{
  "id": "AIBD-0290",
  "title": "Smartwatch alert for an irregular rate above 180 bpm leads to a ventricular tachycardia diagnosis, an ICD, and the incidental discovery and resection of a lung adenocarcinoma",
  "summary": "A 58-year-old's smartwatch flagged an irregular rate over 180 bpm; NSVT was diagnosed from watch data, an ICD placed, and the post-procedure X-ray found a 28 mm lung adenocarcinoma, resected.",
  "date_observed": "2022-01-04",
  "date_basis": "unassessed",
  "date_precision": "unassessed",
  "benefit_status": null,
  "source_collection": null,
  "source_entry": null,
  "account": "Cole, Kar, Nimako and Smelt reported a case in JRSM Open (4 January 2022; event dates not reported). They are of St George's Healthcare NHS Trust (thoracic surgery) and East Surrey Hospital (respiratory medicine) in England's National Health Service (NHS). A previously well 58-year-old non-smoker's smartwatch alerted him that his heart rate was irregular and exceeding 180 beats per minute while he felt nothing. His GP's 12-lead electrocardiogram (ECG) showed tachycardia without arrhythmia and he was admitted. Inpatient ECGs showed incomplete right bundle branch block and intermittent first-degree AV block but captured no significant arrhythmia. From the smartwatch results, the cardiologist diagnosed non-sustained ventricular tachycardia (NSVT) and an implantable cardioverter-defibrillator (ICD) was inserted. The post-procedure chest X-ray, taken to exclude pneumothorax, incidentally showed a right upper zone abnormality. Computed tomography (CT) found a 28 mm lesion, PET showed FDG-avid nodes, and biopsy showed lepidic adenocarcinoma, staged cT1c N0 M0. He had a video-assisted right upper lobectomy with node dissection and was discharged on day 10. The 35 mm tumor was staged pT2a pN0 M0 with clear margins. The nodes showed sarcoidosis and cardiac magnetic resonance imaging (MRI) found no cardiac sarcoid. The authors call this the first reported case of a smartwatch assisting the diagnosis of both NSVT and lung adenocarcinoma. The watch's brand and model are not stated.",
  "category": "benefit created",
  "unexpected": true,
  "purpose": "The watch's heart-rate alert was its intended function. The lung cancer diagnosis was an incidental consequence of the ICD procedure the alert set in motion, outside anything the device was built to do.",
  "system": "Smartwatch heart-rate and irregular-rhythm alert (brand and model not stated)",
  "model_version": null,
  "developer": "Not stated (the report does not name the device's maker)",
  "deployer": null,
  "location": "United Kingdom (authors at St George's Healthcare NHS Trust, London, and East Surrey Hospital, Redhill; the treating hospitals are not named)",
  "domain": "Healthcare (cardiology; thoracic oncology)",
  "segment": "Consumer wearables",
  "benefit_type": "Improved Physical Health",
  "taxonomy_note": null,
  "registry_ids": {},
  "ratings": [
    {
      "group": "personal",
      "depth": 3,
      "reason": "One man received an ICD for ventricular tachycardia and curative resection of a lung adenocarcinoma found at stage pT2a pN0. The authors judge that without the watch the cancer would likely have grown undetected and curative surgery might not have been an option. That counterfactual is their judgment."
    }
  ],
  "ai_role": {
    "status": "assessed",
    "statement": "The watch's alert in an asymptomatic man started the chain. Its stored data were what the cardiologist used to diagnose NSVT when hospital tracings captured nothing. The lung cancer was found by a routine post-ICD X-ray, not by the device. The brand is unknown, so the alerting algorithm cannot be identified. The authors describe smartwatch rhythm monitoring generically as photoplethysmography."
  },
  "evidence": [
    {
      "kind": "case report",
      "citation": "Cole APC, Kar A, Nimako K, Smelt J (2022). Smartwatch helps detects lung cancer: Using personal technology to advance healthcare. JRSM Open 13(1):20542704211068651. doi:10.1177/20542704211068651 (PMC8733372).",
      "title": "Smartwatch helps detects lung cancer: Using personal technology to advance healthcare",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8733372/",
      "date": "2022-01-04",
      "written_by": "independent",
      "quote": "was alerted by his smartwatch that his heart rate was irregular and exceeding 180 beats-per-minute, he remained asymptomatic throughout"
    },
    {
      "kind": "case report",
      "citation": "Cole APC et al. (2022), JRSM Open 13(1):20542704211068651, cardiac diagnosis.",
      "title": "Smartwatch helps detects lung cancer: Using personal technology to advance healthcare",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8733372/",
      "date": "2022-01-04",
      "written_by": "independent",
      "quote": "Using the results from his smartwatch, the cardiologist diagnosed non-sustained ventricular tachycardia and he subsequently had an Implantable Cardiac Defibrillator inserted."
