How Wearable Technology has Revolutionized Health Research 1 How Wearable Technology has Revolutionized Health Research 1

How Wearable Technology has Revolutionized Health Research 2 How Wearable Technology has Revolutionized Health Research 2 HOW WEARABLE TECHNOLOGY HAS REVOLUTIONIZED HEALTH RESEARCH Aaron Coleman, Founder & CEO, Fitabase June 9, 2016

How Wearable Technology has Revolutionized Health Research 3 How Wearable Technology has Revolutionized Health Research 3

How Wearable Technology has Revolutionized Health Research 4 How Wearable Technology has Revolutionized Health Research 4

How Wearable Technology has Revolutionized Health Research 5 How Wearable Technology has Revolutionized Health Research 5 Wearable technology represents a meaningful and critical new way to measure, track, and engage with research participants

How Wearable Technology has Revolutionized Health Research 6 How Wearable Technology has Revolutionized Health Research 6 Hi, I’m Aaron Obama Technology Field Team S.M.A.R.T Study Center for Wireless & Population Health Systems UCSD Founded Fitabase Partnered w Fitbit 1st Customer 3 months later 2008 2009 2012 Bootstrapped to profitability, proving robust platform with good validation papers in literature. 2014 Still at it. Learning from research community and building next gen data tools. 2016

How Wearable Technology has Revolutionized Health Research 7 How Wearable Technology has Revolutionized Health Research 7 1,900,000,000+ Minutes of Fitbit Data Collected 150+ Research Projects

How Wearable Technology has Revolutionized Health Research 8 How Wearable Technology has Revolutionized Health Research 8 Research :: Measurement “Accurate and minute measurement seems to the non- scientific imagination, a less lofty and dignified work than looking for something new. But nearly all the grandest discoveries of science have been but the rewards of accurate measurement and patient long-continued labour in the minute sifting of numerical results.” — Baron William Thomson Kelvin, 1871

How Wearable Technology has Revolutionized Health Research 9 9 SELF REPORT

How Wearable Technology has Revolutionized Health Research 10 10 DIRECT OBSERVATION

How Wearable Technology has Revolutionized Health Research 11 11 RESEARCH DEVICES

How Wearable Technology has Revolutionized Health Research 12 How Wearable Technology has Revolutionized Health Research 12 “manpo-kei” 万歩計 10,000 Steps? Catrine Tudor-Locke (2003). Manpo-Kei: The Art and Science of Step Counting. Victoria, Canada: Trafford Publishing. ISBN 1-55395-481-5.

How Wearable Technology has Revolutionized Health Research 13 How Wearable Technology has Revolutionized Health Research 13 Health Is Social Nicholas A. Christakis, M.D., Ph.D., M.P.H., and James H. Fowler, Ph.D. N Engl J Med 2007; 357:370-379July 26, 2007DOI: 10.1056/NEJMsa066082

How Wearable Technology has Revolutionized Health Research 14 How Wearable Technology has Revolutionized Health Research 14 Communicating Progress Consolvo, S., Mcdonald, D. W., Toscos, T., Chen, M. Y., Froehlich, J., Harrison, B., … Landay, J. A. (2008). Activity Sensing in the Wild : A Field Trial of UbiFit Garden. CHI 2008 Proceedings - Personal Health, 1797–1806.

How Wearable Technology has Revolutionized Health Research 15 How Wearable Technology has Revolutionized Health Research 15 Physical Activity Guidelines •  Healthy Adult National Guidelines for Physical Activity •  Last revised 2008 •  62% of Americans are meeting guidelines!* 150min MVPA per week, 10min bouts

How Wearable Technology has Revolutionized Health Research 16 How Wearable Technology has Revolutionized Health Research 16 Physical Activity in the US •  2005 – 2006 (published 2008) •  3,082 Adults •  Good data = 4 days,10hrs per day •  < 10% meet national guidelines Tucker, J. M., Welk, G. J., & Beyler, N. K. (2011). Physical activity in U.S.: adults compliance with the Physical Activity Guidelines for Americans. American Journal of Preventive Medicine, 40(4), 454–61.

How Wearable Technology has Revolutionized Health Research 17 How Wearable Technology has Revolutionized Health Research 17 Fitabase works with researchers and organizations to take advantage of the new tools of wellness.

How Wearable Technology has Revolutionized Health Research 18 How Wearable Technology has Revolutionized Health Research 18 The New Tools

How Wearable Technology has Revolutionized Health Research 19 19 Participant DATA FITABASE Scalable cloud technologies, robust APIs, and mobile connectivity enable exciting new models for health research.

How Wearable Technology has Revolutionized Health Research 20 20 Privacy •  What are identifiable / vs de- identifiable data sets? At what resolution? •  How immediate does data flow? Are there moral obligations to intervene if something looks bad? •  How is the data capture conveyed to participants?

How Wearable Technology has Revolutionized Health Research 21 How Wearable Technology has Revolutionized Health Research 21 How it Works •  Give participants devices and create accounts •  Recruit current Fitbit users and authenticate •  View and Analyze Data •  Dashboard Monitoring •  Easy to Navigate Report Pages •  Reports Latest Sync & Battery Level •  Export Participant or Batch Data (.csv)

How Wearable Technology has Revolutionized Health Research 22 How Wearable Technology has Revolutionized Health Research 22

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How Wearable Technology has Revolutionized Health Research 26 How Wearable Technology has Revolutionized Health Research 26 Proudly Supporting

How Wearable Technology has Revolutionized Health Research 27 How Wearable Technology has Revolutionized Health Research 27 Studies We Support •  Measurement •  Validity & Reliability •  Intervention Effects •  Post-Operative Care •  Pharma Trials •  Behavioral

How Wearable Technology has Revolutionized Health Research 28 How Wearable Technology has Revolutionized Health Research 28 ClinicalTrials.gov / NIH •  63 Currently open studies (101 registered) o  Diabetes o  Cancer o  Obesity o  Lupus o  Rehabilitation o  Osteoarthritis o  Cardiovascular Disease o  Peripheral Arterial Disease o  Weight Loss o  ….Many More!

