Remote Activity Monitoring and Electronic Patient-Reported Outcomes Collection During Radiotherapy for Head and Neck Cancer: A Pilot Study.

Authors

• Nitin Ohri
• Voichita Bar-Ad
• Christian Fernandez
• Christine Rakowski
• Benjamin E Leiby
• Gerard Hoeltzel
• Anna Sung
• Nida Zubair
• Camilo Henao
• Adam P Dicker

Publication/Presentation Date

4-1-2023

Abstract

PURPOSE: Modern wearable devices provide objective and continuous activity data that could be leveraged to enhance cancer care. We prospectively studied the feasibility of monitoring physical activity using a commercial wearable device and collecting electronic patient-reported outcomes (ePROs) during radiotherapy (RT) for head and neck cancer (HNC).

METHODS: Patients planned for a course of external beam RT with curative intent for HNC were instructed to use a commercial fitness tracker throughout the RT course. During weekly clinic visits, physician-scored adverse events were recorded during using Common Terminology Criteria for Adverse Events version 4.0, and patients completed ePRO surveys using a clinic tablet or computer. Feasibility of activity monitoring was defined as collection of step data for at least 80% of the RT course for at least 80% of patients. Exploratory analyses described associations between step counts, ePROs, and clinical events.

RESULTS: Twenty-nine patients with HNC were enrolled and had analyzable data. Overall, step data were recorded on 70% of the days during patients' RT courses, and there were only 11 patients (38%) for whom step data were collected on at least 80% of days during RT. Mixed effects linear regression models demonstrated declines in daily step counts and worsening of most PROs during RT. Cox proportional hazards models revealed a potential association between high daily step counts and both reduced risk of feeding tube placement (hazard ratio [HR], 0.87 per 1,000 steps,

CONCLUSION: We did not achieve our feasibility end point, suggesting that rigorous workflows are required to achieve continuous activity monitoring during RT. Although limited by a modest sample size, our findings are consistent with previous reports indicating that wearable device data can help identify patients who are at risk for unplanned hospitalization.

Volume

7

First Page

2200132

Last Page

2200132

ISSN

2473-4276

Published In/Presented At

Ohri, N., Bar-Ad, V., Fernandez, C., Rakowski, C., Leiby, B. E., Hoeltzel, G., Sung, A., Zubair, N., Henao, C., & Dicker, A. P. (2023). Remote Activity Monitoring and Electronic Patient-Reported Outcomes Collection During Radiotherapy for Head and Neck Cancer: A Pilot Study. JCO clinical cancer informatics, 7, e2200132. https://doi.org/10.1200/CCI.22.00132

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

37071027

Department(s)

Administration and Leadership

Document Type

Article