Smart Ring in Clinical Medicine: A Systematic Review
Abstract
Background: Smart rings enable continuous physiological monitoring through finger-worn sensors. Despite growing consumer adoption, their clinical utility beyond sleep tracking remains unclear.
Objectives: To systematically review evidence for smart ring applications in clinical medicine, assess measurement accuracy, and evaluate clinical outcomes.
Methods: We searched PubMed/MEDLINE, Embase, Cochrane Library, and Web of Science through 31 July 2025. Two reviewers independently screened studies and extracted data. Risk of bias was assessed using ROBINS-I and RoB 2.0.
Results: From 862 citations, 107 studies met inclusion criteria including approximately 100,000 participants. Studies were equally distributed between sleep (47.7%) and non-sleep applications (52.3%). Smart rings demonstrated high accuracy: heart rate r2 = 0.996, heart rate variability r2 = 0.980, and sleep detection 93-96% sensitivity. Predictive capabilities included COVID-19 detection 2.75 days pre-symptom (82% sensitivity), inflammatory bowel disease flare prediction 7 weeks early (72% accuracy), and bipolar episode detection 3-7 days early (79% sensitivity). However, 65% of studies had moderate-to-high bias risk. Limitations included small samples, proprietary algorithms (89%), poor diversity reporting (35%), and declining adherence (80% at 3 months to 43% at 12 months).
Conclusion: Smart rings have evolved into clinical tools capable of early disease detection. However, algorithmic opacity, population…
How strong is the evidence?
Evidence Hub reads this as a systematic review. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 100,000 participants or records.
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