Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
All relevant data are within the paper, and those are available at the corresponding author. For a better visualization of the key figures, you can visit the following link: https://github.com/AntonioAlbin-dev/wearable_healthcare (accessed on 27 October 2022).
Currently, wearable technology is present in different fields that aim to satisfy our needs in daily life, including the improvement of our health in general, the monitoring of patient health, ensuring the safety of people in the workplace or supporting athlete training. The objective of this bibliometric analysis is to examine and map the scientific advances in wearable technologies in healthcare, as well as to identify future challenges within this field and put forward some proposals to address them. In order to achieve this objective, a search of the most recent related literature was carried out in the Scopus database. Our results show that the research can be divided into two periods: before 2013, it focused on design and development of sensors and wearable systems from an engineering perspective and, since 2013, it has focused on the application of this technology to monitoring health and well-being in general, and in alignment with the Sustainable Development Goals wherever feasible. Our results reveal that the United States has been the country with the highest publication rates, with 208 articles (34.7%). The University of California, Los Angeles, is the institution with the most studies on this topic, 19 (3.1%). Sensors journal (Switzerland) is the platform with the most studies on the subject, 51 (8.5%), and has one of the highest citation rates, 1461. We put forward an analysis of keywords and, more specifically, a pennant chart to illustrate the trends in this field of research, prioritizing the area of data collection through wearable sensors, smart clothing and other forms of discrete collection of physiological data.
Keywords: wearable technologies, healthcare, wearable sensors, bibliometric analysis, Sustainable Development Goals, VOSviewer, CiteSpace, scientific visualization
Currently, electronic health (eHealth) is understood as an emerging field of medical informatics, referring to the organization and provision of health services and information using the Internet and related technologies for the improvement of healthcare at all levels [1]. eHealth, made up of the set of Information and Communication Technologies (ICTs) that are used for prevention, diagnosis, treatment, monitoring and health management, is considered one of the fastest growing areas in health, saving costs in healthcare systems and improving effectiveness and efficiency [2]. Since 2016, with the World Health Organization’s EB 142/20 report, the WHO’s executive board has considered the use of mobile health (mHealth) to be of vital importance—that is, mobile wireless technologies for public health, specifically in health monitoring. This report declares the usefulness of mHealth in increasing access to health information, services and skills, and it also makes clear how these tools promote positive changes in health behavior and disease control [3].
Subsequently, in 2018, the WHO expanded the range of coverage of mHealth to include the use of other digital technologies for public health. Resolution WHA71.7 urged member states to prioritize the design and use of digital technologies as a mechanism for promoting Universal Health Coverage and the Sustainable Development Goals [4,5].
This type of technology is perfectly aligned with Sustainable Development Goal (SDG) 3 (Health and Well-being). Currently, there are a multitude of wearable devices capable of measuring physiological data such as heart rate, steps, blood oxygen levels or even electrocardiograms. All these data can be used to analyze the health status of the user and improve their well-being, allowing synergy with SDG 3.
An increasing number of these types of devices are designed in a sustainable way by promoting repair, mending or recycling, the use of the collaborative economy, ensuring the second life of products or contributing to a circular wearable device system. In this case, it is aligned with SDG 11 (sustainable cities and communities) and SDG 12 (responsible production and consumption).
In this way, notable progress is observed from initiatives such as the European Commission’s eHealth Action Plan 2012–2020. Although it already included a special approach to mHealth, this Plan was more focused on offering patients and healthcare workers better access to the most recent initiatives mentioned above [6] in connection to other types of information technologies and devices (eHealth) in the healthcare system.
These developments are emerging against the backdrop of population aging, which can be described as a global phenomenon. Every country in the world is experiencing an exponential growth in the proportion of older people. While in 2019 the figures indicated that there were around 703 million people aged 65 or over in the world, it is expected that by 2050 the number of elderly people will double, reaching 1500 million [7]. Wearable technologies (WT) make up a set of devices that are an integral part of providing solutions in healthcare to a world population characterized by notable demographic aging [8].
Recently, trends in research have broadened their focus, and numerous studies have been conducted evaluating the impact of WT in different populations and with different objectives. Thus, depending on their role, we can find studies on WT aimed at preventing diseases and injuries [9,10,11,12,13]; diagnostic support systems [14,15,16,17]; rehabilitation [18,19,20,21,22]; and mainly for health surveillance and monitoring [23,24].
Currently, the importance of having precise control of physiological measurements, such as heart rate variability and heart beats per minute, has become clear. Abnormal changes in these indicators can be an early sign of respiratory infections such as those caused by the SARS-CoV-2 virus (COVID-19) [25]. This information can be easily collected by wearable wrist biometric devices and smartphones [26].
Likewise, there is ever more research on the applications of wearable devices as support systems in detection, diagnosis, acquisition and processing of data related to disorders and chronic conditions in populations with different age ranges [27,28,29,30].
Similarly, electrochemical sensors and wearable biosensors are becoming increasingly important in the field of non-invasive or minimally invasive monitoring of the health status of individuals. This may be mainly due to certain specific characteristics such as their performance, inherent miniaturization, low cost and wide applicability [31]. In particular, wearable chemical sensors offer the opportunity to monitor (bio)chemical parameters through body biofluids. Another advantage of these systems is the possibility of directly converting (bio)chemical information to the digital domain, which facilitates the interpretation of data by professionals from different areas [32]. Biological fluids provide clinically useful information on the health status of individuals. In these non-invasive or minimally invasive samples, body fluids that are easily accessible, such as saliva, sweat, blood or urine, have been used [33,34].
These data on biochemical activity, collected by discrete and long-term monitoring, will be essential for the control of many chronic diseases such as diabetes, gout, or Parkinson’s disease [35].
Due to this significant increase in scientific production in the field of wearable technology in healthcare (WTH), it seems relevant to carry out a bibliometric study with the aim of outlining the evolution of the intellectual structure of this area of knowledge over time. Our goal is to analyze and map scientific advancements in WTH, identify future challenges within the field and put forward some proposals to address them. More specifically, this paper tries to answer the following research questions:
Specific Research Question (SRQ) 1: How many specific publications are there on this subject in Scopus and what trends can be observed?