Using Smartphones to Capture Novel Recovery Metrics After Cancer Surgery

Abstract

IMPORTANCE Patient-generated health data captured from smartphone sensors have the potential to better quantify the physical outcomes of surgery. The ability of these data to discriminate between postoperative trends in physical activity remains unknown. OBJECTIVE To assess whether physical activity captured from smartphone accelerometer data can be used to describe postoperative recovery among patients undergoing cancer operations. DESIGN, SETTING, AND PARTICIPANTS This prospective observational cohort study was conducted from July 2017 to April 2019 in a single academic tertiary care hospital in the United States. Preoperatively, adults (age Ն18 years) who spoke English and were undergoing elective operations for skin, soft tissue, head, neck, and abdominal cancers were approached. Patients were excluded if they did not own a smartphone. EXPOSURES Study participants downloaded an application that collected smartphone accelerometer data continuously for 1 week preoperatively and 6 months postoperatively. MAIN OUTCOMES AND MEASURES The primary end points were trends in daily exertional activity and the ability to achieve at least 60 minutes of daily exertional activity after surgery among patients with vs without a clinically significant postoperative event. Postoperative events were defined as complications, emergency department presentations, readmissions, reoperations, and mortality. RESULTS A total of 139 individuals were approached. In the 62 enrolled patients, who were followed up for a median (interquartile range [IQR]) of 147 (77-179) days, there were no preprocedural differences between patients with vs without a postoperative event. Seventeen patients (27%) experienced a postoperative event. These patients had longer operations than those without a postoperative event (median [IQR], 225 [152-402] minutes vs 107 [68-174] minutes; P < .001), as well as greater blood loss (median [IQR], 200 [35-515] mL vs 25 [5-100] mL; P = .006) and more follow-up visits (median [IQR], 2 [2-4] visits vs 1 [1-2] visits; P = .002). Compared with mean baseline daily exertional activity, patients with a postoperative event had lower activity at week 1

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“…understanding the daily behaviors of healthy undergraduate students, 26 evaluating the risk of disordered eating among women with and without histories of childhood trauma and food insecurity, monitoring patient recovery after cancer surgery, 27 and providing enhanced medical care within a cohort of patients with advanced cancer. 28 However, researchers have also called for a better understanding of how these data are collected, 29 greater emphasis on methodology and techniques for analyses of these data rather than just on the collection itself, 16,30 and, as with any new area of research, establishing more ethical standards and guidelines for data collection.…”