Yintoni iiyure ze-82,000 ze-Apple Watch zibonisa abafundisi malunga ne-fitness kunye ne-health

Umbhali: James Truslow Angela Spillane Huiming Lin Katherine Cyr Adeeti Ullal Edith Arnold Ron Huang Laura Rhodes Jennifer Block Jamie Stark James Kretlow Alexis L. Beatty Andreas Werdich Deepali Bankar Matt Bianchi Ian Shapiro Jaime Villalpando Sharon Ravindran Irida Mance Adam Phillips John Earl Rahul C. Deo Sumbul A. Desai Calum A. MacRae Umbhali: U-James Truslow U-Angela Spillane Ukucinga Lin Katherine Cyr Uluhlu lwe-Ullal U-Arnold Edith U-Ron Huang I-Laura Rhodes I-Jennifer Block UJamie Stark U-James Kretlow U-Alexis L. Beatty U-Andreas Werdich Deepali Bankar U-Matt Bianchi U-Ian Shapiro U-Jaime Villalpando Sharon Ravindran I-Irina Mance UAdam Phillips UJohn Earl U-Rahul C. Deo I-Sumbul A. Desai I-Calum A. MacRae Ukucinga Kwakhona, idatha ye-individual ye-differential responses kwiintlobo ezahlukeneyo ze-activity ayinezantsi ngokubanzi, ixesha okanye izinga le-annotation ukufumana iinkqubo ze-results ezizodwa okanye ukunceda ukunxibelelana kwimeko ezizodwa. I-Apple Heart & Movement Study yenzelwe ukufumana iinkcukacha zonyango ze-physiological ezinxulumene kwi-Apple Watch kunye ne-iPhone ukusuka kwinqanaba elikhulu ye-real-world ezisetyenziswa kwi-USA ukuze zibonise lezi zenzululwazi. Iingxaki ezininzi ze-exercise kunye ne-incident disease rates ezincinane zeengxaki ezininzi ziye zibonwa kwizifundo ezininzi ze-research-grade, kunye ne-consumer-grade, i-wearables. , , Ukusabela kwezilwanyana ezahlukeneyo kwi-exercise zibonakalisa njengama-predictors ezininzi zokusabela kweziphumo ze-clinical kwiingxaki ezininzi kuquka i-diabetes, i-hips fractures, i-cancer kunye ne-rate ye-cognitive decline. , , , . 1 2 3 4 5 6 7 Iingcebiso zonyango zokusetyenziswa kwimveliso zangaphakathi ziyafumaneka, ikakhulu ngenxa yeengxaki ezincinane zeengcebiso zokusetyenziswa ngexesha elide, kunye neengxaki yeengxaki zeengcebiso kunye neengxaki zeengcebiso zeengcebiso ezifanayo. Iziqinisekiso zibonisa ukuba amaxabiso ezininzi abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli . Better understanding of the relationships between specific activities and individual physiologic adaptation requires granular documentation of the attributes of different activities and their effects across a range of individuals with discrete response outcomes , , I-Convergence ye-wearable technologies, i-electronic health records, kunye ne-modern data science yenza izifundo zayo zibonakalayo. 1 8 8 9 10 I-Apple Watch (i-Watch) yintlobo ye-multi-sensor ye-wearable elihlanganisa i-metric ye-physiological ye-passively traced (isib. i-activity, gait, and heart rate metrics) kwaye ibandakanya i-anotation yeengiso kwi-"at the wrist" nge-user-input njenge-logging types of workouts. I-Apple Heart & Movement Study (AH&MS) yenzelwe ukufumana i-longitudinal ye-sensor, i-activity kunye neendatha ze-health evela kumadoda ukufundisa i-relationship phakathi kwe-activity, i-wellness kunye ne-health. I-study ibandakanya ukuxhumanisa iimodeli ze-physiological ezinxulumene nge- I-manuscript elidlulileyo ibonisa i-design yobugcisa kunye needatha ze-base-line evela kumadoda abaphumeleleyo ukuxhaswa. I-studium ifumaneka, kwaye ukwamkela iinkcukacha ibandakanya iinzuzo ezintsha, iingcebiso ezintsha kunye nezinye iinkcukacha. I-app ye-Research, i-application ye-mobile eyenziwe ukusetyenziswa nokufaka kunye ne-studium, ivumela iingcebiso ezininzi kwi-studium (ngokusetyenziswa kwe-IRB) ukunceda ukuxhaswa kwimeko ezintsha, ezifana ne-pandemic okanye iintlobo ezintsha zeedatha. Iidatha ziquka i-time stamped kunye ne-versioned (i-hardware kunye ne Iimvavanyo epheleleyo kunye neendaba zokuxhumana ezijoliswe kwiminyaka engaphansi kwiminyaka yokuqala ziyafumaneka kwi-intanethi. I-cohort e-manuscript esebenza ngexesha le-2021-11-13, iinyanga ezimbini emva kokuchofoza kwimvavanyo, ngoko ngamazwe ngamazwe ngamazwe ngamazwe omncinane ngonyaka epheleleyo, kwaye engaphezulu kweinyanga ezimbini. Emva kokuchofoza zonke iingcebiso ze-selection, i-cohort yokuqala iye iye iye iye iye yi-82,809 abasebenzisi. Iimpawu ezininzi zabasetyenziswa kwi-Table I-Table ye-Extra I-study cohort i-72% White, i-74% male at birth, i-74% self-identified as male with an average age at enrollment is 39.3 years (± 13.1 years). I-80% of participants are part-time or full-time employed, i-62% college-graduate, i-52% married. Abasetyhini asebenza 5.3% of the cohort. I-Body Mass Index (BMI) yi-28.4 kg/m2 (±6.5 kg/m2). Iingxaki ezininzi ezininzi ezidlulileyo ezaziwa kwabasetyhini ziyi-allergy (26.0%), i-depression (26.0%), kunye ne-anxiety disorders (24.1%) kodwa phantse ubudala weengcali zophando, ezinye iimeko zonyango zithunyelwa ngexabiso I-61% yabasetyhini isetyenziswa ngexesha lokufumana iiyobisi eyodwa (i-Table Supplementary) inguqulelo 1 6 2 7 Ukubonisa ububanzi iinkcukacha ze-HealthKit ezahlulwe kwi-cohort ngexesha elinani elinye, sinikezela imiphumo kwi-period ye-7 yodongano yokubhalisa iincwadi ze-weekly kwi-activity ye-participant (I-Table) Uhlobo lokusetyenziswa okuphumelela kakhulu yaba yokuhamba, leyo lihlanganiswa ngexesha elinye ngexesha nge-20.0% ye-cohort. I-25.304 (30.6%) abantu kwi-cohort lihlanganiswa ngexabiso elinye ngexabiso ngexesha le-observation, ngexabiso, phakathi kwabo, i-6.54 workouts ngalinye. 