    },
    {
      "kind": "case report",
      "citation": "Cole APC et al. (2022), JRSM Open 13(1):20542704211068651, incidental finding.",
      "title": "Smartwatch helps detects lung cancer: Using personal technology to advance healthcare",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8733372/",
      "date": "2022-01-04",
      "written_by": "independent",
      "quote": "A post procedure Chest X-ray ruled out iatrogenic pneumothorax but this incidentally showed an abnormality in his right upper lung zone"
    },
    {
      "kind": "case report",
      "citation": "Cole APC et al. (2022), JRSM Open 13(1):20542704211068651, conclusions.",
      "title": "Smartwatch helps detects lung cancer: Using personal technology to advance healthcare",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8733372/",
      "date": "2022-01-04",
      "written_by": "independent",
      "quote": "it is likely without his smartwatch his lung adenocarcinoma would have continued to grow undetected, curative surgery may not have been an option"
    }
  ],
  "replication": {
    "produced_by": [
      "An asymptomatic wearer whose smartwatch alerted to an irregular rate above 180 bpm and who took it to his GP",
      "A cardiologist willing to diagnose from the watch's stored data when hospital tracings were silent",
      "A procedure (ICD insertion) whose routine follow-up imaging happened to cover the lung"
    ],
    "must_hold": [
      "The arrhythmia is one the watch records while hospital monitoring misses it",
      "The incidental finding is in the field of the post-procedure X-ray and caught early enough for curative surgery. The authors cite an estimated 1 in 25 cancers diagnosed incidentally."
    ],
    "echoes": []
  },
  "paired_incident": null,
  "headline": "Smartwatch alert leads to an ICD and finds a lung adenocarcinoma",
  "metric": "found a 28 mm lung adenocarcinoma, resected",
  "comparator": {
    "against": "no smartwatch (the authors' counterfactual for the same patient)",
    "before": "his lung adenocarcinoma would have continued to grow undetected, curative surgery may not have been an option",
    "after": "The upper lobe adenocarcinoma measured 35 mm and was staged as pT2a pN0 M0 with clear resection margins.",
    "basis": "assumed",
    "quote": "For the patient described, it is likely without his smartwatch his lung adenocarcinoma would have continued to grow undetected, curative surgery may not have been an option, and the prognosis for him would have undoubtable been poorer.",
    "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8733372/"
  },
  "later": {
    "status": "unknown",
    "date": null,
    "note": "Nothing later than the January 2022 case report was found; the paper reports no follow-up beyond discharge on the tenth postoperative day and an outpatient cardiac MRI.",
    "quote": null,
    "url": null
  },
  "value": null,
  "developer_country": null,
  "deployer_country": null,
  "unrated_because": null,
  "brief_notes": null,
  "brief": null,
  "revisions": [
    {
      "date": "2026-10-20",
      "change": "Record drafted from the cited sources.",
      "source": null,
      "editor": "AIBD"
    },
    {
      "date": "2026-10-21",
      "change": "Benefit type set to Improved Physical Health under Trustible's full taxonomy of 23 types; it was Improved Accessibility among the six first used.",
      "source": "https://trustible.ai/post/a-framework-for-measuring-the-benefits-of-ai/",
      "editor": "AIBD"
    },
    {
      "date": "2026-10-21",
      "change": "Added what the benefit is measured against from the cited sources.",
      "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8733372/",
      "editor": "AIBD"
    },
    {
      "date": "2026-10-21",
      "change": "Prose pass: a rating reason, account, purpose, the replication conditions, the system's part rewritten in shorter sentences with abbreviations expanded; facts, figures and quotations unchanged.",
      "source": null,
      "editor": "AIBD"
    }
  ],
  "confidence": "studied",
  "shade": "high",
  "claim_status": "Independently studied",
  "claim_basis": "Sources: one independent case report. The cited evidence includes no finding by a regulator or court.",
  "profile": {
    "case_id": "AIBD-0290",
    "catalog_version": "1.0.0",
    "source_fingerprint": "edfbcdfdd559c6924d94147f530a4360f28243862f36b7b6080c175d330e770e",
    "collection_refs": [
      {
        "collection_id": "aibd",
        "version": "snapshot-8bf7cfec9cb185aa"
      },
      {
        "collection_id": "aibd",
        "version": "2026-10-25"
      }
    ],
    "source_ids": [
      "AIBD-0290-source-0001",
      "AIBD-0290-source-0002",
      "AIBD-0290-source-0003",
      "AIBD-0290-source-0004"
    ],
    "families": {
      "strategic assessments": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial",
        "record_ids": []
      },
      "evaluations": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial",
        "record_ids": []
      },
      "monetary observations": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial",
        "record_ids": []
      },
      "institutional decisions": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial",
        "record_ids": []
      }
    },
    "fields": {
      "actors[]": {
        "state": "value_present",
        "value": {
          "kind": "record_fields",
          "fields": {
            "developer": "Not stated (the report does not name the device's maker)"
          }
        },
        "provenance": {
          "kind": "legacy_record",
          "basis": "Preserved from the existing AIBD record; external sources were not rechecked.",
          "record_fields": [
            "developer"
          ],
          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "partial"
      },
      "actors[].ownership_control": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "ai_contribution": {
        "state": "value_present",
        "value": {
          "kind": "record_fields",
          "fields": {
            "ai_role": {
              "status": "assessed",
              "statement": "The watch's alert in an asymptomatic man started the chain. Its stored data were what the cardiologist used to diagnose NSVT when hospital tracings captured nothing. The lung cancer was found by a routine post-ICD X-ray, not by the device. The brand is unknown, so the alerting algorithm cannot be identified. The authors describe smartwatch rhythm monitoring generically as photoplethysmography."
