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Accuracy of the Apple Watch in measuring oxygen saturation: comparison with pulse oximetry and ABG

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Abstract

Background

Smartwatches have gained tremendous attention in recent years and have become widely accepted by patients, despite not being intended for medical diagnosis.

Objective

This study aimed to determine the accuracy of Apple Watch oxygen saturation measurement in patients with acute exacerbation of COPD by comparing it with medical-grade pulse oximetry and ABG.

Method

This single-center, prospective, cross-sectional study involved 167 patients. Patients presenting with cardiac arrest, life-threatening symptoms, severe hypoxia, or obvious jaundice were excluded. Additionally, patients whose SpO2 measurements with the Apple Watch took more than 2 min or required eight attempts were also excluded. Vital signs were measured simultaneously using the IntelliVue MX500 monitor with the Masimo Rainbow Set pulse oximeter and the Apple Watch. Concurrently, arterial blood gas (ABG) samples were drawn.

Results

A strong correlation between the Apple Watch 6 and medical-grade pulse oximetry (r = 0.89, ICC = 0.940) was noted. The Bland-Altman analysis revealed a mean error of 0.458% between the Apple Watch 6 and ABG (SD: 2.78, level of agreement: − 5.912 to 4.996). The mean error between pulse oximetry and ABG (SD: 5.086, level of agreement; − 10.983 to 8.953) was 1.015%. There was a correlation between respiratory rate and the number of attempts to measure SpO2 with the Apple Watch 6 (r = 0.75, p < 0.05).

Conclusion

Apple Watch 6 is an accurate and reliable method for measuring SpO2 levels in emergency patients who presented with acute exacerbation of COPD. However, tachypneic patients may encounter challenges due to the potential need for multiple attempts to measure their oxygen saturation.

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Availability of data and materials

The datasets generated during the current study are available from the corresponding author.

Abbreviations

ABG:

Arterial blood gas

AF:

Atrial fibrillation

COPD:

Chronic obstructive pulmonary disease.

CHF:

Congestive heart failure

ED:

Emergency department

SpO2 :

Peripheral oxygen saturation

SaO2 :

Arterial oxygen saturation

SBP:

Systolic blood pressure

DBP:

Diastolic blood pressure

HR:

Heart rate

HT:

Hypertension

PaO2 :

Partial pressure of oxygen in the arterial blood

RR:

Respiratory rate

VBG:

Venous blood gas

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Acknowledgements

Apple Inc. was not involved in the design, implementation, data analysis, or manuscript preparation of the study.

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Authors and Affiliations

  1. Department of Emergency Medicine, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey

    Banu Arslan, Kemal Sener, Ramazan Guven, Mucahit Kapci, Semih Korkut & Mehmet N. Sutasir

  2. Department of Biostatistics, İzmir Katip Celebi University Faculty of Medicine, İzmir, Turkey

    Mustafa A. Tekindal

Authors
  1. Banu Arslan
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  2. Kemal Sener
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  7. Mustafa A. Tekindal
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Contributions

Arslan B. is the research principal. She also wrote the first draft of the manuscript. All authors reviewed and edited the manuscript and approved the final version of the manuscript.

Corresponding author

Correspondence to Banu Arslan.

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Ethics approval

The present research was approved by the Ethics and Research Committee of the Basaksehir Cam and Sakura City Hospital. The registration number is 2021.03.3.

Animal and human rights statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. No animal studies were carried out by the authors for this article.

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Written informed consent was obtained from the patients for their anonymized information to be published in this article.

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The authors declare no competing interests.

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Arslan, B., Sener, K., Guven, R. et al. Accuracy of the Apple Watch in measuring oxygen saturation: comparison with pulse oximetry and ABG. Ir J Med Sci 193, 477–483 (2024). https://doi.org/10.1007/s11845-023-03456-w

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  • DOI: https://doi.org/10.1007/s11845-023-03456-w

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