3 I-Workouts yinto eyodwa ye-tracking ye-exercise, kwi-class yobugcisa ye-HealthKit, ezininzi iintlobo ezininzi ezikhoyo (i-Table Supplementary) ). Kwiimeko ezininzi, iintlobo ze-sampling ezahlukileyo zihlanganisa ziquka iintlobo ze-Apple Watch zokusetyenziswa ngosuku zonke kunye ne-sensors kunye ne-software eyenziwe kwi-Watch. Ngokwenza oku, i-step count, i-heart rate kunye ne-stand hours zihlanganiswa kunye ne-studium ngexesha elifanelekileyo ebonakalayo kwiminyaka emininzi ye-cohort. Iintlobo ze-sampling ezahlukileyo ezahlukileyo zihlanganiswa zihlanganisa: i-session ye-Mindfulness (i-5.5% yahlukileyo ngexesha elifanelekileyo), ebonakalise i-sense mindful that is guided by Watch but requires active participant engagement; kunye ne-high 8 I-cohort iquka i-66,752 abantu (i-80.6%) abo, ngexesha elinye ngexesha elidlulileyo kwiminyaka yayo yokuqala emva kokufikelela, i-Apple Watch efanelekileyo yokubonisa i-ECG efanelekileyo kunye ne-Research app. I-ECG ye-single-lead ingaba ifumaneka ngexesha elinye nge-app ye-ECG ngexesha elide i-30 imizuzu. Kwi-subset yayo, kukho i-55,740 abantu (i-83,5% yaye abaninzi be-ECG efanelekileyo i-Watch) abalandeli kunye ne-ECG kwiminyaka yayo yokufikelela kwiminyaka yokufikelela kwiminyaka yokufikelela, ngexabiso ze-1,132,473 ye-ECGs ( ). 25,402 ECGs (2.2%) ziye ziye ziye zibonise fibrillation atrial, zihlanganisa 1641 abalandeli (2.0% of the cohort (bheka Table Supplementary) Of these participants, 477 (29.1%) wabhalisela ukuba babonakala ukuba babe fibrillation atrial, oku kubonisa ukuba iziphumo zikhuthaza iziphumo ezithile. 4 9 I-Apple Health ifumaneka kubasebenzisi ukulayisha iinkcukacha zonyango zonyango evela kumaziko ezihlangeneyo ngokuchofoza kwi-portal ye-healthcare provider yaye ukhethe ukunikela idatha ze-Fast Healthcare Interoperability Resources (FHIR) kunye ne-HealthKit. Kwixesha lokugqibela, i-proportion of participants who have been able to share these data types is modest (~10%) as a consequence of local FHIR compliance and the process required. Ukucacisa ukuxhaswa kweengcali kwi-studio ngexesha elide, sinikezela iindices ezimbini ezincinci ezongezelela iinkcukacha ezininzi zeengcali kunye ne-HealthKit ye-sharing online. Lezi zihlanganisa: 1) i-Apple Watch yeyure yabasetyhini yabasetyhini ye-HealthKit "Stand Hour" kunye ne-Research app; 2) i-App ye-Research yabasetyhini yabasetyhini yabasetyhini ze-Apple ye-study se-safe. Ukubonisa iindidi ezimbini zeengxowa kwi-scales ze-time. I-Panel a ibonisa i-fraction ye-cohort ebonakalayo kwi-post-enrollment yeentsuku eyodwa (00:00:00 ukuya kwi-23:59:59 UTC). I-Panel b ibonisa i-fraction ebonakalayo iintsuku elifanelekileyo emva kokufaka kwaye ingathengiswa njenge umlinganiselo lokuphuma kwe-cohort ngexesha elide, ngexabiso umlinganiselo we-fraction eyenza ngexesha elide, ngokuvumelana ne-indice yokufaka. Ngoko ke, kumabini iindices ezininzi, ukunciphisa kokufumana kwimihla ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ng 1 Yonke ixesha emva Iingxaki ze-blue zibonisa i-proportion of participants who have not contributed a Stand Hour sample, ebizwa nge-Watch. Iingxaki ze-red zibonisa i-proportion of participants who have not uploaded any data at all from their Research app. Iingxaki ze-blue zibonisa i-proportion of participants who have not uploaded any data at all from their Research app. Panel ( ) ibonisa inqaku ye-cohort eyenza kwiintlobo ezimbini ezidlulileyo kwiintsuku ezidlulileyo, emva-enrollment. Panel ( ) ibonisa inqaku leyo elidlulileyo ngexesha elinye emva kwexesha elidlulileyo, emva kokufikelela, njengomdla we-incidence ye-cumulative of dropout from the study. a b I-AH&MS ibandakanya i-series ye-16 zophando ezidlulileyo ezidlulileyo kubathengi kunye ne-Table. Ngaphandle kwezifundo ze-5 ezidlulileyo ezidlulileyo ezidlulileyo ezidlulileyo ezidlulileyo kwi-Watch, phantse zonke iifundo zihlanganisa i-participation rate engaphezulu kwe70%. Ukubonisa izinga lokuphendula vs. ixesha ukususela kokufikelela kwizifundo ezimbini ezidlulileyo - isifundo sesibiniweyo ye-Stress Scale kunye nesifundo sesibiniweyo ye-Changes in Health. Ukukhutshwa kwe-trend yokuphendula kwinqanaba lokuphendula ngexesha kunokufikelela ngokufanelekileyo kwi-Fig. Ngokutsho kokuphumelela kwizifundo kubandakanyeka kubafundi, le phantsi kwe-69.55% kunye nokukhula ngokushesha kwi-32.48% emva kwenyaka. Ngokutsho kokuphumelela kokufunda kwizifundo kubafundi kubafundi, le phantsi kwenyaka kwiminyaka eyodwa kubafundi kubafundi kubafundi kubafundi kubafundi kubafundi kubafundi kubafundi kubafundi kubafundi. I-Panel b, leyo ibonisa ukuba kuphela i-28% ye-cohort ibonakalisa ngempumelelo ngexesha elifanayo ngexesha elifanayo. I-Trend ye-response rate ebonakalayo ngexesha elandelayo ibonakalisa kwi-Changes in Health survey. 5 2 2 1 Ukucinga Ukusetyenziswa kwe-Stress Scale, i-percentage ifumaneka phakathi kwe-sub-cohort ye-42,181 abantu njengoko kuphela abantu abalandeli emva kwe-2020-05-01 kubonakala ukunceda kwimibelelwano ye-frequency yokusetyenziswa kwimibelelwano. Ukusetyenziswa kwimibelelwano ye-Changes in Health, yonke i-82,809 abalandeli kubandakanya. I-AH&MS inama-scale efana neengxaki ezininzi zeendaba zeendaba ze-wearable kwaye iye iye iye iye zibonise iimpumelelo ezininzi zeengxaki ezidlulileyo ze-activity kunye ne-adaptation ye-physiological. . I-combination ye-sensors ezininzi ezinxulumeneyo, i-anotation ye-physiological ye-anotation ye-granular 'at the wrist', kunye ne-access kwi-health conditions and health outcomes ngaphakathi kwe-ecosystem ye-Apple ibonelela kwi-dimensionality ephakamileyo kwi-cohorte elikhulu ngaphandle kwizicelo zonyango ezininzi. I-AH&MS ibonelela uphando se-longitudinal ye-spectrum ye-validated physical performance attributes kunye ne-metadata ye-contextual dense kunye ne-extensive outcome metrics. Ukuphumelela okuqhubekayo kwinxalenye yabasetyhini lithunywe kakhulu ukusuka kwizifundo ezidlulileyo ze-health questionnaires. Kukho iimpawu , , ukufikelela umxholo we-high-resolution ye-anotation, kunye nokufumana ukufikelela kwiphepha le-health kunye ne-claims data. 1 11 12 Zibonisa ukuba i-AH&MS isifundo lwezifundo iya kuxhomekeke ngqo kwimfuneko yokufuneka iinkcukacha phakathi kwezifundo ze-longitudinal ze-real wearable kunye nezifundo ze-cross-sectional ze-clinical okanye ze-biological research zihlanganisa kwizifundo ze-biomedical. Zininzi izifundo ze-epidemiological ezidlulileyo ziyafumaneka iinkcukacha ze-objective