“Emily,” one of my girlfriends who enjoys tinkering with her health, just purchased the ura Ring, a clever little device.
It appears to be a regular silver ring from the outside, but it’s actually laced with sensors that track heart rate, breathing, temperature, body mobility, and other factors. On her iPhone, algorithms are analyzing data and drawing judgments.
The ring shows Emily how much exercise and sleep she gets, and it gently advises her on how she might improve her habits.
Perhaps get some extra exercise tomorrow and go to bed a little sooner tonight.
To help her fall asleep, the ura app even gives recordings of uninteresting stories read by someone with a delightfully somniferous voice.
The ring is a work of engineering that is nearly mystical. All of that sensory and cognitive capacity in such a little, attractive container! And the ring’s logic appears to be unquestionable at first inspection.
The ring sends more and more data from users to its creator, ura, which is constantly fine-tuning its algorithms to improve the accuracy of its “precise, tailored health insights.”
The ring should, in theory, aid in the development of better habits and alert you to issues that require medical attention.
Emily is hoping for this. I shook my head and exclaimed, “No way,” when she insisted on getting me an ura Ring.
I’m concerned that the ring is causing her to become overly concerned about her health. (Emily disagrees; see her comments below.) It would almost certainly have the same impact on me.
My concerns are addressed by a technology reviewer for the New York Times.
“I can’t say that the ura Ring has made me healthier,” Justin Redman adds, “but it has made me more health-conscious.”
“Each morning, I checked my ura Ring data to make sure I was fine (and didn’t have COVID-19).” This eventually resulted in an unhealthy reliance on the ring and its information.
Before you buy a device like this, think about whether you’ll use the data to make better decisions or if it’ll just cause you stress.”
This is a question that we should ask ourselves about all of our electronic equipment.
Are they, overall, beneficial to our health? We live in the “big data” era, in which businesses collect ever-increasing amounts of information about us via the internet, cellphones, and other devices.
The ura Ring and Fitbit are just a couple of examples of this trend in health and fitness devices. According to a recent report in a health care–business journal, the market for “wearable” health-tracking devices is rapidly expanding, with tech behemoths like Google, Amazon, and Apple, as well as smaller firms like ura, competing for customers.
The report states that “demand has skyrocketed during the COVID-19 pandemic and is only expected to accelerate in 2021.”
Fitness trackers, like the ura Ring, are supposed to empower us by giving us more control over our health, and it appears that some users are nudged to exercise more.
According to a recent meta-analysis of 28 studies involving 7,454 healthy adults, “interventions using smartphone apps or physical activity trackers have a significant small-to-moderate effect in increasing physical activity,” which equates to 1,850 steps per day.
However, according to a study published in the American Journal of Medicine in 2019, “the devices provide little benefit in terms of chronic disease health outcomes.”
Wearable devices can help motivate and accelerate physical activity, but there are no other clear health benefits currently available.”
Devices that monitor diet and exercise have raised concerns among researchers.
According to a 2016 study published in the Journal of the American Medical Association, people who used devices to track their calorie intake and exercise lost less weight than people who did not.
In 2017, Virginia Commonwealth University psychologists linked such devices to an increased risk of “eating disorder symptomology,” such as bingeing and purging.
The researchers state, “Although preliminary, overall results suggest that these devices may do more harm than good for some individuals.”
Another issue is that Americans are already over-tested for medical issues, particularly cancer. Overtesting of asymptomatic men and women can result in overdiagnosis (flapping of microtumors and other anomalies that would never have harmed health) and overtreatment.
According to a 2013 meta-analysis by the Cochrane network, which conducts impartial evaluations of medical interventions, for every woman whose life is extended by a mammogram, as many as ten women receive unnecessary breast cancer treatment, including surgery, chemotherapy, and radiation.
“More than 200 women will suffer significant psychological distress, including anxiety and uncertainty, for years as a result of false positive results,” according to the study.