            }
          }
        },
        "provenance": {
          "kind": "legacy_record",
          "basis": "Preserved from the existing AIBD record; external sources were not rechecked.",
          "record_fields": [
            "ai_role"
          ],
          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "partial"
      },
      "ai_relationship": {
        "state": "value_present",
        "value": {
          "kind": "record_fields",
          "fields": {
            "category": "benefit created",
            "ai_role": {
              "status": "assessed",
              "statement": "The watch's alert in an asymptomatic man started the chain. Its stored data were what the cardiologist used to diagnose NSVT when hospital tracings captured nothing. The lung cancer was found by a routine post-ICD X-ray, not by the device. The brand is unknown, so the alerting algorithm cannot be identified. The authors describe smartwatch rhythm monitoring generically as photoplethysmography."
            }
          }
        },
        "provenance": {
          "kind": "legacy_record",
          "basis": "Preserved from the existing AIBD record; external sources were not rechecked.",
          "record_fields": [
            "ai_role",
            "category"
          ],
          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "partial"
      },
      "assessments[].alternatives": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "assessments[].assessor_date": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "assessments[].depth": {
        "state": "value_present",
        "value": {
          "kind": "record_fields",
          "fields": {
            "ratings": [
              {
                "group": "personal",
                "depth": 3,
                "reason": "One man received an ICD for ventricular tachycardia and curative resection of a lung adenocarcinoma found at stage pT2a pN0. The authors judge that without the watch the cancer would likely have grown undetected and curative surgery might not have been an option. That counterfactual is their judgment."
              }
            ]
          }
        },
        "provenance": {
          "kind": "legacy_record",
          "basis": "Preserved from the existing AIBD record; external sources were not rechecked.",
          "record_fields": [
            "ratings"
          ],
          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "partial"
      },
      "assessments[].display_confidence": {
        "state": "value_present",
        "value": {
          "kind": "structured",
          "data": {
            "confidence": "high",
            "evidence_word": "studied",
            "claim_status": "Independently studied",
            "basis": "Sources: one independent case report. The cited evidence includes no finding by a regulator or court.",
            "interpretation": "Existing display rule preserved; the richer outcome-specific confidence question still needs review."
          }
        },
        "provenance": {
          "kind": "curatorial",
          "basis": "Derived from the existing case display properties; not a new evidentiary judgment.",
          "record_fields": [],
          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "partial"
      },
      "assessments[].rationale": {
        "state": "value_present",
        "value": {
          "kind": "record_fields",
          "fields": {
            "ratings": [
              {
                "group": "personal",
                "depth": 3,
                "reason": "One man received an ICD for ventricular tachycardia and curative resection of a lung adenocarcinoma found at stage pT2a pN0. The authors judge that without the watch the cancer would likely have grown undetected and curative surgery might not have been an option. That counterfactual is their judgment."
              }
            ]
          }
        },
        "provenance": {
          "kind": "legacy_record",
          "basis": "Preserved from the existing AIBD record; external sources were not rechecked.",
          "record_fields": [
            "ratings"
          ],
          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "partial"
      },
      "assessments[].rubric_version": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "assessments[].status_basis": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "assessments[].target": {
        "state": "value_present",
        "value": {
          "kind": "record_fields",
          "fields": {
            "ratings": [
              {
                "group": "personal",
                "depth": 3,
                "reason": "One man received an ICD for ventricular tachycardia and curative resection of a lung adenocarcinoma found at stage pT2a pN0. The authors judge that without the watch the cancer would likely have grown undetected and curative surgery might not have been an option. That counterfactual is their judgment."