kwiimfuneko ze-living core, ngelixa iinkcukacha zokusetyenziswa zokusetyenziswa kwizizathu ezizodwa ze-mortality kunye ne-morbidity. AH&MS ibonise kunye nokuqinisekisa iziphumo ezininzi ze-behavioral kunye ne-activity data, kunye ne-demographic, i I-AH&MS yenzelwe ukuvavanya ngokuthe ngqo kunye nezifundo ze-epidemiological ezivamile kunye nezifundo zonyango ze-randomized ngokusebenzisa iinkcukacha ezininzi ezahlukileyo ezahlukileyo ezahlukileyo. Ukwazi ukuxhaswa kubandakanyeka kubandakanyeka kubandakanyeka ngalinye kubandakanyeka kubandakanyeka ngqongqo kwi-sampling ye-structured. I-trends ye-longitudinal kwi-physiological metric complex ingaba kubandakanyeka kunye neengxaki ze-interpolated ze-external, ezidlulileyo ziye zithathwe kwi-cross-sectional mode kwiipopulations ezininzi ezahlukileyo. Iimodeli ezidlulileyo kwi-sub-cohorts eyenziwe ng Ukusebenza kwe-Apple Watch ye-anotation yeengxaki kunye ne-reel-time ye-anotation ye-activity kunye ne-registration ye-passive eyongezelelweyo ibonelela kwi-AH&MS. Le app ye-Research ibonelela ngokukhawuleza ukuguqulwa ngokukhawuleza kwaye ibonelela kwimibuzo ze-Research ezintsha okanye ze-secondary, njenge-response ye-SARS Co-V-2 pandemic. I-AH&MS ikwazi ukufikelela kwakhona iinkcukacha zokusetyenziswa kwiinkcukacha zonyango zeengcali zeengcali kunye neenkcukacha ze-"Blue Button" zokusetyenziswa kwiinkcukacha nge-FHIR application programming interfaces (APIs), kwaye zombini iintlobo zeedatha zihlanganisa emva kweengcaciso zokuqala ngenxa yokusetyenziswa kwezempilo ezincinane ngexesha le-COVID. Njengoko inqubo yokusetyenziswa kweedatha ze-EHR kwi-AH&MS lula, sinxibelelana nangokufunda iinkcukacha zokusetyenziswa ngexesha elifanelekileyo zeengcaciso ze-study. Le datasets iyafumanisa ukuhlanganiswa kwe-long-term wearable trajectories kunye Uhlalutyo lweMechanism ye-growth campaign yinto ezininzi iingcebiso ezidlulileyo. I-studi zihlanganisa kubasebenzisi be-Apple iPhone kunye ne-Apple Watch, kwaye kukho iingcebiso malunga ne-generalizability kwamanye amazwe. I-study design ye-Naturalistic, kunye ne-sampling kunye ne-anticipation, ingasetyenzisa iingcebiso ze-confusion ezincinane njengoko ukongeza okuqhubekayo iingcebiso ezintsha okanye i-sensors ezintsha. Iingcebiso ze-follow-up ezilinganiselwe ukusuka kwinqanaba le-inspect ngenyanga zihlanganisa ngaphezulu kunezinye iingcebiso zophando, nangona iimpawu ze-inspect kunye Ukuphendula iingxaki ze-physiological kwiingxaki ze-external inikeza ulwazi kwinqanaba ye-system on the physiological set points of the individual and has been shown to lead to a much more rigorous discrimination of intrinsic differences between individuals than passive cross-sectional measurement. Lezi zincwadi zibonisa i-potential to enokufumana iingxelo ezininzi eziqhelekileyo malunga neengxaki zeengxaki zeengxaki zeengxaki zeengxaki zeengxaki zeengxaki zeengxaki zeengxaki zeengxaki zeengxaki zeengxaki zeengxaki zeengxaki zeengxaki zeengxaki zeengxaki zeengxaki zeengxaki zeengxaki zeengxaki zeengxaki zeengx Ukucinga Ukucinga design Yinto i-mobile app-based longitudinal cohort study ebandakanya ukusika iinkcukacha ze-sensor, i-survey, kunye ne-health data. Abasetyenziswa kwi-study nge-IRB-approved materials, kuquka iisayithi ze-study ezisetyenziselwa i-Apple, i-American Heart Association (AHA) kunye neBrigham and Women's Hospital. Abasetyenziswa ukwamkela i-series ye-survey kunye nokuxhomekeka ukutshintshiselela idatha ebandakanya kwi-App ye-Health (e-HealthKit framework) kunye ne-sensor data ebandakanya ngqo kwi-iPhone kunye ne-Apple Watch (i-Apple Watch Supplementary Table). ). I-Research app framework ivumela abalandeli ukuba abalandeli ukuba bafumane iintlobo ezithile zeendaba zempilo kunye nophando. I-Study yasungula ukufikelela ngoNovemba 14, 2019 kunye nenkceda ukufikelela kwama-500,000 abalandeli. Ixesha elidlulileyo le-studi ye-5 ngonyaka, ngexesha ngoNovemba 2024, kunye ne-potency ye-extension okanye i-follow-up eyongezelelweyo ngexesha elide. I-Study ilawulwe yi-Advarra Central Institutional Review Board (PRO00036784) kwaye ilawulwe kwi-ClinicalTrials.gov (Identifier ye-ClinicalTrials.gov: NCT04198194). Akukho i-compensation for participation. 1 Iingxaki ze-survey ziye ziye zibonakalisa iinkcukacha ezivela kwizifundo ze-United States ze-health, njenge-National Health and Nutrition Examination Survey (NHANES) ezisetyenziselwa i-Centers for Disease Control and Prevention. i-All of Us Study, inkqubo esikhulu sokucwaninga esekelwe yi-National Institutes of Health Iingxaki ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye ziye zibe. I-Apple Hearing Study . 13 14 11 12 I-User Interface ye-Research app yenzelwe ukuba yinto elula kunye ne-intuitive nangokukwazi ukufumana idatha, ngeengxaki ezifana nokugqibela kwizifundo, ukuba zithunyelwe ngexesha elide, ukuze ukunciphise ubunzima weengcali. Ixesha elidlulileyo yokusabela kwizifundo lithunyelwe malunga ne-30 min ngenyanga yokuqala, kunye ne-10 min ngenyanga ngexesha lokusebenzisana okuqhubekayo njengoko izifundo ezongezelelweyo ezisekelwe kwizifundo okanye kuxhomekeka kweedatha ezongezelelweyo (isib. iinkcukacha ze-COVID). Ukusetyenziswa kwe-HIPAA (I-Health Insurance Portability and Accountability Act) Ukusetyenziswa kwinkqubo yokusetyenziswa kwimfuneko yokusetyenziswa kwe-HIPAA (I-Health Insurance Portability and Accountability Act). Ukusetyenziswa kwe-Privacy ye-Participant kunye ne-Confidentiality ye-Health Data kunye nokunciphisa ingozi yokusetyenziswa kwe-Data ye-Participant, i-workflow yokusetyenziswa kwe-Data ye-Data ye-Data ye-Data ye-Data ye-Data ye-Data ye-Data ye-Data ye-Data ye-Data ye-Data ye-Data ye-Data ye-Data ye-Data ye-D Ukufumaneka, Ukuhlolwa, kunye nokuxhomekeka Similar to the Apple Women’s Health Study and Apple Hearing Study , Iingxelo zokusetyenziswa zihlanganisa ukufikelela kwi-iPhone kunye ne-Research app eyakhiwe, ukuxhaswa kwe-English ebhalisiweyo kunye ne-English ebhalisiweyo, ukufikelela kwi-United States, ubudala obungaphezulu kwe-18 (ubungaphezulu kwe-19 e-Alabama kunye ne-Nebraska, ubudala obungaphezulu kwe-21 e-Puerto Rico), ukusetyenziswa kwe-iCloud okanye i-iPhone, kunye nokukwazi ukunikezela ukuxhaswa kwe-studium. Inani elongezelelweyo ye-AH&MS ibandakanya ukusetyenziswa kwe-Apple Watch (i-Series 1 okanye engaphezulu) ebandakanya ne-iPhone ngexesha lokubhalisa. 