“… 12 Recently, however, also mobile devices have been used to assess fatiguability. 30 Perceptions of fatigue (state fatigue), as assessed via VAS ratings, form the second type of fatigue as defined by Kluger et al., which does not necessarily relate to the first type. While these two types of fatigue have to be treated separately and do not have to occur at the same time, they can influence each other and might be observed together.…”
“… 12 Recently, however, also mobile devices have been used to assess fatiguability. 30 Perceptions of fatigue (state fatigue), as assessed via VAS ratings, form the second type of fatigue as defined by Kluger et al., which does not necessarily relate to the first type. While these two types of fatigue have to be treated separately and do not have to occur at the same time, they can influence each other and might be observed together.…”
“…A hand kinematic analysis in patients that reported numbness with or without neuropathic pain due to chemotherapy used 3D recordings of the hand grip-release test and revealed CIPN cases had more jerks in grasp movement but not in reach movement [ 31 ]. It would be difficult to adapt this test into a smartphone app–based functional assessment, but there may be opportunities for other manual strength and dexterity tasks such as finger tapping [ 32 , 33 ] or line tracing [ 34 ].…”
Background
Severe chemotherapy-induced peripheral neuropathy (CIPN) can cause long-term dysfunction of the hands and feet, interfere with activities of daily living, and diminish the quality of life. Monitoring to identify CIPN and adjust treatment before it progressing to a life-altering severity relies on patients self-reporting subjective symptoms to their clinical team. Objective assessment is not a standard component of CIPN monitoring due to the requirement for specially trained health care professionals and equipment. Smartphone apps have the potential to conveniently collect both subjective and objective CIPN data directly from patients, which could improve CIPN monitoring.
Objective
The objective of this cross-sectional pilot study was to assess the feasibility of functional CIPN assessment via a smartphone app in patients with cancer that have received neurotoxic chemotherapy.
Methods
A total of 26 patients who had completed neurotoxic chemotherapy were enrolled and classified as CIPN cases (n=17) or controls (n=9) based on self-report symptoms. All participants completed CIPN assessments within the NeuroDetect app a single time, including patient-reported surveys (CIPN20 [European Organization for Research and Treatment of Cancer Quality of Life Questionnaire for Chemotherapy-induced Peripheral Neuropathy 20-item scale] and PRO-CTCAE [Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events]) and functional assessments (Gait and Balance and 9-Hole Peg Test). Functional assessment data were decomposed into features. The primary analysis was done to identify features indicative of the difference between CIPN cases and controls using partial least squares analyses. Exploratory analyses were performed to test if any features were associated with specific symptom subtypes or patient-reported survey scores. Patient interviews were also conducted to understand the challenges they experienced with the app.
Results
Comparisons between CIPN cases and controls indicate that CIPN cases had shorter step length (P=.007), unique swaying acceleration patterns during a walking task, and shorter hand moving distance in the dominant hands during a manual dexterity task (variable importance in projection scores ≥2). Exploratory analyses showed similar signatures associated with symptoms subtypes, CIPN20, and PRO-CTCAE. The interview results showed that some patients had difficulties due to technical issues, which indicated a need for additional training or oversight during the initial app download.
Conclusions
Our results supported the feasibility of remote CIPN assessment via a smartphone app and suggested that functional assessments may indicate CIPN manifestations in the hands and feet. Additional work is needed to determine which functional assessments are most indicative of CIPN and could be used for CIPN monitoring within clinical care.
“…ChartDetective is implemented in TypeScript using React 4 for the interface, Ploty.js 5 to reconstruct an interactive version of the chart, Tesseract.js 6 to recover rendered text, and PDF.js 7 to parse and render PDFs. While there are multiple vector formats, internally, we use the PDF representation as it is the most low-level and any vector format can be trivially converted to PDF.…”
elements partially or completely occluded. Compared to other approaches relying on raster images, our tool successfully recovered all data, even when hidden, with a 78% lower relative error.
CCS CONCEPTS• Human-centered computing → Interactive systems and tools.
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