A study published in JAMA Psychiatry found that wrist-wearable devices may have utility for screening for pain, sleep, and/or anxiety symptoms among survivors of trauma.
Investigators from the University of North Carolina at Chapel Hill sourced data for this study from the Advancing Understanding of Recovery After Trauma (AURORA) study which recruited survivors of a traumatic event at 27 emergency departments (ED) between 2017 and 2020. Participants (N=2021) received a watch from Verily Life Sciences and were instructed to wear the device for ≥21 hours per day for 8 weeks and to respond to self-report surveys about symptoms. For this analysis, the participants were randomly divided into identification (n=1010) and validation (n=1010) cohorts, and the utility of data collected from the wearable devices were evaluated for adverse posttraumatic neuropsychiatric sequelae (APNS) outcomes.
Participants had a mean age of 35.8 (SD, 13.0) years, 62.2% were women, 50.2% were Black, and 75.2% had been in a motor vehicle collision.
A total of 8 device biomarkers exceeded significance thresholds in the derivation cohort. In the cross-sectional validation, only pain remained significant (r, -0.14; P <.008).
A total of 13 individual state biomarkers exceeded significance thresholds in the derivation cohort. In the cross-sectional validation, 11 markers remained significant. The biomarkers were maximum daily activity (r, -0.15; P <.001), average activity of most active 10 hours (r, -014; P <001), average daily activity (r, -0.13; P <.001), baseline activity (r, -0.13; P <.001), SD of daily activity (r, -0.12; P <.001), peak activity timing (r, -0.07; P <.001), and proportion of 24 hours spent awake (r, -0.05; P =.02) as markers for pain and number of transitions between sleep and wake (r range, 0.04-0.13; P ≤.003) as markers for pain, sleep discontinuity, anxiety, depression, and somatic symptoms.
These biomarkers were able to predict worsening (sensitivity range, 0.36-0.44; specificity range, 0.58-0.69; accuracy range, 0.56-0.64) or improving (sensitivity range, 0.58-0.69; specificity range, 0.36-0.44; accuracy range, 0.56-0.64) self-reported symptom trajectories.
The findings of this study may not be generalizable for survivors of trauma who do not seek medical attention in the ED setting.
Study authors concluded, “Wrist-wearable devices are common and frequently use built-in accelerometers to detect 24-hour activity patterns. Thus, a proportion of the population may be using devices capable of yielding useful information to help screen for trauma survivors with high pain levels at a point in time and/or poor pain, sleep, and/or anxiety recovery over time. In the future, such biomarkers might be useful to identify trauma survivors who merit further evaluation for adverse trauma outcomes, particularly in vulnerable populations.”
Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.
Straus LD, An X, Ji Y, McClean SA, Neylan TC, Aurora Study Group. Utility of wrist-wearable data for assessing pain, sleep, and anxiety outcomes after traumatic stress exporsure. JAMA Psychiatry. Published online January 11, 2023. doi:10.1001/jamapsychiatry.2022.4533