11 12 Kwixesha lokubhalisa, abalandeli kubandakanya iprofayili ebandakanya iinkcukacha ezifana nama, idatha lokuzalwa, i-imeyile, inombolo yefoni, indawo yayo yayo kunye nenkundla yayo. Le data isetyenziselwa ukuguqulwa iimfuneko. Kwi-AH & MS, i-Research app iyakwazi ukuguqulwa ukuba i-Apple Watch ibandakanya ne-iPhone. Ukuba iimfuneko ze-age, i-location, kunye ne-Watch-pairing-status zithathwe, abantu bangathola ukufundisa, kubandakanya ukufundisa ne-ICF, i-HIPAA Authorization, kunye ne-California Bill of Rights (kuya kuxhomekeke). Ukusuka kwizifundo, kukho imibuzo yokuguqulwa Emva kokufaka, abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli. Ukulungiselela ngexesha Ukusetyenziswa kwe-Institutional Review Board (IRB), i-website yobugcisa esekelwe kwi-Brigham and Women's Hospital/Harvard Medical School yasungulwa ngokubanzi. I-American Heart Association (AHA) kwakhona yasungula i-website yobugcisa ukunyusa ukubaluleka kwizifundo (Novemba 2019), kuquka i-IRB-approved social media kunye ne-email campaigns (Oktobha 2020). I-AHA kwakhona yasungula i-website kwi-heart.org ukwandisa ukubaluleka kwizifundo kunye nokwandisa iimpumelelo zophando. Ukongezelela, i-Research app entsha yasungulwa ngo-Oktobha 2020 ukuze kufumanise iimveliso ngokuthe ngqo kumadoda kwi-app yokukhutha Data Survey – ngexesha lokubhalisa kunye ngonyaka emva Xa uqhagamshelane, abalandeli be-AH&MS abalandeli kwi-Research Profile Survey ngaphakathi kwe-Research app kunye ne-Demographics Survey. Iinkcukacha zihlanganisa i-year of birth, i-state of residence, i-race and ethnicity, i-marital status, i-employment status, i-level of education, i-gender identity, i-sex assigned at birth, kunye ne-subjective social status. Kwiintsuku yokuqala emva kokufikelela, abalandeli abalandeli abalandeli zilandelayo: i-Risk of Falling survey (ngokusekelwe kwifundo lwe-Steadi, iiyure ze-12) , a Medical History survey, a Medications survey, and a Health Behaviors survey (based on the Alcohol Use Disorders Identification Test (AUDIT-C) and All of Us Study, NIH) I-Activity Status Survey, isibuyekezo esixhasiweyo esixhasiweyo, ilawulwa ekupheleni kweenyanga ezimbini. Izibuyekezo zonyaka zithunyelwe ngexesha elifanelekileyo ukunciphisa isibuyekezo yabasetyhini, kwaye kubandakanya ukuba kunzima malunga neenyanga ze-5 ngamnye ngamnye. Yonke isibuyekezo ivuliwe malunga iintsuku ze-28, ngaphandle kweSibuyekezo seDemographics, elizwi. 15 16 14 Iingxelo ze-interim kunye ne-timing Iingxaki ziye zithunyelwe kwizifundo ze-quarterly, ngokukodwa, i-Mental Health Survey (PHQ-2, GAD-2) , isibuyekezo se-Activity Status (I-Modified Rosow-Breslau) Ukuhlolwa kwe-Perceived Stress Scale (PSS-4) Ukubuyekezwa kwe-Disability Assessment Survey (i-WHODAS 2.0) , and reported outcomes related to changes in health in the Changes in Health survey. These surveys are also staggered across months two, three, and four, with an estimation of 10 min for survey completion each month. 17 18 19 20 Iingxelo ze-Trigger kunye ne-Timing I-Design ye-studium ibandakanya izifundo zithunyelwa kubafundi kuphela xa ziyafumaneka iingcali ezithile ezivela ngexesha lokufundiswa kwisifundo. Kukho izifundo ze-3 ezivela ekuqaleni kwe-studium ezinxulumene needatha ze-sensor ezivela kwi-Apple Watch, kunye ne-approximately 5 min ezidlulileyo ekugqibeleni yonke isifundo. I-Irregular Rhythm Follow-up Survey isetyenziselwa iinyanga ezili-3 emva kokufumana i-irregular heart rhythm notification ngelixa i-Watch i-versions ezihambelana ne-functionality, leyo i-Watch inokufumana ngempumelelo. I-Irregular Rhythm Follow-up Survey yenzelwe ukufumana into eyenziwa kwi-notification kunye nokufumaneka kwi-administration eyodwa ngexesha le-90 ngosuku xa i-trigger criterion iyatholakala. I-second triggered survey, ebizwa ngokuba yi-ECG Follow-up, isetyenziselwa 3 iinyanga emva kokufumana umphumela we-fibrillation atrial ngexesha lokusetyenziswa kwe-Apple Watch ECG feature. Iingxaki zihlanganisa nayiphi na iimveliso ezisetyenziswa kunye neengxaki zithunyelwe emva kokufumana umphumela. Oku yenzelwe ukuba isetyenziswe kuphela ngexesha elinye ngexesha ngexesha le-ECG enomdla umphumela we-fibrillation atrial. I-Potential Fall Survey, eyenziwa xa i-Apple Watch ibonise i-motion signatures ezibonisa ukuba umdlali umlilo, njenge-high-fall. Le-questionary iboniswe ngosuku emva kokufumana umdlali, i-Research app iye yenzelwe ukuqinisekisa ukuba umdlali yaba umdlali, ukubonisa imisebenzi umdlali ngexesha le-high-probability, kwaye ibonise ukuba kukho umdlali abavela. Ukunciphisa umdlali we-high-probability umdlali, le nophando ibonise inani lomdlali we-Potential Fall kwi-4 ngexesha, ngexesha lokuthumela kwi-1 ngenyanga ngexesha le-high-probability. Ukuzibandakanya kwezifundo ezisetyenziswa kwabasetyenziswa kwabasetyhini Ukusetyenziswa kwinkqubo yokusebenza ukufumana ulwazi oluthe ngexabiso kwabasetyhini abaqhelekanga ukufumana malunga neengxaki, njenge-potencial fall, ezihambelana neengxaki eziqhelekileyo ze-protocol. Ukusetyenziswa kweengxaki, abasebenzi beBWH usebenzisa isicelo ye-mobile kunye neengxaki yokusebenza ukufumana ulwazi lomsebenzisi kuquka i-imeyili, i-telephone, kunye ne-imeyili eyenza kwi-Apple. Ukusetyenziswa kwe-IRB- i-approved script, imibuzo yeengxaki ezininzi malunga neengxaki zihlanganisa kwi-structure eyenziwe, leyo ilawulwa ngenxa yokunyaniseka kunye nokukhutshwa kwadatha Ukucaciswa kwe-sensor kunye ne-usage data Iingxaki zihlanganisa