PSA (prostate-specific antigen) tests for prostate cancer in men have an even worse ratio.
PSA tests do not reduce mortality, and they lead to unnecessary biopsies and treatments in one out of every five men, according to an analysis by the NNT group, which, like Cochrane, evaluates medical procedures.
The authors conclude, “The strategy of routinely screening all men with PSA tests results in interventions that do not save lives and may cause harm.”
I am concerned that consumer devices like ura and Fitbit will increase our anxiety, making us more likely to undergo unnecessary tests, resulting in even more overdiagnosis and overtreatment.
Those who support artificial intelligence claim that it will improve test accuracy.
Watson, IBM’s much-heralded AI program, was said to be used in this way. Following Watson’s victory on the television game show Jeopardy in 2011, IBM wanted to capitalize on the positive press by developing Watson for medical applications.
Watson “could reduce diagnosis errors, optimize treatments, and even alleviate doctor shortages—not by replacing doctors, but by helping them do their jobs faster and better,” according to Eliza Strickland of the technology journal IEEE Spectrum in 2019.
However, neither Watson nor other IBM AI products have lived up to their promises. Many of IBM’s initiatives “failed terribly,” according to Stricklan.
Nonetheless, deep learning would surpass radiologists in five years, according to AI pioneer Geoffrey Hinton, who predicted this in 2016.
That hasn’t happened, to say the least.
Only 11 percent of radiologists use AI for image interpretation, according to economist Gary Smith and technology expert Jeffrey Funk in the business journal Quartz, while the remaining 72 percent have no plans to.
Only 5.7 percent of customers “claimed that AI always works,” while 94% “reported inconsistent performance,” according to Smith and Funk.
Funk told me through e-mail that claims that big data and artificial intelligence will improve health care are “mainly hype.”
“All too frequently, AI and big data are educated on a small set of data and then applied to circumstances where the data is irrelevant.
Solving this problem will necessitate a significant increase in training, which will significantly increase the cost and typically result in inferior explanatory power.”
Consider this: Even though the United States is a major creator, marketer, and adopter of medical technology, particularly those using big data and AI, the country’s health-care system is dismal.
Despite spending far more per capita on health care than any other country, the US population’s health lags below that of comparable industrialized countries, including Costa Rica, which spends less than a tenth of what the US does.
Even if they are skeptical of the benefits, I believe that an increasing percentage of individuals will become reliant on health-tracking devices.
Take, for example, this current ura Ring review. Chris, the reviewer, said he hoped the ring would help him “find things I’ve been doing wrong and repair them so I could sleep like a baby and become superhuman,” but that didn’t happen; after 11 months, neither his sleep nor any other aspect of his health had improved.
Chris, like Instagram and other social networking sites, checks his ring’s production every morning.
Likes and favorable comments give him a “dopamine rush,” and ura data suggesting a good night’s sleep gives him one as well.
Chris claims he would replace the ring if he misplaced it. Will the ura Ring and other devices help customers take control of their health? It’s unlikely.
The devices, on the other hand, clearly empower and benefit the businesses that manufacture them. Our digital devices create data that companies use to make them even more addicting.
“I don’t think your criticisms of my use of the ura Ring are fair,” “Emily” responds.
The ring allows me to keep track of the intricacies of my sleep and heart rates, which allows me to learn more about my energy and stress patterns, and it has proven to be beneficial.
That is your fear: I am not reliant on it. If I were you, I’d prefer to rely on this than on a lot of other things.
It’s just another tool, like a treadmill or a bike.
I’m going to give it the two months ura recommends. Instead of comparing myself to everyone else, as most medicine does, this will establish a baseline for my exercise and sleep goals based on my parameters. Wearable technology is heading in that direction.”
About the author:
John Horgan directs the Center for Science Writings at the Stevens Institute of Technology. His books include The End of Science, The End of War and Mind-Body Problems, available for free at mindbodyproblems.com. For many years, he wrote the immensely popular blog Cross Check for Scientific American.