Smartwatch czy lekarz? Co potrafią nowoczesne urządzenia wearable.

on the long-term side. Good morning, my name is Professor Marek Postuła. Good morning, Marko, hello. Hello, good morning. My name is Krzysztof Łoniewski and in the previous episode we promised that we would deal with smartwatches, bands, wearables, whatever Marko called. As a cardiologist, I understand that you are a fan of smartwatches. You even wear two. I wear two smartwatches. There is no good Polish philosopher who would know about the functionality of these devices, I think. English wearable was okay, right? Wearable, yes. Of course, because each of these definitions probably covers some other devices, but you are right that I have been using smartwatches for a long time. Every day. I have more of them, but why do I have more of them? I'm sure we will get to that in a moment. Absolutely, I'm not a gadgeter, it's not... Let's say at the beginning. It's not connected to what we started with. I came very septically to my first smartwatch. The first smartwatch that I used, it was a typical sports watch, which I used only for physical activity, which had very limited functionality, but the functionality was limited to what I needed, i.e. to monitor the physical activity of my training, the duration of the time, the load. However, I did not use full functionality. It seemed to me that some parameters that we will be talking about today are completely unnecessary and I am not interested in them. However, there came a moment when I started to look at it a little bit, because more and more information came to me or I read more and more. How potentially we can use these devices in such a modern prevention, i.e. a prevention that is supported not only in the classical medical science, but also in the new technology. I think that the world measures in the direction that these new technologies will be our doctor in the pocket for a while, or a doctor in the overhouse or maybe not a doctor, but our medical counselor who will tell us a lot of things based on what we are able to read from our body today, but also observing the development of new technologies, I think that we are just a part of such a digital revolution that will allow us to decide to find out more about our body, thanks to the correctness of these sensors that are built in these clocks. I see that you are spreading such a bright future ahead of the government, monitoring the smartwatches very well. You said that at the beginning of your own adventure with smartwatches, you did not use many functions. I think that most of our listeners are still not using many of these functions. What would you recommend to pay attention to when choosing a smartwatch? Which functions are important besides the basic ones? This is a very difficult question because there is no universal answer. As we said, I used a few smartwatches because there is no perfect device on the market. Then tell me why do you use two? Why do I use three? Why do you use three? Well, it turns out that no company has integrated the development and technology. Each company has its own corporate core. In this direction, the marketing and technological aspects mark the development trends of these particular devices. I think that we can use the name without complaining at all. But in Garmin, which is known as a company that specializes in sports cigars, there are of course very well-built sports functionalities. And these next versions of Garmin cigars are also worth paying attention to. Garmin products are very much from cigars of various types. They have stripes, but also stripes on the ring of the ring, monitoring the movement. A pulseometer. Or a computer that is typical for a bike, which I also use. For snorkelling. In Garmin, it came out of the GPS and such devices that served completely differently. But it was probably developed or developed very well in sports. However, there is no such functionality. We call it healthy. Which is very well-built in Apple products. I remind myself of the biography of Steve Jobs, who is now listening to us in the car. To balance the weight and to break away from what surrounds us. To catch, maybe, another flow of the world. However, being a visionary is not so bad in this strange world in which we live. And of course, Apple is such a product that very flirtates. I think it is a good definition with this medical world. Well, let's remind ourselves that Apple Watch is the first watch, the first smartwatch that analyzes EKG. FDA registered it as a potential medical device. So, we can use it as such a device. What is true, our cardiological publications about the use of the population. Well, it's about creating something that is popular. We can use it. The use of the population of this device in functionality slightly disappoints us that it is not so great from the point of view of the population. However, this is mainly EKG. But there is no, for example, something that, as a cardiologist, the size of the blood pressure is the size of the blood pressure. The dream of each of us is to not have to remember the size of the blood pressure, but to measure it as if the blood saturation, which the smartwatch measures, because these sensors allow to measure the blood saturation without our participation, without pressing additional functionalities. Probably, in