Marijn Eversdijk

Smartwatch detects cardiac arrest, but … “I’d rather not wear it to bed”

Science Works 4 minutes Femke Trommels

Every year in the Netherlands, 17,000 people suffer a life-threatening cardiac arrest, and nearly 7,000 of them are alone when they do. In 2022, the Hartstichting (heart foundation) donated EUR 1.9 million towards developing a smartwatch that can both detect when its wearer is going into cardiac arrest and efficiently call in assistance. For Tilburg University, Marijn Eversdijk is involved in this extensive research project; he studies the psychological impact and ethical aspects of this new technology. What do users want? What ethical preconditions must be met? “The technological scope is vast. It is up to us to decide how far we want things to go.”

Even before starting a PhD project at Tilburg University in the summer of 2022, Marijn Eversdijk had gained clinical experience and researched smart technology and motion sensors. “I enjoy exploring technological innovations and probe psychological aspects of how people want to use them. The speed of technological developments is beyond fast, and while the ethical debate seems to lag behind a bit, ethical awareness is absolutely critical.”

marijn eversdijk

Ethical awareness of the use of technology is absolutely critical

Marijn Eversdijk

Fotografie: Gerdien Wolthaus Paauw

Understanding user needs

At the Tilburg University Center of Research on Psychological disorders and Somatic diseases (CoRPS) Eversdijk’s research is part of a wide range of cardio-psychological studies, particularly of the connection between lifestyle and psychological factors, such as stress, and the development and treatment of heart conditions. “The clear relevance of this research is that it fills a gap in the evolution of technological tools in healthcare,” Eversdijk argues. “To make the smartwatch a success, we also need to understand what needs users have. How do people want to use the watch? And what is it they don’t want? What are their concerns? Sometimes the outcomes surprise even the developers.”


A key objective of Eversdijk’s research is to identify groups of people who stand to benefit most from the new smartwatch. “High-risk patients come to mind first: these patients have suffered trauma, like a heart attack, before. Or single senior citizens, often women, who are more likely to be alone when they suffer cardiac arrest. We also involve more stakeholders, like other potential users among the general public, doctors, and other healthcare professionals. How, for example, do we prevent notifications on the smartwatch from increasing the number of people who visit doctors? How do we make sure the watch isn’t too sensitive, but picks up the crucial signals at the right time? Who is responsible for any false notifications? While we can’t guarantee that this watch will reduce the workload in healthcare, we definitely don’t want to achieve the opposite effect.”

People don’t want to be confronted with their condition and vulnerability all day long

Deciding together

“We aim to come up with a product that keeps physical and psychological discomfort to a minimum. That is why the entire development and design process is infused with ethics. The fun part is that users help us decide how the end product works. We’re doing interviews to find out what people want and what their concerns are. One example, given the sensitivity of GPS data, is the need to ensure privacy. Some people have practical wishes, like longer battery life, but essential psychological issues also surface. How can we ensure people aren’t confronted with their condition and vulnerability all day long? Learning from people who’ve been using a smartwatch for a while [BD1] and know what it’s like to have a heart condition offers valuable input to designers. This enables us to design a product the target demographic has a real use for.”

It would be gratifying if this product could give vulnerable people the security they’re looking for

Personal choice

“Research shows that people who have suffered cardiac arrest experience anxiety. And not just them, but the people close to them, too. Do you feel uneasy leaving home to do some shopping when you know your partner has a serious heart condition? Maybe you won’t when you know they’re being looked after while you’re away. It would be gratifying if this product could give vulnerable people the security they’re looking for and enable them to stay active.”

“Research conducted by our cardio group also shows that lifestyle plays a key role: heart conditions are worsened by inactivity and stress. Then again, improving quality of life is not an end in itself. Users’ personal choice is what fascinates me most about this project. Possibilities abound, but in the end it’s up to people themselves to decide how far they are prepared to let technology go. I sometimes speak elderly people who are happy to wear the watch during the day but prefer to take it off at night because they can live with the idea of dying in their sleep.”

About the research project

Marijn Eversdijk’s research is part of the BECA project (BEating Cardiac Arrest). This project was started to increase survival rates among people who suffer cardiac arrest when they are alone. Funded by the Hartstichting, the research is conducted by a consortium consisting of TU/Eindhoven, Stan B.V., and Philips for technology, and the cardiology departments of AMC Amsterdam and Catharina Hospital Eindhoven for scientific cardiological knowledge. The AMC Medical Ethics department is also involved in Eversdijk’s project. Oriented towards the humanities and social sciences, Tilburg University generates knowledge of ethical and psychological facets of heart conditions and the use of technology. Eversdijk’s PhD research is supervised by Dr. Mirela Habibovic and Professor Willem Johan (Wijo) Kop of Tilburg University and Dr. Marieke Bak of the AMC Ethics department.

Date of publication: 26 January 2023