Remote Monitoring of the Performance Status and Burden of Symptoms of Patients With Gastrointestinal Cancer Via a Consumer-Based Activity Tracker: Quantitative Cohort Study (2024)

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Remote Monitoring of the Performance Status and Burden of Symptoms of Patients With Gastrointestinal Cancer Via a Consumer-Based Activity Tracker: Quantitative Cohort Study (1)

Author(s):

Alireza Ghods , PhD 1 ,

Armin Shahrokni , MPH, MD 2 , ,

Hassan Ghasemzadeh , PhD 1 ,

Diane Cook , PhD 1

Editor(s):

Gunther Eysenbach

Other contributor(s):

Dong Woon Han (Reviewer),

Hamed Mehdizadeh (Reviewer)

Publication date (Electronic): 26 November 2021

Journal: JMIR Cancer

Publisher: JMIR Publications

Keywords: step count, performance status, symptom, wearable, activity tracker, gastrointestinal cancer, monitoring, cancer, gastrointestinal, burden

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      Abstract

      Background

      The number of older patients with gastrointestinal cancer is increasing due to an aging global population. Minimizing reliance on an in-clinic patient performance status test to determine a patient’s prognosis and course of treatment can improve resource utilization. Further, current performance status measurements cannot capture patients' constant changes. These measurements also rely on self-reports, which are subjective and subject to bias. Real-time monitoring of patients' activities may allow for a more accurate assessment of patients’ performance status while minimizing resource utilization.

      Objective

      This study investigates the validity of consumer-based activity trackers for monitoring the performance status of patients with gastrointestinal cancer.

      Methods

      A total of 27 consenting patients (63% male, median age 58 years) wore a consumer-based activity tracker 7 days before chemotherapy and 14 days after receiving their first treatment. The provider assessed patients using the Eastern Cooperative Oncology Group Performance Status (ECOG-PS) scale and Memorial Symptom Assessment Scale-Short Form (MSAS-SF) before and after chemotherapy visits. The statistical correlations between ECOG-PS and MSAS-SF scores and patients’ daily step counts were assessed.

      Results

      The daily step counts yielded the highest correlation with the patients' ECOG-PS scores after chemotherapy ( P<.001). The patients with higher ECOG-PS scores experienced a higher fluctuation in their step counts. The patients who walked more prechemotherapy (mean 6071 steps per day) and postchemotherapy (mean 5930 steps per day) had a lower MSAS-SF score (lower burden of symptoms) compared to patients who walked less prechemotherapy (mean 5205 steps per day) and postchemotherapy (mean 4437 steps per day).

      Conclusions

      This study demonstrates the feasibility of using inexpensive, consumer-based activity trackers for the remote monitoring of performance status in the gastrointestinal cancer population. The findings need to be validated in a larger population for generalizability.

      Related collections

      JMIR Publications

      Most cited references28

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      Toxicity and response criteria of the Eastern Cooperative Oncology Group.

      Martin M. Oken, Richard H. Creech, Douglass C. Tormey (1982)

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        Global Burden of 5 Major Types Of Gastrointestinal Cancer

        Melina Arnold, Christian C Abnet, Rachel E Neale (2020)

        There were an estimated 4.8 million new cases of gastrointestinal (GI) cancers and 3.4 million related deaths, worldwide, in 2018. GI cancers account for 26% of the global cancer incidence and 35% of all cancer-related deaths. We investigated the global burden from the 5 major GI cancers, as well as geographic and temporal trends in cancer-specific incidence and mortality.

