A pilot study of a wearable monitoring system as an adjunct to geriatric assessment in older adults with cancer.
Published in Journal of Clinical Oncology, 2020
Background: Advances in health technology provide potential tools that can aid in assessing and monitoring the functional status of the growing older adult population diagnosed with cancer. We piloted a novel wearable monitoring platform, Sensing in At-Risk Populations (SARP), which consists of a smartwatch, software application for health monitoring, and a central data processing and analytics engine.
Methods: This is a prospective single center, single arm study, utilizing the SARP platform to risk stratify older adults with cancer and determine correlation with treatment-related adverse events and healthcare utilization. Pts age ≥60 undergoing active treatment, were offered participation. Pts were instructed to wear the smartwatch for ≥7 days. We used Kruskal-Wallis to correlate wearable data with clinical outcomes: toxicity, ED visits, hospitalizations, and mortality. We also compared SARP data to independently collected ECOG PS, CARG score, ADLs, and IADLs.
Results: From 8/2016 to 8/2017, 54 older adults were consented, and 26 had wearable data available for analysis. The average age was 72 years, with 18 males and 8 females. 12 pts had ECOG PS of 0, 12 with ECOG of 1, and 2 with ECOG of 2. 4 pts had CARG score of low, 17 intermediate, and 3 high. Energy intensity was significantly correlated with ED visits, with an effect size of 0.95 (p = 0.04). Similarly, energy intensity and hospitalizations had an effect size of 0.87 (p = 0.06). The CARG scores were noted to be significantly correlated with dose delay and dose reduction with an effect size 0.45 (p = 0.05) and 0.4 (p = 0.05), respectively. Spearman correlation analysis demonstrated that walking time, active time, and energy intensity positively correlate with ADLs and IADLs, and inversely correlated with ECOG PS and CARG risk.
Conclusions: Though this is a limited study due to sample size, the overall trend demonstrated that the SARP platform offers an adjunct tool in assessing and risk stratifying older patients with cancer undergoing active therapy. Additional cohorts are now enrolled with an at-home monitoring system.