this regard, we will measure that in a moment I have a good news for you. We will be able to measure this pressure, because it is already... I wanted to ask this question. Is there any smartwatch on the market that measures the blood pressure well? Listen, there is a Huawei smartwatch, which has this functionality. For now, it is still, you can say, this functionality, maybe not so manual, which will show the trends in which the world of smartwatch will develop, because it is still such a classic, you know, when you measure pressure. Yes, of course. You have to pump the market. Yes, you have measured it many times. The gold standard is to make sure that it was on the shoulder, i.e. at the heart level. What is known is that it stands in front of it. How do you do it? The watch, of course. Because it is above all on the fingerboard. And this will also bring the attention of all our listeners, that the correct measurement should be on the shoulder, not on the fingerboard, because there are also pressure measures on the market, which measure it from the fingerboard. From the fingerboard and, of course, always this measurement is a bit too much, but probably more comfortable. If I were to evaluate why such solutions are on the market. And that's it. We are returning to the watch. The watch measures it above the fingerboard. This whole pillow that is pumping, this is very interesting and also an interesting experience, because you have a watch on your hand, a watch that has a band, and you can't see it from below. First of all, when you look at it, it is such a cut, which in the middle of the device of this watch, i.e. in the heart of the watch, there is a form of a pump, that's what it looks like, which fills this pillow with air, and at some point it presses on your hand. So it's such a mini band? A mini band, exactly. I tested it, I compared it, of course, to such standardized pressure measures, which have validation, because it is also very important that the pressure must be measured in a validated, certified device. And tell me, is it really very interesting? Well, it turned out that these measurements are surprising, so I will tell you that this is... Please, this is what the cardiologist says. It surprised me. What's more, listen, we are monitoring the pressure treatment, because of course you can imagine that this is not a play for you, if you don't have pressure, as you would have said, listen, but you recommend it to me. And I am, Mark, at such an age, that this pressure can appear to me. Of course, and we will go over it in a moment, but for a potentially healthy person, this is probably not a clock, which has these additional functionalities, they are such that I would say, wow. In such a case, it is so-called added value that it can measure pressure so much that everyone should now switch and have this clock on their hands. But for sure, for those who know the technical part, there are people who have the history of the birth of heart disease treatment, i.e. the birth of a child, it is also... By the time of the podcast about the clocks, I remind you that grandma, grandpa, aunt, uncle, it is not necessarily a birth certificate, even though I always see patients, when I ask about the parents of the birth certificate, they say "grandma, grandpa". I don't know why, because I always clearly find out that I ask about the parents of the birth certificate, most patients start asking me whether I want to tell them or not. Really? Yes, yes, this is some kind of... This is such a hearing and I think that it is a matter of cabinet stress that we stop thinking about the birth certificate, we think about grandmothers and grandmothers and so on. Going back to the topic, it has a very nice functionality, because the patient with the birth certificate should control the birth certificate from time to time. The simplest recommendation is to die in the morning, in the evening, in the morning before the doctor, in the evening after dinner, this is my recommendation to die in my cabinet. Everyone should have such an recommendation, because it is so overwhelming. Once a year each of us should do it, in order to answer the question whether there is any sort of orange flag there, or maybe red, as the values are too high. And I think that after 40 years each of us should do it regularly. Practically nothing costs, only to remember. I had one patient who measured the pressure a few dozen times a day. And he brought me... Really, this is a great case. Professor of Polytechnic and Emeritus, who probably got bored, he brought me a few thousand measurements, a whole book. He had different theories that he had written, and it was... I asked him about the electronic version of these measurements, and sometimes I used it as a curiosity. Did he build some algorithm? No, but he had, for example, he did experiments, that the salt... He turned it off. He turned it off and showed me, "Here, I turned off the salt, and here, take a look." And as if he was studying what we know from science, we don't have to repeat it on ourselves. He wanted to study it first. He wanted to study it, exactly. Turn off the salt and lower the pressure, that's how it works. When it comes to this pressure, it has a great functionality for the patient. Can I interrupt you? All the time you're talking about the Huawei