Wearable Technology in Healthcare: Benefits, Limitations and Clinical Applications

Wearable technologies are increasingly being integrated into clinical trials and healthcare, offering new tools to capture physiological and behavioral endpoints in real-world settings. These devices enable continuous, remote, participant-friendly monitoring while addressing key limitations of traditional trials such as frequent site visits, sparse sampling and limited ecological validity.

A review of 1,021 interventional trials registered between 2001 and 2025 that incorporated wearable-derived data identified five application archetypes: drug effects, dosing optimization, adherence, delivery medium and delivery technique optimization. Adhesive patches, largely driven by continuous glucose monitoring, now dominate trial deployments, with expanding coverage of physiological domains including sleep, cardiovascular function, motor activity and brain signals. Despite this progress, formal regulatory qualification of wearable-derived measures remains rare, with SV95C in Duchenne muscular dystrophy being the only such example to date.

From a cardiologist's perspective, the biggest benefit of wearables is general health awareness, encouraging people to pay attention to activity, sleep and exercise habits. In specific situations, they can be useful for documenting palpitations that are otherwise hard to capture. However, the biggest limitation is added stress, as most data collected is low quality and rarely clinically actionable. Many patients fixate on individual "findings," which creates anxiety, and wearable companies rarely prioritize clinical accuracy.

Patients now routinely bring heart rate trends and alerts for "irregular rhythm" or "possible atrial fibrillation" to appointments. Common worries include changes in resting heart rate or heart rate responses to activity that are often normal physiological responses but feel abnormal due to how the information is framed. ECG tracings from some wearables can be useful and, in limited situations, comparable to clinical ECGs, especially when recorded during symptoms like palpitations. Other wearable data is much less reliable, with many derived measures such as heart rate variability or sleep scores based on proprietary algorithms that are generally not very helpful clinically.

Not all sensors are equal. Some devices include ECG features that allow users to capture single-lead tracings similar to one part of a standard clinical ECG. Other sensors, especially PPG-based heart rate monitors worn below the elbow, are highly inaccurate and rarely validated. Most wearable companies are focused on sales and engagement rather than clinical validation, and smartphone apps often present large amounts of data without clear explanations of how it was derived or what it means.

For medical monitoring, ECG capability is the only feature that consistently adds value. For general health, activity and sleep tracking can be helpful, while most other metrics fall into the realm of pseudoscience. Beyond ECG recordings, wearables may be useful for guiding exercise programs and tracking activity related to weight loss or fitness. Looking ahead, emerging biochemical sensing modalities beyond glucose, as well as transdermal spectroscopy and wearable ultrasound, represent new frontiers for wearable technology in healthcare.