              }
            ]
          }
        },
        "provenance": {
          "kind": "legacy_record",
          "basis": "Preserved from the existing AIBD record; external sources were not rechecked.",
          "record_fields": [
            "ratings"
          ],
          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "partial"
      },
      "availability": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "brief": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "case_kind": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "case_links[]": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "claims[].evidence_links": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "claims[].evidence_strength": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "claims[].missingness": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "claims[].proposition": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "cross_border_flows[]": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "decisions[].action_outcome": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial",
        "family": "institutional decisions"
      },
      "decisions[].grounds": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial",
        "family": "institutional decisions"
      },
      "decisions[].institution_task": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial",
        "family": "institutional decisions"
      },
      "decisions[].success_criterion": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial",
        "family": "institutional decisions"
      },
      "deployment_stage": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "economics[].amount": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial",
        "family": "monetary observations"
      },
      "economics[].costs[]": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial",
        "family": "monetary observations"
      },
      "economics[].counterfactual": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial",
        "family": "monetary observations"
      },
      "economics[].currency_price_basis": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial",
        "family": "monetary observations"
      },
      "economics[].gross_net": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial",
        "family": "monetary observations"
      },
      "economics[].measure_type": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial",
        "family": "monetary observations"
      },
      "economics[].period_unit": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial",
        "family": "monetary observations"
      },
      "economics[].realization": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial",
        "family": "monetary observations"
      },
      "economics[].recipient_payer": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial",
        "family": "monetary observations"
      },
      "economics[].return_payback": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial",
        "family": "monetary observations"
      },
      "economics[].valuation_method": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial",
        "family": "monetary observations"
      },
      "evaluations[].ai_uplift": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial",
        "family": "evaluations"
      },
      "evaluations[].comparator": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial",
        "family": "evaluations"
      },
      "evaluations[].design": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial",
        "family": "evaluations"
      },
      "evaluations[].effect": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial",
        "family": "evaluations"
      },
      "evaluations[].exposure": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial",
        "family": "evaluations"
      },
      "evaluations[].id": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial",
        "family": "evaluations"
      },
      "evaluations[].measurement_method": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial",
        "family": "evaluations"
      },
      "evaluations[].metric": {
        "state": "not_assessed",
        "provenance": {
          "kind": "legacy_record",
          "basis": "Mapped from the existing case description without a new external source review.",
          "record_fields": [
            "metric"
          ],
          "source_refs": []
        },
        "review_state": "not_assessed",
        "coverage": "partial",
        "family": "evaluations",
        "display": {
          "answer": "found a 28 mm lung adenocarcinoma, resected",
          "editor_note": ""
        }
      },
      "evaluations[].reproduction_materials": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial",
        "family": "evaluations"
      },
      "evaluations[].setting_sample": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial",
        "family": "evaluations"
      },
      "evaluations[].uncertainty_limitations": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial",
        "family": "evaluations"
      },
      "external_references[]": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "follow_up[]": {
        "state": "value_present",
        "value": {
          "kind": "record_fields",
          "fields": {
            "later": {
              "status": "unknown",
              "note": "Nothing later than the January 2022 case report was found; the paper reports no follow-up beyond discharge on the tenth postoperative day and an outpatient cardiac MRI."
            }
          }
        },
        "provenance": {
          "kind": "legacy_record",
          "basis": "Preserved from the existing AIBD record; external sources were not rechecked.",
          "record_fields": [
            "later"
          ],
          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "partial"
      },
      "human_oversight": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "id": {
        "state": "value_present",
        "value": {
          "kind": "record_fields",
          "fields": {
            "id": "AIBD-0290"
          }
        },
        "provenance": {
          "kind": "legacy_record",
          "basis": "Preserved from the existing AIBD record; external sources were not rechecked.",
          "record_fields": [
            "id"
          ],
          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "partial"
      },
      "infrastructure_dependencies[]": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "outcomes[].beneficiaries": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "outcomes[].beneficiary_count": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "outcomes[].benefit_type": {
        "state": "value_present",
        "value": {
          "kind": "record_fields",
          "fields": {
            "benefit_type": "Improved Physical Health"
          }
        },
        "provenance": {
          "kind": "legacy_record",
          "basis": "Preserved from the existing AIBD record; external sources were not rechecked.",
          "record_fields": [
            "benefit_type"
          ],
          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "partial"
      },
      "outcomes[].claim": {
        "state": "value_present",
        "value": {
          "kind": "record_fields",
          "fields": {
            "account": "Cole, Kar, Nimako and Smelt reported a case in JRSM Open (4 January 2022; event dates not reported). They are of St George's Healthcare NHS Trust (thoracic surgery) and East Surrey Hospital (respiratory medicine) in England's National Health Service (NHS). A previously well 58-year-old non-smoker's smartwatch alerted him that his heart rate was irregular and exceeding 180 beats per minute while he felt nothing. His GP's 12-lead electrocardiogram (ECG) showed tachycardia without arrhythmia and he was admitted. Inpatient ECGs showed incomplete right bundle branch block and intermittent first-degree AV block but captured no significant arrhythmia. From the smartwatch results, the cardiologist diagnosed non-sustained ventricular tachycardia (NSVT) and an implantable cardioverter-defibrillator (ICD) was inserted. The post-procedure chest X-ray, taken to exclude pneumothorax, incidentally showed a right upper zone abnormality. Computed tomography (CT) found a 28 mm lesion, PET showed FDG-avid nodes, and biopsy showed lepidic adenocarcinoma, staged cT1c N0 M0. He had a video-assisted right upper lobectomy with node dissection and was discharged on day 10. The 35 mm tumor was staged pT2a pN0 M0 with clear margins. The nodes showed sarcoidosis and cardiac magnetic resonance imaging (MRI) found no cardiac sarcoid. The authors call this the first reported case of a smartwatch assisting the diagnosis of both NSVT and lung adenocarcinoma. The watch's brand and model are not stated.",
            "benefit_type": "Improved Physical Health"
          }
        },
        "provenance": {
          "kind": "legacy_record",
          "basis": "Preserved from the existing AIBD record; external sources were not rechecked.",
          "record_fields": [
            "account",
            "benefit_type"
          ],
          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "partial"
      },
      "outcomes[].distribution": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "outcomes[].duration": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "outcomes[].id": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "outcomes[].stakeholder_group": {
        "state": "value_present",
        "value": {
          "kind": "record_fields",
          "fields": {
            "ratings": [
              {
                "group": "personal",
                "depth": 3,
                "reason": "One man received an ICD for ventricular tachycardia and curative resection of a lung adenocarcinoma found at stage pT2a pN0. The authors judge that without the watch the cancer would likely have grown undetected and curative surgery might not have been an option. That counterfactual is their judgment."