or something else? All the time. With the pressure? Pressure, because you have the possibility to turn it on, so that the measurements turn on automatically, not manually, but to follow what we call in medicine a pressure holder. So, for example, when you have a patient with pressure, and from time to time, he/she modifies the treatment. Do you want to judge if the treatment I suggested to him, or if the lifestyle modification works? I recommend the pressure holder. And here you have the pressure holder. I turned it on too, because I wanted to see, I like the so-called patient experience, that is, what I recommend to my patients. What does it do? Does it work or does it not cause discomfort? Because if you tell me, "Listen, these tablets, or this kind of physical activity, or any other intervention that you have interested in, it does not tolerate it at all. Yes, Marko, but on the other hand, I will immediately press the question button. Because the pressure holder is something that many of our listeners have probably tried once in their life. It is a big discomfort for us, for the virus. Do you, as a cardiologist, already have the possibility to change it from one to one? No, absolutely not. The pressure holder is validated, it is also a lot of other parameters. So it is a practice, as you say, right? Yes, it is a means to answer yourself, whether the pressure control is valid or not. And also whether we have a nightfall, pressure drops, what is the correct answer to the organism. You just dropped the pressure. You got the news. Has it grown? It has grown. You know what? Today I have such a day, that I am constantly underpinned. It certainly will never replace medical tools. But there is also such a direction, significant information, to deepen, for example, the diagnosis, right? I think that it is more, you have to understand that this is something that you can do at any time. Because life is like that, sometimes patients come to me often, and they say that suddenly the pressure has increased. And the question is whether it has grown for a while, because they have been denervated. Because they are not proven. Because they are not proven, or they have been denervated as a result of elections. Not only them. Is this a situation, which is, for example, if we have an increase all the time, or an increase at night, then it is a sign of something like that. Okay, I have to go to the doctor. I treat wearable or smartwatch as a medical concealer on the hand, which can tell us a lot, but you have to be able to use these data and probably find the right one for yourself. Because someone more depends on controlling the pressure, because it is his main weak health point. And someone else, for example, trains and wants to find his HRV. Exactly. And wants to know your progress. Mark, you said a very important thing, that here we do not agree with everyone, each of us has to answer in some way what we need. Method of trying errors, right? It is possible. So using different smartwatches, that there is such a possibility of testing them. Because we will not say universal, but we are definitely in sleep. You know, these smartwatches are on the market. A few hundred. And we will come back to that, because there is also a publication, right? She showed, which in some way tried to test, or also scientists, came up with this idea. 2016 they examined the device. Exactly, you can see it. This is kind of the number of attacks, which, even when I read this publication, I wonder where they took these smartwatches, because I know a few companies, probably I don't know all of them. No, no, 216 is surprising. Listen, we are talking about measuring pressure. Yes. Well, this is also something that I brought from the European Cardiological Society, which took place last year in London. And I always, like all my colleagues, go to these sessions, so-called hotlines, that is, physical, that is, what excites us every year, cardiologists. In the Bible, that is, how should we proceed in the data of health units, and in these physical ones, we always have three or four published. On the basis of scientific research. Of course, yes. Well, this knowledge changes so dynamically, that you can say that such a contemporary doctor is in the process of education, in order to achieve it, of course, you have to read a lot. I think it should be. Well, of course. But you know, it's probably like that with everyone. In every branch, right? In every branch, there are people who want to be up-to-date, as they say, but there are those who, at some point, have achieved their goal and in the end, the nail will be damaged, they will say, they will learn that. That nail hits like that. That's right. However, I always look for such technological innovations. And indeed, in the last year, I was at a session about rings, that is, Werebli again, only in the form of a ring. Who make furor in the world of longevity, right? Yes. Well, there is an aura company, which probably, those people who know each other, or are also interested, this is, you can say, a benchmark for others. But this is kind of a different shelf and probably these features of the aura are a bit different than such a classic smartwatch. But it is high in these hierarchies, of course. of these measuring devices, but later on. Yes, it is. There was a presentation