ukusetyenziswa kwinxalenye yeendaba (ukubuyiselwa umdlali) ye-metric derived etholakalayo kwi-iPhone sensors kunye ne-Apple Watch. Le data kubandakanya iinkcukacha ze-ECG, i-heart rate via the optical sensor (PPG), ukuphakama (ugcisa ye-barometric), umzimba (i-accelerometer, i-gyroscope), isantya kunye ne-distance (eyenziwe nge-GPS) kunye nezinye iinkcukacha ze-sensor ezifana ne- "i-state-on-wrist", iinkcukacha ze-pedometer, kunye ne-statistics ze-fall zihlanganisa kwi-Table Supplementary Emva kokufikelela, abahlali angakwazi ukufikelela okanye ukunceda ukusuka kubahlala iintlobo ezithile zeedatha kunye ne-Study ngokusebenzisa izixhobo ezinikezwayo kwi-Research app. 2 HealthKit data Ukusetyenziswa kwinkqubo ye-HealthKit ukufumana iintlobo zeendaba ezihambelana kunye neendaba ezihambelanayo, i-HealthKit ibonelela iinkcukacha zempilo kunye ne-fitness kwi-iPhone kunye ne-Apple Watch. Ngokusetyenziswa oku, izicelo ezithile zithatha kunye nokufunda idatha ngokusebenzisa i-HealthKit, leyo ingatholakala ukufikelela kunye nokufaka kwi-Research app ngelixa ukugcina ubumfihlo kunye ne-control yeengcali. I-HealthKit ibonelela iinkcukacha ezihambelana kwizilwanyana ezininzi kwaye ibonelela iintlobo zeedatha ezifana ne-heart rate, i-work out data, i-sleep analysis, kunye ne-clinical health records (i-lab tests, Ukusebenzisana Le nophando yenzelwe ukuvumelela kwiindlela ezilandelayo ezihambelana: (1) ukusabela iingxaki zeengxaki kwi-Research app; (2) ukuhambisa iinkcukacha ze-HealthKit; (3) ukuhambisa iinkcukacha ze-sensor kunye ne-usage, eziquka iinkcukacha ze-sensor-based ze-SensorKit (SK); kunye (4) ukuhambisa ukuhambisa ngqo kwabasebenzi ze-studi ifumaneka iingxaki ze-IRB ezizodwa. Ngokuvamile, umdlali ibizwa ukuba usebenzise ngokugqithisileyo xa usebenzise iinkcukacha ngeendlela ezininzi. Ukucaciswa kwe-demographic variables Ukusetyenziswa kwifayile elifanayo esetyenziswa ukuhlaziywa kwe-race kunye ne-ethnicity kwi-NIH-sponsored All of Us Study kwaye sinyathwe imibuzo kwi-reporting ye-race kunye ne-ethnicity. Zonke iiyure ze-Research app izifundo zisebenzisa i-MacArthur Scale of Subjective Social Status I-MacArthur Scale ifumaneka ne-Objective socioeconomic status (SES), kodwa inezinto ezininzi yokusetyenziswa njenge-markers ye-status ye-social kunokuba iintlobo ezininzi ze-SES kwizigidi ezininzi ze-non-White. Thina i-catalogue ngokucacileyo iingxaki ezilandelayo: 1 ukuya ku-4 kuxhomekeke ku-low, 5 ukuya ku-6 kuxhomekeke ku-middle, kunye ne-7 ukuya ku-10 kuxhomekeke ku-high. 21 Ukuhlolwa kwe-Statistical Planned Statistical analyses are planned for the following 3 categories of study: (1) longitudinal analyses of survey data, (2) longitudinal analyses of passively collected iPhone and Apple Watch data, and (3) analyses of associations between the survey data and passively collected data including clinical health record data. In each category, we will perform exploratory descriptive analyses and formulate more specific hypothesis-driven models. Kuba zonke iintlobo ze-3 zokusetyenziswa, siza kusetyenzisa iinkqubo ze-regression, ezifana ne-linear kunye ne-generalized linear mixed models, i-statistical learning techniques for high-dimensional data, kunye ne-functional data analysis methods. I-longitudinal analysis of the survey data, siza kusetyenzisa i-associations phakathi kwezobungcali kunye ne-risk factors kunye ne-functional outcomes ezizodwa, kunye neendlela ezininzi ezininzi ezininzi kwi-age range of the study population. Ukuze i-longitudinal analysis of passive data, siza kusetyenzise i-analytics ye-individual-level ukucacisa iindawo ezinokufumaneka kwimifanekiso ngexesha elandelayo kunye neendlela ezijongene Abalandeli abalandeli kodwa abalandeli ukubhalisela i-Demographics ziyafumaneka kwi-cohort ezijoliswe kule nqaku. I-Test ye-Welch ye-double sample, ye-t-test ye-double-sided yenzelwe ukuguquka ubomi obungapheliyo lokubhalisa phakathi kwabasetyenziswa kwabasetyenziswa kwabasetyenziswa kwabasetyenziswa kwabasetyenziswa kwabasetyenziswa kwabasetyenziswa kwabasetyenziswa kwabasetyenziswa kwabasetyenziswa kwabasetyenziswa kwabasetyenziswa kwabasetyenziswa kwabasetyenziswa kwabasetyenziswa kwabasetyenziswa kwabasetyenziswa kwabasetyenziswa kwabasetyenziswa kwabasetyenziswa kwabasetyenziswa kwabasetyenziswa kwabasetyenz Ukucinga Izici zeBaseline zeNcedisi Ukubonisa iimpawu, ezilinganiselwe ngexesha lokugqibela ukufikelela, kwi-cohort yabasetyenziswa kwiminyaka yokuqala ye-studium, i-2019-11-14 ukuya kwi-2020-11-13. I-cohort kwi-manuscript yamanje iye ilawulwa ngexesha le-2021-11-13, iinyanga ezimbini emva kwexesha lokuqala le-studium, ukuze ngamnye abasetyenziswa ilawulwa ngexesha elinye ngexesha elifanelekileyo, kwaye ngexesha elide le-2 ngexesha. Izixhobo ezilandelayo ziquka: (1) iinkcukacha ezisetyenziswa ukulayishwa kwe-Research for quality assurance purposes ( = 29); 2) iimeko apho ukufikelela kwangaphambili kwangaphambili emva kokufikelela (isib. umdla umdla wehlabathi okanye i-address emva kokufikelela kubandakanya ubudala engaphansi kweeminyaka yendawo yokufikelela ( = 100); okanye, (3) umdlali wahlala i-Demographic Survey emva kokufikelela ( = 1751). Emva kokusetyenziswa zonke iingcebiso zololiweyo, i-cohort yokuqala ngexesha le-2020-11-13 ifumaneka kwi-82,809 abalandeli. n n n Kuba iimpawu ezaziwayo kwi-Table , i-value ebonakalayo kumazwe ngamazwe ngamazwe yi-value ebonakalayo ebonakalayo kumazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe ngamazwe 1 Ukubala le 82,809 abantu kwi-1751 abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli Ukucinga iimveliso Ngokusekelwe ubomi kunye ne-state ye-residence yabasetyenziswa (ezinombolo zithunyelwe kwi-Research app ngaphambi kokufikelela, ngaphandle kokufikelela kwi-Demographics Survey). I-1751 abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli abalandeli). 