This review assesses wearable sensors for the continuous biochemical monitoring of body fluids such as sweat, saliva and interstitial fluid, confirming their potential for decentralised healthcare through pilot trials. It emphasises that successful clinical translation depends on large-scale validation and the integration of ethical and sociocultural considerations.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
This review establishes that microsampling across blood, saliva, urine and stool matrices offers validated workflows and regulatory recognition for human biomonitoring comparable to conventional methods. It finds that these decentralised approaches enhance participant acceptability and enable screening in remote or low-resource settings.
This narrative review finds that saliva is best suited to repeated neuroendocrine and metabolic measurements during exercise, sweat is most mature for electrolyte and sweat-rate monitoring with wearable compatibility, and exhaled breath offers access to volatile metabolism but remains instrumentally demanding. Each matrix requires matching to a defined clinical or exercise question with matrix-specific validation before translational use.
Decentralised monitoring of people with type 2 diabetes using continuous glucose monitoring and a hybrid smartwatch was feasible, with high participant retention and successful collection of glucose, heart rate, activity, sleep and GPS data via a study app.
A fully remote decentralised clinical trial in Danish adults with type 2 diabetes demonstrated operational feasibility with rapid recruitment, high retention (87 percent), and excellent adherence to continuous glucose monitoring (95 percent achieving ≥70 percent data coverage) and telemedicine visits (97 percent). Activity tracker adherence was poor (12 percent) due to technical issues, but remote safety monitoring was effective with no unexpected adverse events, supporting the viability of remote diabetes management.
Wearable-derived digital biomarkers have been accepted by regulatory agencies as endpoints in clinical trials for Duchenne muscular dystrophy, showing their potential to support decentralised diagnostics through patient-centric monitoring. This matters because it enables more sensitive and continuous assessment of disease progression outside clinical settings.