of the Korean company, which presented a ring, i.e. a ring, which measures pressure. Oh, please. And without this... Without this pillow? Without this pillow. Well, I would say, that the ring is small. And it has to be matched to the finger. Well, it's not possible to pack there, additionally, what else would you use for the pillow? Besides, the maintenance is not so different. Well, because it has to be, knowing the rules of measurement of pressure, there are no such things under the skin, which would allow you to measure the pressure in the ring. And this is a typical sensor, as we have on our hands in the clocks, which, basically, the current wave and how the light is reflected from the ring, or from the blood wave that flows there, an algorithm has been developed which will calculate the pressure. Well, it's interesting. Well, it's interesting. What I saw, and of course they have scientific work, it's not a marketing product, but they invented it and sell it, it's not validated, but they presented it first of all, if it was shown at the arrival of the cardiologists from all over the world, because there are always 6,000 cardiologists, imagine what kind of meeting it is. So where are they pushing you, at the stadium of the football team? No, it was, listen, in Excel, in London, that is, there is such a... I thought that at Stanford Bridge, or at Emirates, there is more, it doesn't matter. Well, listen, and... I see in your eyes that it is reliable. Because there were scientific work. I will tell you honestly, I went there, there is a lot of interest, but I look at the session for a moment, I say, OK, I'll see it, I read the program, I thought that it would be my fascination, because of course, when I took it to my hand, I started to wonder how it is possible. Well, there was such a session, which explains how it works, on the one hand, that is, this methodological or technological, and for a moment there was such a clinic, that is, showing how it is in the clinical world, it turns out that in Korea, this device is normally paid by health care units, that is, if you press the button, such a device serves you, which has your health care units, so listen, we, if we say... I closed my eyes, is it not reliable, I have an impression in our country? No, I think that it is, you know, everything is reliable, but there is a matter of understanding, what is the value of the prophylaxis, when it comes to the health care system, that if someone is upset with a long list, or with a computer, and he made a good Excel, it would turn out that such an investment will return very quickly to society. Well, but again, we are returning to politics, which somehow cannot come out with me, that it does not pay anyone politically, because the effect will be only for three or four cadences, which everyone will forget, who made a decision there, divorced, for how many years. To turn off the ring, absolutely yes. Well, but look, we see that we are going to miniaturize, that is, we have the miniaturization of something that was still unimaginable, because I remember, when I was a child, the pressure of the retentive measure, which was a large box, of course. I went to the doctor's house, you can say, Grandpa Pradiada, and I even had such an old father-in-law of my grandfather, a doctor. Grandpa with a doctor. Yes, where all these stethoscopes and so on, it was my, you can say, toy. All these stethoscopes, such old, such trunks, which were used, it was all my gadgets, because in the commune, there were no cool toys, but these were my cool toys. I remember that you press the button, it was my toy. I had such a button, where there was a retentive inside, which was then, actually, removed. So I had an exhibition from a child on retentive. That's why you shine so much. I'm a living silver. So, and look, we came from a large box, where you had to have a stethoscope, and so on, to the ring, where you potentially smoke in the application and you have pressure measurement. In real time, pressure measurement. Well, because that's probably the key thing, apart from the devices we're talking about, that here the measurement is made in real time, the force of things is reported in real time, actually, apart from running the disease, because that's the key thing in these devices. Well, I think there are many other things, because if we look there... We can talk about prevention. ...we take a deeper look at the number of cases of retentive disease with risk factor, because we say from an economic perspective, at least, that retentive disease is a disease that, of course, costs a society of 10 million Poles per retentive disease. What else, listen, three-fourth is... There's no point in that. Or you have a bad treatment, or you don't know that. So, one-third of Polish adults have a good retentive disease. Well, it turns out that, and this is a risk factor, many diseases, migratory diseases, heart failure, the whole spectrum of these cardiological diseases is such a ring, which now costs 500 euros, that's what I asked the company, how much it costs. It probably sounds like it's a lot, but on the other hand, it's not just a device that measures... Well, I just wanted to say that, on the bank, it doesn't measure only pressure, but also, you know, other life functions. That's right. It measures just