              }
            ]
          }
        },
        "provenance": {
          "kind": "legacy_record",
          "basis": "Preserved from the existing AIBD record; external sources were not rechecked.",
          "record_fields": [
            "ratings"
          ],
          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "partial"
      },
      "outcomes[].status": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "outcomes[].tradeoffs": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "outcomes[].unexpected": {
        "state": "value_present",
        "value": {
          "kind": "record_fields",
          "fields": {
            "unexpected": true,
            "purpose": "The watch's heart-rate alert was its intended function. The lung cancer diagnosis was an incidental consequence of the ICD procedure the alert set in motion, outside anything the device was built to do."
          }
        },
        "provenance": {
          "kind": "legacy_record",
          "basis": "Preserved from the existing AIBD record; external sources were not rechecked.",
          "record_fields": [
            "unexpected",
            "purpose"
          ],
          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "partial"
      },
      "places[]": {
        "state": "value_present",
        "value": {
          "kind": "record_fields",
          "fields": {
            "location": "United Kingdom (authors at St George's Healthcare NHS Trust, London, and East Surrey Hospital, Redhill; the treating hospitals are not named)"
          }
        },
        "provenance": {
          "kind": "legacy_record",
          "basis": "Preserved from the existing AIBD record; external sources were not rechecked.",
          "record_fields": [
            "location"
          ],
          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "partial"
      },
      "purpose": {
        "state": "value_present",
        "value": {
          "kind": "record_fields",
          "fields": {
            "purpose": "The watch's heart-rate alert was its intended function. The lung cancer diagnosis was an incidental consequence of the ICD procedure the alert set in motion, outside anything the device was built to do."
          }
        },
        "provenance": {
          "kind": "legacy_record",
          "basis": "Preserved from the existing AIBD record; external sources were not rechecked.",
          "record_fields": [
            "purpose"
          ],
          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "partial"
      },
      "record_dates": {
        "state": "value_present",
        "value": {
          "kind": "record_fields",
          "fields": {
            "date_observed": "2022-01-04",
            "revisions": [
              {
                "date": "2026-10-20",
                "change": "Record drafted from the cited sources.",
                "editor": "AIBD"
              },
              {
                "date": "2026-10-21",
                "change": "Benefit type set to Improved Physical Health under Trustible's full taxonomy of 23 types; it was Improved Accessibility among the six first used.",
                "source": "https://trustible.ai/post/a-framework-for-measuring-the-benefits-of-ai/",
                "editor": "AIBD"
              },
              {
                "date": "2026-10-21",
                "change": "Added what the benefit is measured against from the cited sources.",
                "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8733372/",
                "editor": "AIBD"
              },
              {
                "date": "2026-10-21",
                "change": "Prose pass: a rating reason, account, purpose, the replication conditions, the system's part rewritten in shorter sentences with abbreviations expanded; facts, figures and quotations unchanged.",
                "editor": "AIBD"
              }
            ]
          }
        },
        "provenance": {
          "kind": "legacy_record",
          "basis": "Preserved from the existing AIBD record; external sources were not rechecked.",
          "record_fields": [
            "date_observed",
            "revisions"
          ],
          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "partial"
      },
      "replication.attempts[]": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "replication.conditions": {
        "state": "value_present",
        "value": {
          "kind": "record_fields",
          "fields": {
            "replication": {
              "produced_by": [
                "An asymptomatic wearer whose smartwatch alerted to an irregular rate above 180 bpm and who took it to his GP",
                "A cardiologist willing to diagnose from the watch's stored data when hospital tracings were silent",
                "A procedure (ICD insertion) whose routine follow-up imaging happened to cover the lung"
              ],
              "must_hold": [
                "The arrhythmia is one the watch records while hospital monitoring misses it",
                "The incidental finding is in the field of the post-procedure X-ray and caught early enough for curative surgery. The authors cite an estimated 1 in 25 cancers diagnosed incidentally."
