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Devices monitor health from your wrist or pocket

For the past few weeks I’ve been testing three different devices designed — in part — to measure health and fitness. Two of them — the Apple Watch 4 and Fitbit Charge 3 are watches. The other, called Kardia Mobile, is a tiny $99 device that can easily fit into a pocket that you pair with a smartphone.

The Apple Watch, which starts at $399, is a full-featured smartwatch. It not only has lots of features built in but also supports third party apps, similar to the iPhone.

The Fitbit Charge 3, which sells for $149, is billed as a fitness band, but also has essential smartwatch features including text, email, calendar notifications, timers, alarms, weather information and an app designed to help you relax.

The Kardia Mobile works with nearly all smartphones. The Apple Watch requires an iPhone 5 or newer.

What the Kardia Mobile and the Apple Watch have in common is the ability to record electrocardiograms and measure for atrial fibrillation (AFib), a potentially dangerous heart condition that can be a precursor to a stroke. Apple announced that it would be adding the feature to its Apple Watch 4, which reportedly is part of an update rolling out right now.

Before I get into my review of these devices, I think it’s important to shed some light on the issue of who should be using devices like this to monitor their condition.

I’m not a doctor and clearly not qualified to give medical advice, but I did speak at length with Dr. Dave Albert, the founder and chief medical officer at AliveCor — the company that makes Kardia Mobile.

I confessed that I’m nervous about doing my own medical evaluations because I tend to worry about the results, especially if the device gives me a reading that is cause for concern. He said that I’m not alone and acknowledged that any such consumer device, whether from his company, Apple or anyone else, is prone to false positives. He added, “false positives have a cost: a financial cost, an emotional cost, and a resource utilization cost.” And they can lead to interventions, which in some cases, can be risky.

He said that the “average Apple Watch user is 41 years old, not 61” (he was close: a study from Wristly puts the average Apple Watch user at 40) and that the odds of an abnormal ECG or A at that age are extremely low. He said that his device is mostly aimed at people who have already been determined to be at risk for heart problems — not the general public.

Still, there is the possibility that a device such as Karida Mobile or the Apple Watch could detect a real abnormality in someone who has no symptoms and may not even be part of any known risk group.

ZDNET journalist Jason Perlow, is an example. In his late 40s, he’s not in a high-risk group, but when participating in a Stanford study using an older Apple Watch, he was informed of a possible AFib condition after the study’s cloud-based analysis discovered an abnormal pattern, which was later confirmed to be AFib. He was treated for the condition and wrote a ZDNET post titled, “How Apple Watch saved my life.”

As per Kardia Mobile, I overcame my fear of the unknown and took the test. The process was very easy. I installed the app on my phone and simply pressed two fingers from each hand on the small Kardia Mobile band. In about 30 seconds the test was complete. Because I am a new user, the results were sent to a cardiologist who will analyze the data and get back to me within about 24 hours. Once that’s done, I will be able to view my own ECG results, though if I have no indications of a problem, I don’t plan to use this on a regular basis.

Albert said that people who have been diagnosed with an issue should use it on a more regular basis but cautioned that if you have any symptoms, you should first call 911 and then use the device while waiting for medics. The device is also useful as a diagnostic tool in areas where there is no access to professional medical ECGs.

As per Apple Watch 4, I have to say that it’s the most attractive and useful smartwatch I’ve tested. I don’t always wear it (too often I forget to charge it daily as required) but I do enjoy the look, the feel and the data it provides. As of this writing, the ECG feature isn’t available, so I haven’t tested that, but I have gotten several reports “that it looks like you’ve taken a fall,” when I dropped the watch or just put it down a bit too quickly. I’ve always clicked on the “I didn’t fall” link it displays but I wonder if it would call 911 and alert my family members if I failed to dismiss the warning. As much as I love the idea of an automated emergency response, I’d hate to waste the time of my local first responders and worry my family for a false alarm.

The Fitbit Charge 3 is a much more modest device than the Apple Watch but it has dutifully been recording my footsteps, tracking my heart rate and letting me know of incoming calls and text messages — the very things I mostly care about in any smartwatch.

I love the fact that it only needs to be charged about once every five days or so and don’t mind that the screen is in black and white. In addition to measuring footsteps, you can also configure it to track runs, bike rides, swims and other activities. Unfortunately, it doesn’t automatically detect those activities. If you forget to tell it you’re on a bike ride, it might falsely report increased footsteps. It does continuous heart-rate monitoring and reports the results on the screen and on the app along with your exercise data and estimated calories burned.

If you have an iPhone, can afford $399 or more and don’t mind charging your watch daily, an Apple Watch is a great luxury item and potentially a life-saver for those who need to monitor their heart regularly.

A $149 Fitbit Charge 3 is a great alternative for basic fitness data and a handful of essential smartwatch features.

The $99 Kardia Mobile is an excellent and affordable device for those who need it, but I’d consult with a doctor before getting any device to closely monitor your heart and possibly increase your anxiety.

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