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  • Perspective
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Applied body-fluid analysis by wearable devices

Nature volume 636, pages 57–68 (2024)Cite this article

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Abstract

Wearable sensors are a recent paradigm in healthcare, enabling continuous, decentralized, and non- or minimally invasive monitoring of health and disease. Continuous measurements yield information-rich time series of physiological data that are holistic and clinically meaningful. Although most wearable sensors were initially restricted to biophysical measurements, the next generation of wearable devices is now emerging that enable biochemical monitoring of both small and large molecules in a variety of body fluids, such as sweat, breath, saliva, tears and interstitial fluid. Rapidly evolving data analysis and decision-making technologies through artificial intelligence has accelerated the application of wearables around the world. Although recent pilot trials have demonstrated the clinical applicability of these wearable devices, their widespread adoption will require large-scale validation across various conditions, ethical consideration and sociocultural acceptance. Successful translation of wearable devices from laboratory prototypes into clinical tools will further require a comprehensive transitional environment involving all stakeholders. The wearable device platforms must gain acceptance among different user groups, add clinical value for various medical indications, be eligible for reimbursements and contribute to public health initiatives. In this Perspective, we review state-of-the-art wearable devices for body-fluid analysis and their translation into clinical applications, and provide insight into their clinical purpose.

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Fig. 1: The anatomy of wearable sensing platforms for body-fluid analysis.
Fig. 2: Current wearable sensing devices for various body fluids in context of the human life cycle.
Fig. 3: The development of digital endpoints.
Fig. 4: Applied body-fluid analysis by wearable devices in clinical medicine.

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Acknowledgements

N.B. acknowledges an Early-career Fellowship from Collegium Helveticum, Zurich (CH) and a MedLab Fellowship from ETH Zurich (CH). C.D. acknowledges the OrChESTRA project from the European Union’s Horizon Europe’s research and innovation programme under grant agreement number 101079473. The language editing was conducted by A. Curtis.

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Authors and Affiliations

  1. Collegium Helveticum, Zurich, Switzerland

    Noé Brasier

  2. Institute of Translational Medicine, ETH Zurich, Zurich, Switzerland

    Noé Brasier & Jörg Goldhahn

  3. Department of Chemical and Nano Engineering, University of California San Diego, La Jolla, CA, USA

    Joseph Wang

  4. Andrew and Peggy Cherng Department of Medical Engineering, Division of Engineering and Applied Science, California Institute of Technology, Pasadena, CA, USA

    Wei Gao & Juliane R. Sempionatto

  5. FIT Freiburg Center for Interactive Materials and Bioinspired Technologies, University of Freiburg, Freiburg, Germany

    Can Dincer & H. Ceren Ates

  6. Department of Microsystems Engineering (IMTEK), University of Freiburg, Freiburg, Germany

    Can Dincer & H. Ceren Ates

  7. Munich Institute of Biomedical Engineering - MIBE, Department of Electrical Engineering, TUM School of Computation, Information and Technology, Technical University of Munich, Munich, Germany

    Can Dincer

  8. Department of Bioengineering, Imperial College London, London, UK

    Firat Güder & Selin Olenik

  9. European Patients Academy on Therapeutic Innovation (EUPATI CH), Zurich, Switzerland

    Ivo Schauwecker

  10. Digital Trial Innovation Platform (dtip), ETH Zurich, Zurich, Switzerland

    Ivo Schauwecker, Dietmar Schaffarczyk & Jörg Goldhahn

  11. Health Ethics and Policy Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland

    Effy Vayena

  12. University Children’s Hospital Basel UKBB, Basel, Switzerland

    Nicole Ritz

  13. Paediatric Infectious Diseases and Vaccinology, University Children’s Hospital Basel, Basel, Switzerland

    Nicole Ritz

  14. Department of Paediatrics and Paediatric Infectious Diseases, Children’s Hospital, Lucerne Cantonal Hospital, Lucerne, Switzerland

    Nicole Ritz

  15. Department of Health Systems, Impact Evaluation and Policy, Ifakara Health Institute, Ifakara, Tanzania

    Maja Weisser & Sally Mtenga

  16. Swiss Tropical and Public Health Institute, Allschwil, Switzerland

    Maja Weisser

  17. Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland

    Maja Weisser

  18. Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, IL, USA

    Roozbeh Ghaffari & John A. Rogers

  19. Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA

    Roozbeh Ghaffari & John A. Rogers

  20. Epicore Biosystems Inc, Cambridge, MA, USA

    Roozbeh Ghaffari

  21. Department of Materials Science and Engineering, Northwestern University, Evanston, IL, USA

    John A. Rogers

  22. Department of Mechanical Engineering, Northwestern University, Evanston, IL, USA

    John A. Rogers

  23. Department of Chemistry, Northwestern University, Evanston, IL, USA

    John A. Rogers

  24. Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Evanston, IL, USA

    John A. Rogers

Authors
  1. Noé Brasier
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  2. Joseph Wang
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  3. Wei Gao
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Contributions

All authors contributed to writing and reviewing the paper. Specifically, N.B., J.W., C.D. and F.G. planned and outlined the paper. N.B. drafted the figures. W.G., J.W., C.D. and H.C.A. contributed to section ‘Wearable devices for body-fluid analysis’. I.S., J.G., N.B., N.R., M.W. and S.M. contributed to section ‘Translation and healthcare implementation’. J.R.S., F.G., S.O., E.V., D.S., R.G. and J.A.R. contributed to the section ‘The environment required for mainstream adoption’. All authors contributed to editing and finalizing the paper.

Corresponding author

Correspondence to Noé Brasier.

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Competing interests

R.G. is co-founder and CEO of Epicore Biosystems. J.W. is founder and chief scientific officer at Persperion. W.G. is co-founder and advisor at Persperity Health. E.V. serves in the ethics advisory panel of Merck AG and in the ethics advisory panel of IQVIA. J.A.R. is a co-founder and advisor to Sibel Health, Sonica and Epicore Biosystems, and holds patents associated with these companies. The other authors declare no competing interests.

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Nature thanks Sam Emaminejad, Chwee Teck Lim and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

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Brasier, N., Wang, J., Gao, W. et al. Applied body-fluid analysis by wearable devices. Nature 636, 57–68 (2024). https://doi.org/10.1038/s41586-024-08249-4

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