              ],
              "echoes": []
            }
          }
        },
        "provenance": {
          "kind": "legacy_record",
          "basis": "Preserved from the existing AIBD record; external sources were not rechecked.",
          "record_fields": [
            "replication"
          ],
          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "partial"
      },
      "revision_history[]": {
        "state": "value_present",
        "value": {
          "kind": "record_fields",
          "fields": {
            "revisions": [
              {
                "date": "2026-10-20",
                "change": "Record drafted from the cited sources.",
                "editor": "AIBD"
              },
              {
                "date": "2026-10-21",
                "change": "Benefit type set to Improved Physical Health under Trustible's full taxonomy of 23 types; it was Improved Accessibility among the six first used.",
                "source": "https://trustible.ai/post/a-framework-for-measuring-the-benefits-of-ai/",
                "editor": "AIBD"
              },
              {
                "date": "2026-10-21",
                "change": "Added what the benefit is measured against from the cited sources.",
                "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8733372/",
                "editor": "AIBD"
              },
              {
                "date": "2026-10-21",
                "change": "Prose pass: a rating reason, account, purpose, the replication conditions, the system's part rewritten in shorter sentences with abbreviations expanded; facts, figures and quotations unchanged.",
                "editor": "AIBD"
              }
            ]
          }
        },
        "provenance": {
          "kind": "legacy_record",
          "basis": "Preserved from the existing AIBD record; external sources were not rechecked.",
          "record_fields": [
            "revisions"
          ],
          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "partial"
      },
      "sector": {
        "state": "value_present",
        "value": {
          "kind": "record_fields",
          "fields": {
            "domain": "Healthcare (cardiology; thoracic oncology)",
            "segment": "Consumer wearables"
          }
        },
        "provenance": {
          "kind": "legacy_record",
          "basis": "Preserved from the existing AIBD record; external sources were not rechecked.",
          "record_fields": [
            "domain",
            "segment"
          ],
          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "partial"
      },
      "sources[].access_version": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "sources[].citation_locator": {
        "state": "value_present",
        "value": {
          "kind": "record_fields",
          "fields": {
            "evidence": [
              {
                "kind": "case report",
                "citation": "Cole APC, Kar A, Nimako K, Smelt J (2022). Smartwatch helps detects lung cancer: Using personal technology to advance healthcare. JRSM Open 13(1):20542704211068651. doi:10.1177/20542704211068651 (PMC8733372).",
                "title": "Smartwatch helps detects lung cancer: Using personal technology to advance healthcare",
                "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8733372/",
                "date": "2022-01-04",
                "written_by": "independent",
                "quote": "was alerted by his smartwatch that his heart rate was irregular and exceeding 180 beats-per-minute, he remained asymptomatic throughout"
              },
              {
                "kind": "case report",
                "citation": "Cole APC et al. (2022), JRSM Open 13(1):20542704211068651, cardiac diagnosis.",
                "title": "Smartwatch helps detects lung cancer: Using personal technology to advance healthcare",
                "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8733372/",
                "date": "2022-01-04",
                "written_by": "independent",
                "quote": "Using the results from his smartwatch, the cardiologist diagnosed non-sustained ventricular tachycardia and he subsequently had an Implantable Cardiac Defibrillator inserted."
              },
              {
                "kind": "case report",
                "citation": "Cole APC et al. (2022), JRSM Open 13(1):20542704211068651, incidental finding.",
                "title": "Smartwatch helps detects lung cancer: Using personal technology to advance healthcare",
                "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8733372/",
                "date": "2022-01-04",
                "written_by": "independent",
                "quote": "A post procedure Chest X-ray ruled out iatrogenic pneumothorax but this incidentally showed an abnormality in his right upper lung zone"
              },
              {
                "kind": "case report",
                "citation": "Cole APC et al. (2022), JRSM Open 13(1):20542704211068651, conclusions.",
                "title": "Smartwatch helps detects lung cancer: Using personal technology to advance healthcare",
                "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8733372/",
                "date": "2022-01-04",
                "written_by": "independent",
                "quote": "it is likely without his smartwatch his lung adenocarcinoma would have continued to grow undetected, curative surgery may not have been an option"
              }
            ]
          }
        },
        "provenance": {
          "kind": "legacy_record",
          "basis": "Preserved from the existing AIBD record; external sources were not rechecked.",
          "record_fields": [
            "evidence"
          ],
          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "partial"
      },
      "sources[].id": {
        "state": "value_present",
        "value": {
          "kind": "identifiers",
          "identifiers": [
            "AIBD-0290-source-0001",
            "AIBD-0290-source-0002",
            "AIBD-0290-source-0003",
            "AIBD-0290-source-0004"
          ],
          "role": "Existing evidence items, in their original order"
        },
        "provenance": {
          "kind": "curatorial",
          "basis": "Stable within the fingerprinted record version; no source content or source review has been added.",
          "record_fields": [],
          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "complete"
      },
      "sources[].language": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "sources[].relationship": {
        "state": "value_present",
        "value": {
          "kind": "record_fields",
          "fields": {
            "evidence": [
              {
                "kind": "case report",
                "citation": "Cole APC, Kar A, Nimako K, Smelt J (2022). Smartwatch helps detects lung cancer: Using personal technology to advance healthcare. JRSM Open 13(1):20542704211068651. doi:10.1177/20542704211068651 (PMC8733372).",
                "title": "Smartwatch helps detects lung cancer: Using personal technology to advance healthcare",
                "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8733372/",
                "date": "2022-01-04",
                "written_by": "independent",
                "quote": "was alerted by his smartwatch that his heart rate was irregular and exceeding 180 beats-per-minute, he remained asymptomatic throughout"
              },
              {
                "kind": "case report",
                "citation": "Cole APC et al. (2022), JRSM Open 13(1):20542704211068651, cardiac diagnosis.",
                "title": "Smartwatch helps detects lung cancer: Using personal technology to advance healthcare",
                "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8733372/",
                "date": "2022-01-04",
                "written_by": "independent",
                "quote": "Using the results from his smartwatch, the cardiologist diagnosed non-sustained ventricular tachycardia and he subsequently had an Implantable Cardiac Defibrillator inserted."