3 4 5 I-study cohort i-72% White, i-74% i-male at birth, i-74% i-self-identified as male (Tabela Ukulungiselela ubudala ubuncinane ngexesha lokubhalisa i-39.3 (± 13.1 iminyaka). I-11% ye-cohort i-Hispanic; iinkcukacha zokusetyenziswa kwe-racial of this Hispanic population ziyafumaneka kwi-Table Supplementary . I-80% yabasetyhini zithunyelwe ngempumelelo okanye ngempumelelo, i-62% yabasetyhini, i-52% yabasetyhini. Abasetyhini zangaphambili zihlanganisa i-5.3% ye-cohort. I-BMI ye-28.4 kg/m2 (±6.5 kg/m2). 1 6 I-2684 abalandeli (i-3,24% ye-cohort) baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye baye bay . 1 Iingxaki ezidlulileyo ezidlulileyo ezaziwa kwizigulane ze-allergy (26.0%), i-depression (26.0%), kunye ne-anxiety disorders (24.1%) ), kodwa phantse ubudala obungapheliyo yabasetyenziswa kwizifundo, babonisa izimo ezininzi zonyango ngamaxabiso ezininzi. 2 Phakathi bonke abalandeli kwi-cohort, i-61% ibonisa ukuba isetyenzise okungenani i-medication (i-Table Supplementary) ). The most commonly reported medications were NSAIDs (27%), antidepressants (20%), and either ACEIs or ARBs (11%). 7 Ukudibanisa iinkcukacha zempilo kwiveki eyodwa Ukubonisa iintlobo zeendaba ze-HealthKit ezahlulwe kwi-cohort ngexesha elifanayo, sinxulumene iziphumo ngexesha leentsuku seentsuku ze-7 ukuze ubuncinane iintsuku ze-activity ye-participant (iinkcukacha ezibonakalayo). Sifunyenwa ngeveki lokugqibela kwinkqubo yethu ye-observation (2021-11-07 ukuya kwi-2021-11-13) ikakhulukazi ngenxa yokuba bonke abahlulwe ngexesha elinye ngexesha elinye ngexesha elinye, kwaye ukususela kwiinyanga ezimbini emva kokufumana i-studium, le ngxesha elidlulileyo kwiminyaka ye-5 ye-studium. Ukubala le ngeveki kwi-145 iiveki ezininzi phakathi kwe-2019-11-14 kunye ne-20 iimveliso inguqulelo 2A 2B Umbala Ukubonisa i-82 iintlobo zeentlobo zeentlobo zeentlobo ezihlangeneyo ezihlangeneyo kwi-HealthKit kwaye zithunyelwe kwi-Research app ngexabiso ze-100 abasebenzi. Kwiintlobo zeentlobo zeentlobo, le ithebhu ibonisa inani leentlobo abalandeli abalandeli ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngexabiso ngex 3 Iintlobo zokusebenza ziquka i-tracking ye-exercise, kwi-class epheleleyo ye-HealthKit samples, ezininzi iintlobo ezininzi ziquka kwi-Supplementary Table , leyo ibonise idatha ye-HealthKit ukusuka kwiveki le-2021-11-07 kunye ne-100 okanye ngaphezulu abalandeli abalandeli ngalinye iintlobo zeendatha. Le sample ilawulwa kwiminyaka ye-1 abalandeli abalandeli ngexesha elifanelekileyo kwiveki elifanelekileyo kwi-2 yonyaka. Phakathi kwezi, iintlobo ze-sampling ezidibanisa kakhulu ziye ziye ziye ziye zithunyelwa yi-Watch-wear yaye ziye zithunyelwa ngempumelelo yi-Software kunye ne-sensors eyenziwa kwi-Watch. Ngoko ke, i-step count, i-heart rate kunye ne-stand hours ziye zithunyelwa ngexesha elifanelekileyo ezidlulileyo yi-Supplementary Table Iintlobo ze-sampling ezininzi ezahlukileyo zihlanganisa: i-Mindfulness sessions (i-5.5% yahlukileyo ngeveki elifanelekileyo), ezikhokelela i-Mindfulness session eyenziwe ngokuvamile nge-Watch kodwa kuxhomekeke ukuxhaswa kwabasetyhini; kunye ne-high heart rate event (i-2.4% yahlukileyo ngeveki elifanelekileyo), eyenziwe ngempumelelo kwi-Watch kodwa eyenziwe ngempumelelo kwabasetyhini ezinxulumeneyo. Amanye iinkcukacha ezisetyenziswa ngabasetyhini ze-third-party, njl. i-glucose emzimbeni (i-1.1% yahlukileyo ngeveki elifanelekileyo), zihlanganiswa ngempumelelo. 8 8 Ukubala, i-workouts ebonakalayo yabasetyenziswa, xa i-initiated yi-participant okanye i-confirmed ukusuka kwi-auto-detected workout. Le nkqubo, kunye ne-fakto ukuba i-workouts ebonakalayo ayinxalenye kwiinkalo zokusebenza zokusetyenziswa ngosuku, kubalulekile ukuba i-dataset yethu ibandakanya iimveliso ezininzi kunokuba, isibonelo, iimveliso ze-heart rate okanye iimveliso ze-step count. I-ECGs I-cohort iquka i-66,752 abantu (i-80.6%) abo, ngexesha elinye ngexesha elidlulileyo kwiminyaka yayo yokuqala emva kokufikelela, i-Apple Watch efanelekileyo yokubonisa i-ECG efanelekileyo kunye ne-Research app. I-ECG ye-single-lead ingaba ifumaneka ngexesha elinye nge-app ye-ECG ngexesha elide i-30 s. Kwi-subset yayo, i-55,740 abantu (i-83,5% yaye abalandeli i-ECG efanelekileyo i-Watch) abalandeli kunye ne-ECG kwiinyanga lokuqala emva kokufikelela, ngexabiso le-1,132,473 ye-ECG. Ngexesha elidlulileyo yokufaka iinkcukacha le-cohort, kukho izicelo ezimbini ezincinciphisa abalandeli ukuba bafumane i-ECG. Kuba bonke abalandeli abalandeli-Watch, isicelo esifumaneka ekubeni ekubeni i-ECG kwaye isicelo esifumanekanga esifumaneka kwi-April 2021, leyo ilandelayo ngoJanuwari 2022 ukuze bafumane i-ECG kunye nokubhekiselele imiphumo nge-multiple-choice response. 4 25,402 ECGs (2.2%) ziye zihlanganiswa njengoko ibonisa fibrillation atrial, zihlanganisa 1641 abalandeli (2.0% ye-cohort). Izihlanganiswa ezininzi ziyafumaneka kwi-Tables Supplementary iimveliso Ixesha le-collection lihlanganisa i-ECG version 1 kunye ne-ECG version 2, ebonakalayo kwi-WatchOS 7.2 kunye ne-iOS 14.3, ebonakalayo ngoDisemba we-2020, kunye nokusetyenziswa kwe-ECG. 9 10 Iinkcukacha zempilo ze-Clinical I-Apple Health ifumaneka kubasebenzisi ukulayisha iinkcukacha zempilo zonyango (i-FHIR format) kwiziko ezihlangeneyo ngokuchofoza kwi-portal ye-healthcare provider yaye ukhethe ukunikela idatha ze-FHIR kunye ne-HealthKit. Abasebenzi be-studiya bangafuna ukunikela le data kunye ne-studium yethu. Kwixesha lokugqibela, i-proportion of participants who have been able to share these data types is modest (~10%) as a consequence of local FHIR compliance and the process required. Kwi-cohort, 7757 abantu wahlanganisa ubuncinane enye idatha efanayo kunye no-studium yethu ngexesha lokuqala emva kokufikelela. Ukusetyenziswa kwimeko ixesha Ukubala ukuxhaswa kweengcali kwi-studium ngexesha elide, sinikezela iindices ezimbini ezincinci ezongezelela iinkcukacha ezininzi ze-studium kunye ne-HealthKit. Ezi zihlanganisa: (1) i-Apple Watch yeyure yabasetyhini yabasetyhini ye-HealthKit "Stand Hour" kunye ne-Research app; (2) i-App ye-Research yabasetyhini yabasetyhini yabasetyhini ze-Apple ye-study se-safe. Each Stand Hour sample is an estimate by Apple Watch of whether or not the participant has stood and moved for at least 1 min during a given hour of the day. If Watch is not on the wrist and powered on, then no sample is created. Ukusetyenziswa kwe-Stand Hours njenge-proxy ye-Apple Watch yokusetyenziswa, njengoko le i-parameter ifumaneka ngempumelelo kwaye ngenxa yokusetyenziswa kwe-Watch i-indication ye-"Stood" okanye i-"Idle" ngalinye iiyure yabasetyenziswa kwizixhobo. Sifumanisa ukuba isampula ye-Stand Hour ayikho ngosuku eyodwa ukuze kuxhomekeke ukuba umdlali waya i-Stand Hours ngomhla elidlulileyo. Nangona kunjalo, sincoma ukuba ezinye iimeko ezimbini ziyafumaneka ukuba akukho isampula ye-Stand Hour: (1) umzila wabasetyenziswa kwabasetyenziswa kwi-Watch kwi-Research kwaye emva kokuba i-AH&MS I-definition yethu yesibini ye-participation isekelwe kwimfuneko emininzi: ukuba i-app ye-Research ye-participant ifakwe iinkonzo ze-Study kwiinkonzo ze-Study kwiintsuku ezithile. I-upload efana ne-Stand Hour samandla kunye nezinye iinkonzo ze-health kunye ne-sensor, kodwa kunokwenzeka kuphela ukucacisa iinkonzo ezincinane ze-Apple Watch, i-iPhone kunye ne-study servers, njenge-check-in eyenziwe ngexesha elidlulileyo phakathi kwe-Apple Research kunye ne-server. I-upload ye-one of these shows that the participant has the Research app installed on their iPhone and that their iPhone is connected to the internet. Zonke iinkcukacha Figure Ukubonisa iindidi ezimbini zeengxowa kwi-scales ze-time. I-Panel a ibonisa i-fraction ye-cohort ebonakalayo kwi-post-enrollment yeentsuku eyodwa (00:00:00 ukuya kwi-23:59:59 UTC). I-Panel b ibonisa i-fraction ebonakalayo iintsuku efikelelekayo emva-ukubhalisa kwaye ingathengiswa njengamaxesha le-incidence ye-cohort drop-out ngexesha elide, isilinganiso se-fraction eyenza ngexesha elide, ngokutsho le-index ye-participation (kuye kwimeko yokubhalisa, 2022-12-01). Qaphela ukuba ifenisha le-observation for Fig. ixesha elide ukuba i-cohort epheleleyo ifunyenwe ngexesha elide, kodwa le ubudlelwane emva kwiminyaka elide ayidokazi. I-denominator yeenkcukacha zihlanganisa kubalulekileyo: i-82,809 abalandeli. 1 Yonke ixesha emva 1 Kwakhona FIG. a, inqaku ye-cohort enayo i-Research app ayithunyelwe iinkcukacha ngosuku ye-0 kunzima kakhulu, malunga ne-1%, kwaye ibekwe ngokufanelekileyo (kwi-38%) ngexesha elinyanga elandelayo emva kokufikelela. Inqaku le-cohort eyenza iiyure ze-Stand ngokufanelekileyo ngexesha elifanayo, kodwa kunzima ngokufanelekileyo ngexesha elifanelekileyo emva kokufikelela, ukusuka kwi-5% kwaye ukwandisa kwi-44%. Inqaku ye-Stand hour yathunyelwe iimfuno ezongezelelweyo ukuba umdlali uthatha iWatch kunye nokufumana iiyure ze-Stand kunye ne-Research app (kwakhona neemfuno ukuba ziyafumaneka kunye nokufutsh 1 Ukucinga b shows a closely related trend. The fraction of the cohort whose Research app has stopped uploading any data on day 0 is <1%, increasing to 28% at one year post-enrollment. The fraction of the cohort who has indefinitely stopped sharing Stand hours on day 0 is 2%, increasing to 34% at one-year post-enrollment. 1 Ngoko ke, kumazwe angama-indices yobugcisa, ukunciphisa i-DAY PARTICIPATION ngexesha lokugqibela kunokwenzeka kakhulu kwi-accumulation of permanently inactive participants over time, and less attributable to a degradation of study engagement among active participants. For example, 44% of the cohort does not share a Stand hour sample on day 365 post-enrollment, but this is not much larger than the 34% of the cohort that has already stopped sharing Stand hour samples at all times after day 365. Imibuzo Umbala Ukubonisa i-percentage of participants in the cohort who complete at least one survey in their first year following enrollment, for each of the 16 survey types. Ngaphandle kwe-5 enquiries that are triggered by rare events detected by Watch, phantse zonke enquiries have a participation rate greater than 70%. 5 Ukucinga Ukubonisa izinga lokuphendula, vs. ixesha ukususela ukufikelela kwizifundo ezimbini ezidlulileyo - i-Monthly Stress Scale Survey kunye ne-Changes in Health Survey. 2 Kwi-Stress Scale Survey, kuphela abalandeli abalandeli emva kwe-2020-05-01 ziya kubandakanya ukunciphisa iintlawulo ye-delivery xa le nkqubo yokuqala ye-Stress Scale lithunyelwe ngenyanga emva kweMei 2020. Oku kuholela kwi-42.181 (i-denominator ye-response rate) abalandeli. I-time window ethandwa apha ibandakanya ngomhla lokugqibela lokugqibela lokugqibela kwe-12 ye-Stress Scale Survey. I-delivery ephakamileyo ye-stress scale yokugqibela ngexesha elandelayo: le nkqubo yokugqibela yokugqibela yokugqibela ngenyanga lokuqala ngexesha lokugqibela lokugqibela lokugqibela ngexesha lokugqibela lokugqib Ngokutsho kokuphumelela kwizifundo kubandakanyeka kwiminyaka eyodwa, le ubuncinane kwiminyaka engama-69.55% kunye nokukhula ngokugqithisileyo kwi-32.48% emva kwenyaka. Ngokutsho kokuphumelela kwizifundo kubandakanyeka kubandakanyeka kwiminyaka eyodwa, le ubuncinane kwiminyaka eyodwa kubaluleke kakhulu ngexabiso epheleleyo kunye nesilinganiselo kunokuba kubuncinane kubasebenzisi abasebenzayo njengokuphumelela yi-Research app. b, nto leyo ibonisa ukuba kuphela i-28% ye-cohort iya kuba ngempumelelo ngexesha elinye ngonyaka. 2 1 Kwi-Changes in Health Survey, i-cohort epheleleyo ifunyenwe, kunye ne-time window efakwe yi-Fig. iintsuku ezidlulileyo ezidlulileyo ezidlulileyo ezidlulileyo ezidlulileyo kwiintsuku ezili-400 emva kokufikelela ukuba iintsuku ezili-4 ezidlulileyo zeentlawulo zeentlawulo zeentlawulo zeentlawulo zeentlawulo zeentlawulo zeentlawulo zeentlawulo zeentlawulo zeentlawulo zeentlawulo zeentlawulo zeentlawulo zeentlawulo zeentlawulo zeentlawulo zeentlawulo zeentlawulo zeentlawulo zeentlawulo zeentlawulo zeentlawulo zeentlawulo zeentlawulo zeentlawulo zeentlawulo zeentlawulo zeentlawulo zeentlawulo zeentlawulo zeentlawulo zeentlawulo zeentlawulo. 