Innovative Use of Fitbits Predicts Surgical Complications in Children

A pioneering study published in *Science Advances* reveals that consumer wearable devices, specifically Fitbits, can be effectively utilized to predict postoperative complications in children, marking a significant advancement in pediatric health monitoring. Conducted by researchers from Northwestern University, Shirley Ryan AbilityLab, and the University of Alabama at Birmingham, this research demonstrates the potential for these devices to enhance postoperative care and expedite treatment following surgery.

Each year, approximately 4 million children undergo surgical procedures in the United States, with postoperative complications such as infections posing serious health risks. The challenge has traditionally been the timely detection of these complications post-discharge. According to Dr. Arun Jayaraman, Professor of Physical Medicine and Rehabilitation at Northwestern University Feinberg School of Medicine, "Today, consumer wearables are ubiquitous, with many of us relying on them to count our steps, measure our sleep, and more. Our study is the first to take this widely available technology and train the algorithm using new metrics that are more sensitive in detecting complications."

The study involved a cohort of 103 children who were monitored post-appendectomy using commercially available Fitbit devices for 21 days. Researchers trained an algorithm to analyze data not only from standard metrics, such as activity levels and heart rates, but also from novel metrics that consider circadian rhythms of children's activity. This innovative approach resulted in the ability to retrospectively predict postoperative complications with an impressive 91% sensitivity and 74% specificity.

Dr. Fizan Abdullah, a pediatric surgeon at Ann & Robert H. Lurie Children’s Hospital of Chicago and a study collaborator, emphasized the importance of this research, stating, "Historically, we have been reliant upon subjective reporting from children—who often have greater difficulty articulating their symptoms—and their caregivers following hospital discharge. By using widely available wearables, coupled with this novel algorithm, we have an opportunity to change the paradigm of postoperative monitoring and care and improve outcomes for kids in the process."

The researchers are currently engaged in a four-year project funded by the National Institutes of Health (NIH), aiming to transition the retrospective monitoring approach into a real-time system that automatically analyzes data and notifies clinical teams of potential complications. Hassan M.K. Ghomrawi, Vice Chair of Research and Innovation in the Department of Orthopaedic Surgery at the University of Alabama at Birmingham, remarked, "This study reinforces wearables’ potential to complement clinical care for better patient recoveries. Our team is eager to enter the next phase of research exploration."

With this innovative approach, the study not only paves the way for enhanced postoperative care but also highlights the broader implications of integrating consumer technology into clinical practices for pediatric health. As the research progresses, it holds promise for transforming how healthcare providers monitor and respond to the needs of young patients, potentially leading to improved health outcomes and reduced complications in pediatric surgery.