My girlfriend, “Emily,” who likes to hack her health, recently purchased an Oura Ring. From the outside, it looks like an ordinary silver ring, but it’s lined with sensors that monitor heart rate, respiration, temperature, body motion and other variables. Algorithms analyze data and draw conclusions, displayed on her iPhone. The ring tells Emily how much exercise and sleep she’s getting, and it advises her, in a gently bossy way, on how to be healthier. Maybe go to sleep a little earlier tonight, exercise a little more tomorrow.
The ring is an almost magical piece of engineering. All that sensory and analytic power packed into that tiny, elegant package! The ring transmits data to its maker, Oura, which refines its algorithms to make its “precise, personalized health insights” more accurate. Ideally, the ring will help you cultivate healthier habits and alert you to problems requiring medical intervention.
That’s Emily’s hope. But when she urged me to get an Oura Ring, I shook my head and said, No way. I worry that the ring is making her unhealthily anxious about her health. It would surely have a similar effect on me.
A technology reviewer for The New York Times touches on my concerns. Before you purchase a device like this,” he writes, “you need to ask yourself whether you’ll use the data to make better choices, or whether it will cause you unnecessary stress,” We should ask ourselves this question about all our digital devices. On balance, are they good for us?
The market for “wearable” health-tracking devices is growing fast, according to a recent report in a healthcare-business journal, with tech giants such as Google, Amazon and Apple as well as smaller companies such as Oura competing for customers. “Demand has skyrocketed during the COVID-19 pandemic and is only expected to accelerate in 2021,” the report states.
Studies of fitness trackers yield mixed results. A 2019 review in the American Journal of Medicine concluded that “wearable devices play a role as a facilitator in motivating and accelerating physical activity, but current data do not suggest other consistent health benefits.” A 2016 study in the Journal of the American Medical Association found that subjects wearing devices that track calorie intake and exercise lost less weight than controls.
Keep in mind that Americans are already over-tested for potential medical problems, notably cancer. For every woman whose life is extended by a mammogram, as many as 10 women receive unnecessary treatment for breast cancer, including surgery, chemotherapy and radiation, according to a 2013 meta-analysis by the Cochrane network, which conducts impartial evaluations of medical interventions.
The ratio is even worse for PSA (prostate-specific antigen) tests for prostate cancer in men. An analysis by the group NNT, which like Cochrane evaluates medical procedures, concludes that PSA tests do not reduce mortality, and they lead to unnecessary biopsies and treatments in one in five men.
Artificial-intelligence enthusiasts claim that it will improve the accuracy of tests. That was an alleged application of IBM’s much-touted AI program, Watson. But neither Watson nor other AI products developed by IBM have fulfilled their promise. IBM’s efforts “have fizzled,” the technology journal IEEE Spectrum reported in 2019, and a few “have failed spectacularly.”
Economist Gary Smith and technology analyst Jeffrey Funk report in the business journal Quartz that only 11 percent of radiologists employ AI for interpreting images. The reason, Smith and Funk assert, “is poor performance.” Claims that big data plus artificial intelligence will revolutionize healthcare “are mostly hype,” Funk told me via email.
The U.S. is a leading inventor, marketer and adopter of medical technologies, including those involving big data and AI, and yet U.S. health care is abysmal. Although the U.S. spends much more on healthcare per capita than any other nation, the health of the U.S. population lags behind that of comparable industrialized countries and even Costa Rica, which spends less than one tenth as much per capita on healthcare.
My guess is that a growing number of people will become dependent on health-tracking devices, even if they doubt the benefits. Consider this recent review of the Oura Ring. The reviewer, Chris, says that after 11 months of wearing the ring, neither his sleep nor any other components of his health improved.
Chris nonetheless compulsively checks his ring’s output every morning, in the same way that he checks Instagram and other social media sites. Just as likes and positive comments give him a “dopamine hit,” so does Oura data indicating that he got a good night’s sleep. If he lost the ring, Chris says, he would buy a new one.
Will the Oura Ring and other devices empower consumers by helping them to take charge of their health? I doubt it. But the devices certainly empower and enrich the companies that make them. The data we generate with our digital devices helps companies make them even more addictive.
Scientific Curmudgeon is an Opinion column written by CAL Professor and Director of the Stevens Center for Science Writings, John Horgan. Columns are adapted from ones originally published on ScientificAmerican.com.
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