              },
              {
                "kind": "case report",
                "citation": "Cole APC et al. (2022), JRSM Open 13(1):20542704211068651, incidental finding.",
                "title": "Smartwatch helps detects lung cancer: Using personal technology to advance healthcare",
                "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8733372/",
                "date": "2022-01-04",
                "written_by": "independent",
                "quote": "A post procedure Chest X-ray ruled out iatrogenic pneumothorax but this incidentally showed an abnormality in his right upper lung zone"
              },
              {
                "kind": "case report",
                "citation": "Cole APC et al. (2022), JRSM Open 13(1):20542704211068651, conclusions.",
                "title": "Smartwatch helps detects lung cancer: Using personal technology to advance healthcare",
                "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8733372/",
                "date": "2022-01-04",
                "written_by": "independent",
                "quote": "it is likely without his smartwatch his lung adenocarcinoma would have continued to grow undetected, curative surgery may not have been an option"
              }
            ]
          }
        },
        "provenance": {
          "kind": "legacy_record",
          "basis": "Preserved from the existing AIBD record; external sources were not rechecked.",
          "record_fields": [
            "evidence"
          ],
          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "partial"
      },
      "sources[].upstream_sources": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "strategic_assessments[]": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial",
        "family": "strategic assessments"
      },
      "summary": {
        "state": "value_present",
        "value": {
          "kind": "record_fields",
          "fields": {
            "summary": "A 58-year-old's smartwatch flagged an irregular rate over 180 bpm; NSVT was diagnosed from watch data, an ICD placed, and the post-procedure X-ray found a 28 mm lung adenocarcinoma, resected.",
            "account": "Cole, Kar, Nimako and Smelt reported a case in JRSM Open (4 January 2022; event dates not reported). They are of St George's Healthcare NHS Trust (thoracic surgery) and East Surrey Hospital (respiratory medicine) in England's National Health Service (NHS). A previously well 58-year-old non-smoker's smartwatch alerted him that his heart rate was irregular and exceeding 180 beats per minute while he felt nothing. His GP's 12-lead electrocardiogram (ECG) showed tachycardia without arrhythmia and he was admitted. Inpatient ECGs showed incomplete right bundle branch block and intermittent first-degree AV block but captured no significant arrhythmia. From the smartwatch results, the cardiologist diagnosed non-sustained ventricular tachycardia (NSVT) and an implantable cardioverter-defibrillator (ICD) was inserted. The post-procedure chest X-ray, taken to exclude pneumothorax, incidentally showed a right upper zone abnormality. Computed tomography (CT) found a 28 mm lesion, PET showed FDG-avid nodes, and biopsy showed lepidic adenocarcinoma, staged cT1c N0 M0. He had a video-assisted right upper lobectomy with node dissection and was discharged on day 10. The 35 mm tumor was staged pT2a pN0 M0 with clear margins. The nodes showed sarcoidosis and cardiac magnetic resonance imaging (MRI) found no cardiac sarcoid. The authors call this the first reported case of a smartwatch assisting the diagnosis of both NSVT and lung adenocarcinoma. The watch's brand and model are not stated."
