Wearable devices—smartwatches, patches, rings, chest bands, and even smart glasses—are being tested in 174 systematic reviews for their ability to spot disease early, nudge people into healthier habits, and monitor patients before and after surgery. This matters because the evidence on wearables is scattered and inconsistent. Clinicians and health commissioners need to know which devices actually work, for which conditions, and in which settings. The researchers mapped the existing systematic reviews to identify where the evidence is strong and where gaps remain. For early diagnosis, the reviews covered cardiovascular, mental health, neurological, and infectious diseases. For behaviour change, most focused on physical activity, with some on sleep, diet, smoking, and alcohol. For surgical care, the bulk of evidence concerned post-operative monitoring after orthopaedic procedures. If this evidence map succeeds, it will give the NHS and other health providers a clear, visual guide to where wearables are proven effective and where more research is needed. That could accelerate adoption of reliable devices for remote monitoring, reduce unnecessary hospital visits, and help people manage their own health at home. It will also highlight neglected areas—such as pre-operative use or conditions beyond heart disease—where future trials should focus.
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Background Wearable devices (any type of electronic device designed to be worn on or attached to the body capable of measuring physiological or physical parameters) are increasingly used by the general public and healthcare professionals to monitor general health and facilitate earlier diagnoses. We aimed to assess the current availability of systematic review evidence on the use of ambulatory (used while participants went about their daily life) wearable devices for early detection of primary diseases (use case (UC)1), the promotion of behaviour changes to improve health (UC2) and pre- and post-operative care (UC3). Methods We searched Ovid Medline and Ovid Embase for articles published from 1 January 2020 to 21 May 2025. We deemed studies eligible for inclusion if they met our criteria for a systematic review and were looking at the use of ambulatory wearables for (UC1) ‘clinical effectiveness’ (whether the wearable leads to an earlier diagnosis) and/or ‘clinical accuracy’ (how accurate the wearable is at leading to a diagnosis); (UC2) a direct measure of a health behaviour such as physical activity; and (UC3) pre-operative or post-operative monitoring. Titles/abstracts were assessed for eligibility in duplicate with conflicts resolved by committee, and full texts screened independently with exclusions checked by another team member. Where the systematic review included wearables intervention(s), we extracted their search information, eligibility criteria, and the bottom-line results/conclusions from the review. Where the review included a wider intervention that included wearables, we extracted less information. All included systematic reviews were plotted on visual Evidence Gap Maps, using EPPI Mapper. Results We included 174 systematic reviews: 33, 110 and 23 for UC1, UC2 and UC3 respectively (2 reviews were included for both UC2 and UC3). 101 were for wider interventions that included ambulatory wearables and 73 were explicitly for ambulatory wearable interventions. The wearables included in the reviews were smartwatches and wristbands; smart glasses, clothes, rings, patches, armbands, chest, thigh and ankle bands; face masks, pendants and knee- and ear-worn sensors. The types of devices were single lead and portable ECGs, accelerometers/gyroscopes, electrogoniometers, pedometers, GPS, fitness and activity trackers, heart rate monitors and polyplethysmograph non-invasive cuffless devices. For UC1, the primary health conditions included cardiovascular, mental health, neurological, infectious and other diseases. For UC2 the health behaviours were mainly physical activity, but also sedentary, sleep and dietary behaviour and smoking/alcohol consumption. For UC3 most reviews were for post-operative monitoring following orthopaedic surgery, with some general surgery.
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