HRV, which is what... But is this a available device on the market? Unfortunately, in another one, because of course, you know, I was laughing right away, the first thing I gave the company was whether I was planning an expansion in Europe, because unfortunately... I thought I would like to be your representative in Poland. The point is that, you know, it's the same, you have a European Union certificate, so you have to have the CE mark to introduce the product, especially the medical one, on the market. The process is very long, probably expensive, and it's not going to happen here and now. But there is a film by Fajcari, which is called "Aktia". It is, on the other hand, a band, what you wear on your hand. And it also measures pressure, as if it is used. I have a few patients in which I recommended "Aktia", and they use it for something. Patients with pressure, so that it's clear, because there are patients who want to have a cigar, there are patients who want to have a band, there are patients who, again, for ideological reasons, do not buy Chinese products. Well, this is, you know, the whole range. Since this market, I have to, as you can hear, know a little about this market, to be able to propose something in accordance with the needs, with expectations, with ideology, and so on and so on. Good, Mark. So now, at the end, I would like to ask you about this ranking. The ranking is prepared by scientists from the University in Amsterdam and from the University in Singapore. Yes, in Singapore. Yes. 216 devices were tested, then 20 were selected, and finally, four were selected. Yes, it can be such a tip, because I would take into account five criteria, because it is known that it is so that, again, I repeat, what people like, what people need, and it is difficult to say so, because this scientific ranking, of course, you have to include some criteria. It was five criteria, i.e. ability to continue monitoring, i.e. whether the device can be given 24 hours a day, for at least a week. Well, at the moment, not all the batteries are enough, availability and availability, i.e. whether you can easily buy them, carry them, whether they are ergonomic, precision and accuracy of measurements, i.e. based on rigorous validation studies, i.e. whether such validation studies have passed, it is said that not all devices have validation, i.e. this process of intrusion into the market was shortened to a minimum and something was released there, that something is measured, but you do not know whether it is worth or not. Utility and practicality, i.e. comfort of movement, power of the batteries, synchronization of data, i.e. whether there are applications, or how... How is it readable? How it interacts with this digital environment. The device for programming, because there are also such devices that have such programming that before you reach some parameter, or how to measure this parameter, you are frustrated, you know, for me personally, who is not patient, it is a very big limitation. Finally, the cost, i.e. the economy. The cost of quality and the price. Exactly. Well, number four? Number four, it is mentioned by our Aura. i.e. this first day? Yes, i.e. mainly there, let's remember that there, Aura, it is about measuring and transforming this data related to regeneration, i.e. HRV and TENTNO, analysis of SNU, I think that if I were to say, it is probably Aura, it is about functionality number one, but in general, here on the screen, it is located on the fourth, on the third place, there is Fitbit Charged 6, you can have a device for everyone, not for pros, not for amateurs, only such medium-sized devices, i.e. this person is more ambitious, they expect something more, for amateurs it is OK, i.e. those who, starting their adventure with smart devices, you can start with this, it is enough for a long time, i.e. we will not have the need to explore this market further. The second place? The second place, listen, this is of course... Garmin. Garmin, Beavosmart. And the first place? Apple Watch, Seria 9. Exactly, why do you suspect? I think the precision, however, is also, this micro-interface, in which the Apple devices work, because I think that everyone who creates applications on the phone, when they start creating it, they dream of integration with the world of Apple, which is a point of reference, probably of quality, that there is a lack of details, and that is why we are positioned in a completely different way. Please, I hope that we have explained a little bit about this, the smart devices monitoring our activities, the smart watch. Thank you very much, Mark, for this powerful gift of knowledge, and I would like to ask or think quickly, what are we doing next time? Well, you know, next time I'm getting close to the holidays, so I think that we slowly... I'm laughing, maybe in Agra. We slowly get to... To the end of the first season. To the end of the first season. To the end of the first season. And maybe this is the moment to make the episode telling the second season, which I have a completely different idea, what is it about? I'm laughing, but I won't turn it off. We will leave our listeners with such a dose of uncertainty, what will be the topic of the next episode, and what formula it will be. It will certainly be interesting. See you later. See you later. See you later.