2 Ukuguqulwa kweziphumo ze-Health Survey The changes in Health survey is designed to monitor various key events relevant to health, including new medical conditions, changes in medications, new injuries, and major lifestyle changes. There were 56,553 (63.8%) participants who completed at least one changes in Health survey. Umbala Ukubhalisa inani leengcali ebonakalayo ukuguqulwa kwezilwanyana ezintathu ezininzi: iimeko ezintsha zonyango, iingxaki ezintsha zonyango, okanye iingxaki ezininzi. Ngenxa yokuba iingxaki ibandakanya umdlali ukuba uthathe iimali yokuguqulwa, ithebula Ukubonisa iintlobo ezahlukeneyo ezilinganiselwe ngokutsho ukuba umdlali wabelana i-date ye-change, kwaye ukuba i-date ye-change wabelana nexesha yayo kwizifundo. Ukuba umdla wabelana emva kokufikelela, kodwa phambi kwexesha le-quarterly eyenziwa yi-survey ebonakalayo, ke asikwazisa kwiziphi na imibala eTabela . Iintsuku emva kokuphumelela kwizifundo zihlanganiswa njengokungaphumelela. 6 6 6 Emva kokugcwalisa iziganeko ezaziwayo kunye nokugcwalisa iziganeko ezidlulileyo ezidlulileyo ezidlulileyo, iziganeko kwi-category "Other Changes" ziye zithunyelwe ngamanani elikhulu ( = 44,333). Events in categories “Medical Conditions” and “Surgical Procedures” were reported by fewer participants ( = 1443 kwaye = 1294 ngexesha elandelayo). n n n Table Ukubonisa iziganeko ezininzi ngokugqithisileyo. Zonke izimo zonyango ezintsha ziye zithunyelwe ngokushesha eliphantsi (<1% ye-cohort). I-arthritis (0.5%) yinkqubo ezintsha zonyango ziye zithunyelwe ngokushesha eliphantsi. I-procedure ezintsha zonyango ezininzi yaba "i-other bone surgery" (1.1%). I-changing ezininzi zithunyelwe ngokubanzi yaba "ukuguqulwa kwe-insurance", ngathi yi-16.6% ye-cohort ngexesha lokuqala. Iziphumo ezininzi zihlanganisa kwi-Changes in Health survey kodwa engabonakala kwi-Table iimiphumo ezilandelayo: ukutshintsha okanye ukutshintsha ukutshintsha, ezinye izixazululo zonyango, ukutshintsha pre-diabetes okanye ukuchithwa kwe-glucose tolerance, ukutshintsha ngokuvamile i-cigarette, imiphumo emibi yeyiyobisi okanye izidakamizwa, okanye ukutshintsha kwi-arthritis yeengxaki ezantsi. Abalandeli abalandeli iingxaki zonyango ziye zithunyelwe ukuhlaziywa ukuhlaziywa ukuhlaziywa ubude kunye neengxaki zeengxaki zeengxaki zeengxaki zeengxaki zeengxaki zeengxaki zeengxaki. Kwakhona, abalandeli abalandeli iingxaki zeengxaki zeengxaki zeengxaki zeengxaki zeengxaki z 7 7 I-Potential Fall Surveys kunye ne-Follow-up Participation Iingxaki le-cohort zithunyelwe i-2055 iingxaki ze-enquire ezihambelana neengxaki ze-protocol ezihambelana phambi kwe-2021-11-14, zihlanganisa i-1735 abalandeli. I-study iye yathunyelwa ukuba zihlanganise i-1392 iingxaki kwi-telephone, zihlanganisa i-1179 abalandeli. Iingxaki ze-callers zithunyelwa kwi-participant ye-967 yaye zihlanganisa i-829 abalandeli (47% yinkxaso ze-enquire ezihambelana kunye ne-48% yengxaso ze-enquire ezihambelana). Imibuzo demographics I-cohort ingaba kakhulu i-male (74% vs. 49% ye-US), i-white (i-72% vs. 60% ye-US), kunye ne-college (i-89% ye-cohort vs. 62% ye-US agama-25 kunye ne-> 12 iminyaka ye-education). I-recruitment esebenzayo ibandakanya i-demographics ye-studium kwi-national average (iinkcukacha ezikhoyo) kwaye ziya kubhalwe ngokugqithisileyo kwi-manuscripts ezilandelayo. Ngokuhambisana ne-epidemiology yokuzonwabisa okanye ama-cohorts zokuzonwabisa ngexesha lokufikelela, i-cohort eyenziwe ngexesha elifanayo, kodwa sincoma ukuba nge-recruitment kunye ne-strategies ezisetyenziswa ekugqibeleni ukuguqulwa kwe-representation, i-cohort iya kuqhubeka ukuba kwenziwe ngakumbi kwixesha elide. Ngokuqhelekileyo, i-AH&MS ayinezisa i-upper limit kwi-age yeengcali kunye ne-set yeedatha ezahlukahlukeneyo ezahlukahlukeneyo kwi-AH&MS. Umzekelo, i-cohort iye yandise ~19,300 iintlobo ze-cycling, ~14,700 iintlobo ze-running, ~137,000,000 amaxab Ukubalwa kwexesha le-2021-11-07 - i-2021-11-13 kunye nezinye iinyanga ze-7 iintsuku In Supplementary Fig. kunye neFig. inkcazelo lweendalo ye-sharing yeedatha yabasetyhini ye-2021-11-07 ukuya ku-2021-11-13, kwaye sincoma ukuba le ngexesha ilinganiselwe kwiintsuku ezininzi ze-7 ezidlulileyo okanye ezidlulileyo. 2A 2B Ukusebenza le nqakraza ngokufaka iintlobo zenyanga ze-6 iintlobo zeendaba ezahlukileyo ezahlukileyo phakathi kwe-2019-11-14 kunye ne-2022-09-01. Sihlanganisa iintlobo ezintathu zonyango ze-HealthKit ezahlukileyo ezahlukileyo: iiyure ze-stand, i-VO2, i-Max, kunye neengxaki ze-mindful. Ukukhangela iintlobo ze-3 zeentlobo ze-workouts ezidlulileyo: ukunyuka, i-yoga, kunye ne-strength training ezijwayelekile. From this 6-dimensional dataset, we computed the Mahalanobis distance, , ngeveki yethu isampuli ukusuka ububanzi kwezinye iiveki 145. Ngokusho ukuba ngamnye kwezinye iiveki ezisibhozo ezisetyenziswa ngokuvamile, i-quadrat of this Mahalanobis distance, , should be χ2-distributed with ν = 6. This allows us to test for a significant difference between our sample week and the other 145 weeks. We found = 1.57. Ngenxa yokuba sinokufumana ingxaki elikhulu phakathi kwiveki yethu kunye neeveki yokufunda ubunzima. d d2 i2 Kwakhona siyenza i-PCA ye-6-component kwi-dataset kunye ne-2 i-components ezidlulileyo zibonisa i-graphically i-distance ye-sample week yethu ukusuka kwiiveki ze-145 ezidlulileyo. . 2C Ukubhalisa Ukubhalisa Ulwazi oluthe ngexabiso malunga ne-research design ifumaneka kwi linked to this article. Izifundo zeNature Reporting Data Ukuphepha Iinkcukacha ziyafumaneka ngokubanzi. Zonke iinkcukacha ze-data ziya kubhalwe kunye nokuphendula ngexesha elifanelekileyo kwi-protocol yokufunda kunye ne-informed consent form. 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