How Wearable Technology has Revolutionized Health Research 29 How Wearable Technology has Revolutionized Health Research 29 Yale: Fertility Study Improving Reproductive Fitness with Pretreatment with Lifestyle Modification in Obese Women with Unexplained Infertility: FIT-PLESE •  7 sites around the US •  350 Women •  Obese + Unexplained Infertility •  Effect of Exercise or Exercise + Weight Loss •  Fitbit ChargeHR + Aria Scale •  16 Week Trial PI: Richard S. Legro M.D.

How Wearable Technology has Revolutionized Health Research 30 How Wearable Technology has Revolutionized Health Research 30 Harvard: Nurses Health Study 3 •  Nurses Health Study –  Started in 1978; 200,000+ participants •  500 participant subsample •  7-days of monitoring, 4x per year “Novel mobile technologies, such as global positioning systems (GPS) enabled smartphones and consumer wearable accelerometry devices, can provide efficient, rigorous, and objective measures of geographic context, physical activity, and sleep with high spatio-temporal resolution.” PIs: Jorge Chavarro, Peter James

How Wearable Technology has Revolutionized Health Research 31 How Wearable Technology has Revolutionized Health Research 31 Sleep •  32 Adolescents •  Comparing ChargeHR to Polysomnography & Indirect Calorimetry •  Mean age: 17y/o •  Accurate for –  Total time asleep –  Time awake –  Sleep efficiency –  HR = ECG data (< 1bpm difference) de Zambotti, M., Baker, F. C., Willoughby, A. R., Godino, J. G., Wing, D., Patrick, K., & Colrain, I. M. (2016). Measures of sleep and cardiac functioning during sleep using a multi-sensory commercially-available wristband in adolescents. Physiology & Behavior, 158, 143–9.

How Wearable Technology has Revolutionized Health Research 32 How Wearable Technology has Revolutionized Health Research 32 Spine Surgery •  Post spine surgery •  Activity as measure of recovery •  Develop predictions for future patients “We hope to integrate this into our practice so that it becomes a universal and accepted means of evaluating patients and evaluating our outcomes […] we hope to make patients more involved in their own self-evaluation, recovery and spinal health. I strongly believe that a motivated patient will get better results.” PIs: Zachary Smith, Christopher Ames

How Wearable Technology has Revolutionized Health Research 33 How Wearable Technology has Revolutionized Health Research 33 Why Wearables? Why Now?

How Wearable Technology has Revolutionized Health Research 34 How Wearable Technology has Revolutionized Health Research 34 Ernesto Ramirez, PhD

How Wearable Technology has Revolutionized Health Research 35 How Wearable Technology has Revolutionized Health Research 35 Ernesto Ramirez, PhD

How Wearable Technology has Revolutionized Health Research 36 How Wearable Technology has Revolutionized Health Research 36 Ernesto Ramirez, PhD

How Wearable Technology has Revolutionized Health Research 37 How Wearable Technology has Revolutionized Health Research 37 Why Wearables? Why Now? •  Q: Why do we do what we do? •  Lack of data •  Huge Data Sample Size Potential •  20+ million Fitbit Users •  Most existing studies < 10K 20000000

How Wearable Technology has Revolutionized Health Research 38 How Wearable Technology has Revolutionized Health Research 38 Behavior Science + Machine Learning Riley, Mar+n, Rivera, Hekler, et al. 2016; Mar+n, Riley, Rivera, Hekler, et al. 2014

How Wearable Technology has Revolutionized Health Research 39 How Wearable Technology has Revolutionized Health Research 39 Future: Civic

How Wearable Technology has Revolutionized Health Research 40 How Wearable Technology has Revolutionized Health Research 40 Future: Medical

How Wearable Technology has Revolutionized Health Research 41 How Wearable Technology has Revolutionized Health Research 41 Future: Medical

How Wearable Technology has Revolutionized Health Research 42 42 Precision Medicine “Tonight, I'm launching a new Precision Medicine Initiative to bring us closer to curing diseases like cancer and diabetes — and to give all of us access to the personalized information we need to keep ourselves and our families healthier.” President Barack Obama State of the Union Address, 2015

How Wearable Technology has Revolutionized Health Research 43 43 •  $1 Billion in NIH funding from 2016-2020 ($210m FY2016) •  Bipartisan support “Wearable devices can assess heart rate and other physiological states as well as physical activity levels. Smartphones also could keep participants connected to the study, providing feedback on the data they provide as well as the aggregate data and findings of the study." Collins, F. S., & Varmus, H. (2015). A New Initiative on Precision Medicine. The New England Journal of Medicine, 372, 793–795. Precision Medicine

How Wearable Technology has Revolutionized Health Research 44 How Wearable Technology has Revolutionized Health Research 44 We have the tools. We have the people. Now it’s time to turn that into GOOD.

How Wearable Technology has Revolutionized Health Research 45 How Wearable Technology has Revolutionized Health Research 45 THANK YOU. @aaronc [email protected]