Patient and physician perspectives on smartwatch-based out-of-hospital cardiac arrest detection

Aims
The potential application of wearable technology solutions for detecting out-of-hospital cardiac arrest (OHCA) is increasingly explored to enhance survival outcomes, but questions related to device accuracy, psychological well-being, privacy, and equal access need to be sorted out before implementation in clinical care and society. This qualitative interview study investigates patients’ and physicians’ perspectives on end-user needs, preferences, and potential barriers to smartwatch-based OHCA detection.

Methods and results
During the first cycle, 17 patients with elevated OHCA risk were interviewed individually (n = 8) or with their partner (n = 9). The second cycle consisted of interviews with 18 physicians, including cardiologists (n = 9), and other physicians involved in the clinical care of OHCA: general physicians (n = 3), intensivists (n = 3), and neurologists (n = 3). Verbatim interview transcripts were inductively coded for thematic analysis. Five overarching themes were derived: (1) acceptance, use, and optimal informed consent; (2) identifying the target population; (3) technology-related barriers, such as false alarms, localization, and locked doors; (4) design preferences related to privacy, comfort, and hardware alternatives; and (5) public–private partnerships, costs, and equitable access.

Conclusion
This study is the first to explore the perspectives of patients and physicians on smartwatch-based OHCA detection using qualitative analysis of interview data. The results provide important building blocks for the ethically and psychologically sound development and implementation of smartwatch-based OHCA detection in clinical practice, taking the social context into account. The availability of OHCA detection using wearable devices to a wide range of people requires further attention, with emphasis on populations at elevated risk of cardiac arrhythmias.