New algorithm uses data from smartwatches to detect bodily stress, including COVID-19

Using data from smartwatches, a new algorithm reads heart rate as a proxy for physiological or mental stress, potentially alerting wearers they're falling ill before they have symptoms.

Researchers led by Michael Snyder, PhD, professor and chair of genetics, have enrolled thousands of participants in a study that employs the algorithm to look for extended periods during which heart rate is higher than normal — a telltale sign that something may be amiss.

But figuring out what may be wrong takes a little sleuthing. During the study, many stressors triggered an alert. Some folks received them while traveling; some while running a marathon; others after over-indulging at the bar.

The most exciting finding, Snyder said, was that the algorithm was able to detect 80% of confirmed COVID-19 cases before or when participants were symptomatic.

The idea is for people to eventually use this information to decide whether they need to get a COVID-19 test or self-isolate. We're not there yet — we still need to test this in clinical trials — but that's the ultimate goal."

Michael Snyder, PhD, professor and chair of genetics

The algorithm can't differentiate between someone who's knocked back a few too many, someone's who's stressed because of work and someone who's ill with a virus. Although it pinged users who had COVID-19, more refining is needed before people can depend on their smartwatches to warn them of an impending infection with SARS-CoV-2 or other viruses.

A paper detailing the study was published online in Nature Medicine Nov. 29. Snyder, the Stanford W. Ascherman, MD, FACS, Professor of Genetics, and Amir Bahmani, PhD, lecturer and director of Stanford's Deep Data Research Computing Center, are co-senior authors. Arash Alavi, PhD, research and development lead in Stanford's Deep Data Research Computing Center; research scientist Meng Wang, PhD; and postdoctoral scholars Gireesh Bogu, PhD, Ekanath Srihari Rangan, MBBS, and Andrew Brooks, PhD, share lead authorship. The alert system was built using MyPHD, a scalable, secure platform for health data.

Stress detection

During the study, which ran for about eight months in 2020 and 2021, 2,155 participants donned a smartwatch, which tracked mental and physical "stress events" via heart rate. When notified of a stress event, through an alert paired with an app on their phone, participants recorded what they were doing. To trigger an alert, their heart rate needed to be elevated for more than a few hours, so a quick jog around the block or a sudden loud noise didn't set it off.

"What's great about this is people can contextualize their alerts," Snyder said. "If you're traveling via airline and you receive an alert, you know that air travel is likely the culprit."