morningside; Mount Sinai Queens; Mount Sinai South Nassau; Mount Sinai West; and New York Eye and Ear Infirmary of Mount Sinai.
About the Mount Sinai Health System
Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 43,000 employees working across eight hospitals, over 400 outpatient practices, nearly 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time — discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it.
Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes approximately 7,300 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics and top 20 in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report’s “Best Children’s Hospitals” ranks Mount Sinai Kravis Children's Hospital among the country’s best in several pediatric specialties.