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          The validity of consumer-level, activity monitors in healthy adults worn in free-living conditions: a cross-sectional study

          Ty Ferguson, Alex V Rowlands, Tim Olds (2015)

          Background Technological advances have seen a burgeoning industry for accelerometer-based wearable activity monitors targeted at the consumer market. The purpose of this study was to determine the convergent validity of a selection of consumer-level accelerometer-based activity monitors. Methods 21 healthy adults wore seven consumer-level activity monitors (Fitbit One, Fitbit Zip, Jawbone UP, Misfit Shine, Nike Fuelband, Striiv Smart Pedometer and Withings Pulse) and two research-grade accelerometers/multi-sensor devices (BodyMedia SenseWear, and ActiGraph GT3X+) for 48-hours. Participants went about their daily life in free-living conditions during data collection. The validity of the consumer-level activity monitors relative to the research devices for step count, moderate to vigorous physical activity (MVPA), sleep and total daily energy expenditure (TDEE) was quantified using Bland-Altman analysis, median absolute difference and Pearson’s correlation. Results All consumer-level activity monitors correlated strongly (r > 0.8) with research-grade devices for step count and sleep time, but only moderately-to-strongly for TDEE (r = 0.74-0.81) and MVPA (r = 0.52-0.91). Median absolute differences were generally modest for sleep and steps (<10% of research device mean values for the majority of devices) moderate for TDEE (<30% of research device mean values), and large for MVPA (26-298%). Across the constructs examined, the Fitbit One, Fitbit Zip and Withings Pulse performed most strongly. Conclusions In free-living conditions, the consumer-level activity monitors showed strong validity for the measurement of steps and sleep duration, and moderate valid for measurement of TDEE and MVPA. Validity for each construct ranged widely between devices, with the Fitbit One, Fitbit Zip and Withings Pulse being the strongest performers.

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            Author and article information

            Contributors

            Armin Shahrokni:

            ORCID: https://orcid.org/0000-0001-9828-9997

            Geriatrics / Gastrointestinal Oncology ServiceMemorial Sloan-Kettering Cancer CenterBox 2051275 York AveNew York, NY, 10065United States1 646 888 31811 646 888 3250shahroka@mskcc.org

            Journal

            Journal ID (nlm-ta): JMIR Cancer

            Journal ID (iso-abbrev): JMIR Cancer

            Journal ID (publisher-id): JC

            Title: JMIR Cancer

            Publisher: JMIR Publications (Toronto, Canada )

            ISSN (Electronic): 2369-1999

            Publication date Collection: Oct-Dec 2021

            Publication date (Electronic): 26 November 2021

            Volume: 7

            Issue: 4

            Electronic Location Identifier: e22931

            Affiliations

            [1 ] School of Electrical Engineering and Computer Science Washington State University Pullman, WA United States

            [2 ] Geriatrics / Gastrointestinal Oncology Service Memorial Sloan-Kettering Cancer Center New York, NY United States

            Author notes

            Corresponding Author: Armin Shahrokni shahroka@ 123456mskcc.org

            Author information
            Article

            Publisher ID: v7i4e22931

            DOI: 10.2196/22931

            PMC ID: 8665393

            PubMed ID: 34842527

            SO-VID: d896111d-7d60-4773-af1d-f7cc647643f6

            Copyright © ©Alireza Ghods, Armin Shahrokni, Hassan Ghasemzadeh, Diane Cook. Originally published in JMIR Cancer (https://cancer.jmir.org), 26.11.2021.

            License:

            This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Cancer, is properly cited. The complete bibliographic information, a link to the original publication on https://cancer.jmir.org/, as well as this copyright and license information must be included.

            History

            Date received : 27 July 2020

            Date revision requested : 18 October 2020

            Date revision received : 14 December 2020

            Date accepted : 25 September 2021

            Categories

            Subject: Original Paper

            Subject: Original Paper


            Keywords: step count,performance status,symptom,wearable,activity tracker,gastrointestinal cancer,monitoring,cancer,gastrointestinal,burden

            Data availability:

            Keywords: step count, performance status, symptom, wearable, activity tracker, gastrointestinal cancer, monitoring, cancer, gastrointestinal, burden

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            Remote Monitoring of the Performance Status and Burden of Symptoms of Patients With Gastrointestinal Cancer Via a Consumer-Based Activity Tracker: Quantitative Cohort Study (2024)
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