The remote monitoring of gastrointestinal cancer patients’ performance status and burden of symptoms via a consumer-based activity tracker: qualitative focus group study (Preprint)

BACKGROUND The number of elderly patients with gastrointestinal cancer is increasing due to rapid global aging. Minimizing the reliance on an in-clinic patients performance status (PS) test for prognosis and determining patients' treatment can improve resource utilization. Further, the current PS measurements cannot capture patients' constant changes. They also rely on self-reports, resulting in bias and subjectivity. Real-time monitoring of patients' activities may allow for a more accurate assessment of patients' PS while minimizing resource utilization. OBJECTIVE This study investigates the validity of consumer-based activity trackers for monitoring gastrointestinal patients' PS. METHODS : Twenty-seven consenting patients (63% male, median age 58 years) wear a consumer-based activity tracker seven days before chemotherapy and fourteen days after receiving their first treatment. The provider assesses patients' ECOG-PS and Memorial Symptom Assessment Checklist-Short Form (MSAS-SF) pre- and post-chemotherapy visits. The statistical correlations between ECOG-PS and MSAS-SF scores and patients daily step counts' are assessed. RESULTS The daily step counts yield the highest correlation with the patients' ECOG-PS after chemotherapy (P = 6.4e-11). The patients with higher ECOG-PS experience a higher fluctuation in their step counts. The patients who walk more (mean: 6071 steps per day) pre-chemotherapy and (mean: 5930 steps per day) post-chemotherapy have a lower MSAS score (less burden of symptoms) compare to patients who walk less (mean: 5205 steps per day) pre-chemotherapy and (mean: 4437 steps per day) post-chemotherapy. CONCLUSIONS : This study demonstrates the feasibility of inexpensive, consumer-based activity trackers in remote monitoring patients’ PS and MSAS in the gastrointestinal cancer population. The findings need to be validated in a larger population for generalizability. CLINICALTRIAL