          }
        },
        "provenance": {
          "kind": "legacy_record",
          "basis": "Preserved from the existing AIBD record; external sources were not rechecked.",
          "record_fields": [
            "summary",
            "account"
          ],
          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "partial"
      },
      "systems[].autonomy_permissions": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "systems[].component_role": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "systems[].deployment_configuration": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "systems[].inputs_outputs": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "systems[].model_name": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "systems[].model_version": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "systems[].product_name": {
        "state": "value_present",
        "value": {
          "kind": "record_fields",
          "fields": {
            "system": "Smartwatch heart-rate and irregular-rhythm alert (brand and model not stated)"
          }
        },
        "provenance": {
          "kind": "legacy_record",
          "basis": "Preserved from the existing AIBD record; external sources were not rechecked.",
          "record_fields": [
            "system"
          ],
          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "partial"
      },
      "systems[].provider": {
        "state": "value_present",
        "value": {
          "kind": "structured",
          "data": {
            "application_developer": "Not stated (the report does not name the device's maker)"
          }
        },
        "provenance": {
          "kind": "legacy_record",
          "basis": "Mapped from the existing case description without a new external source review.",
          "record_fields": [
            "developer"
          ],
          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "partial"
      },
      "taxonomy_crosswalks[]": {
        "state": "not_assessed",
        "review_state": "not_assessed",
        "coverage": "partial"
      },
      "title": {
        "state": "value_present",
        "value": {
          "kind": "record_fields",
          "fields": {
            "title": "Smartwatch alert for an irregular rate above 180 bpm leads to a ventricular tachycardia diagnosis, an ICD, and the incidental discovery and resection of a lung adenocarcinoma",
            "headline": "Smartwatch alert leads to an ICD and finds a lung adenocarcinoma"
          }
        },
        "provenance": {
          "kind": "legacy_record",
          "basis": "Preserved from the existing AIBD record; external sources were not rechecked.",
          "record_fields": [
            "title",
            "headline"
          ],
          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "partial"
      },
      "version": {
        "state": "value_present",
        "value": {
          "kind": "identifiers",
          "identifiers": [
            "edfbcdfdd559c6924d94147f530a4360f28243862f36b7b6080c175d330e770e"
          ],
          "role": "SHA-256 of normalized original case data"
        },
        "provenance": {
          "kind": "curatorial",
          "basis": "Deterministic content version assigned by the local migration.",
          "record_fields": [],
          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "complete"
      },
      "workflow": {
        "state": "value_present",
        "value": {
          "kind": "record_fields",
          "fields": {
            "account": "Cole, Kar, Nimako and Smelt reported a case in JRSM Open (4 January 2022; event dates not reported). They are of St George's Healthcare NHS Trust (thoracic surgery) and East Surrey Hospital (respiratory medicine) in England's National Health Service (NHS). A previously well 58-year-old non-smoker's smartwatch alerted him that his heart rate was irregular and exceeding 180 beats per minute while he felt nothing. His GP's 12-lead electrocardiogram (ECG) showed tachycardia without arrhythmia and he was admitted. Inpatient ECGs showed incomplete right bundle branch block and intermittent first-degree AV block but captured no significant arrhythmia. From the smartwatch results, the cardiologist diagnosed non-sustained ventricular tachycardia (NSVT) and an implantable cardioverter-defibrillator (ICD) was inserted. The post-procedure chest X-ray, taken to exclude pneumothorax, incidentally showed a right upper zone abnormality. Computed tomography (CT) found a 28 mm lesion, PET showed FDG-avid nodes, and biopsy showed lepidic adenocarcinoma, staged cT1c N0 M0. He had a video-assisted right upper lobectomy with node dissection and was discharged on day 10. The 35 mm tumor was staged pT2a pN0 M0 with clear margins. The nodes showed sarcoidosis and cardiac magnetic resonance imaging (MRI) found no cardiac sarcoid. The authors call this the first reported case of a smartwatch assisting the diagnosis of both NSVT and lung adenocarcinoma. The watch's brand and model are not stated.",
            "replication": {
              "produced_by": [
                "An asymptomatic wearer whose smartwatch alerted to an irregular rate above 180 bpm and who took it to his GP",
                "A cardiologist willing to diagnose from the watch's stored data when hospital tracings were silent",
                "A procedure (ICD insertion) whose routine follow-up imaging happened to cover the lung"
              ],
              "must_hold": [
                "The arrhythmia is one the watch records while hospital monitoring misses it",
                "The incidental finding is in the field of the post-procedure X-ray and caught early enough for curative surgery. The authors cite an estimated 1 in 25 cancers diagnosed incidentally."
              ],
              "echoes": []
            }
          }
        },
        "provenance": {
          "kind": "legacy_record",
          "basis": "Preserved from the existing AIBD record; external sources were not rechecked.",
          "record_fields": [
            "account",
            "replication"
          ],
          "source_refs": []
        },
        "review_state": "record_mapped",
        "coverage": "partial"
      }
    },
    "summary": {
      "total": 91,
      "addressed": 91,
      "known": 28,
      "reviewed": 0,
      "record_mapped": 28,
      "not_assessed": 63,
      "complete": false,
      "by_state": {
        "value_present": 28,
        "not_reported": 0,
        "unresolved": 0,
        "not_assessed": 63,
        "not_applicable": 0,
        "withheld": 0,
        "source_unavailable": 0
      }
    }
  }
}