Utility of Wearable Sensors to Assess Postoperative Recovery in Pediatric Patients After Appendectomy

Boer, Christopher De; Ghomrawi, Hassan; Many, Benjamin T.; Bouchard, Megan E.; Linton, Samuel; Figueroa, Angie; Kwon, Soyang

doi:10.1016/j.jss.2021.01.030

Cited by 25 publications

(27 citation statements)

References 21 publications

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“…Twenty-one (50%) [ 25 – 45 ] of the included articles were from North America, 12 (29%) [ 30 , 46 – 56 ] from Europe, and 9 from Asia (21%) [ 49 , 57 – 64 ]. The included studies were conducted in 15 different countries, most commonly in the USA ( n = 20, 48%) [ 25 – 29 , 31 – 45 ], India ( n = 4, 10%) [ 57 , 58 , 61 , 63 ], and Netherlands ( n = 3, 7%) [ 47 , 55 , 56 ]. A total of 32 (76%) articles were published between 2019 and 2022 [ 25 – 31 , 33 , 35 – 39 , 41 – 43 , 45 , 46 , 48 – 51 , 53 – 55 , 57 , 59 – 62 , 65 , 66 ] (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…While this review excluded articles consisting only of adult participants, it included studies which had both children and adult participants. Nine (21%) included articles featured adult participants [ 35 , 36 , 38 – 40 , 42 , 45 , 50 , 63 ], and 25 (60%) articles included samples spanning multiple age categories [ 25 , 28 , 29 , 31 , 35 , 36 , 38 – 46 , 48 , 50 – 52 , 54 , 55 , 60 , 63 – 65 ].…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-one (50%) of the included articles were from North America, 12 (29%) [30,[46][47][48][49][50][51][52][53][54][55][56] from Europe, and 9 from Asia (21%) [49,[57][58][59][60][61][62][63][64]. The included studies were conducted in 15 different countries, most commonly in the USA (n = 20, 48%) [25][26][27][28][29][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45], India (n = 4, 10%) [57,58,61,63], and Netherlands (n = 3, 7%) [47,55,56]. A total of 32 (76%) articles were published between 2019 and 2022…”

Section: Demographicsmentioning

confidence: 99%

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Wireless monitoring devices in hospitalized children: a scoping review

et al. 2023

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The purpose of this study is to provide a structured overview of existing wireless monitoring technologies for hospitalized children. A systematic search of the literature published after 2010 was conducted in Medline, Embase, Scielo, Cochrane, and Web of Science. Two investigators independently reviewed articles to determine eligibility for inclusion. Information on study type, hospital setting, number of participants, use of a reference sensor, type and number of vital signs monitored, duration of monitoring, type of wireless information transfer, and outcomes of the wireless devices was extracted. A descriptive analysis was applied. Of the 1130 studies identified from our search, 42 met eligibility for subsequent analysis. Most included studies were observational studies with sample sizes of 50 or less published between 2019 and 2022. Common problems pertaining to study methodology and outcomes observed were short duration of monitoring, single focus on validity, and lack information on wireless transfer and data management. Conclusion : Research on the use of wireless monitoring for children in hospitals has been increasing in recent years but often limited by methodological problems. More rigorous studies are necessary to establish the safety and accuracy of novel wireless monitoring devices in hospitalized children. What is Known: • Continuous monitoring of vital signs using wired sensors is the standard of care for hospitalized pediatric patients. However, the use of wires may pose significant challenges to optimal care. What is New: • Interest in wireless monitoring for hospitalized pediatric patients has been rapidly growing in recent years. • However, most devices are in early stages of clinical testing and are limited by inconsistent clinical and technological reporting. Supplementary Information The online version contains supplementary material available at 10.1007/s00431-023-04881-w.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Demographicsmentioning

confidence: 99%

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Wireless monitoring devices in hospitalized children: a scoping review

et al. 2023

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“…A similar study also found that data from wearables can help to distinguish recovery trajectories in paediatric patients after appendicectomy. 193 One feasibility study examined the use of smart glasses during urological surgery, and found this technology to be safe and useful by the surgeons. 194 Capogna et al used smart glasses to examine differing visual focus between experts and novices during lumbar puncture.…”

Section: Patrick Longmanmentioning

confidence: 99%

Future of Surgery: Technology Enhanced Surgical Training: Report of the FOS:TEST Commission

Adebayo¹,

Aldoori²,

Allum³

et al. 2022

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Over the past 50 years the capability of technology to improve surgical care has been realised and while surgical trainees and trainers strive to deliver care and train; the technological ‘solutions’ market continues to expand. However, there remains no coordinated process to assess these technologies. The FOS:TEST Report aimed to (1) define the current, unmet needs in surgical training, (2) assess the current evidence-base of technologies that may be beneficial to training and map these onto both the patient and trainee pathway and (3) make recommendations on the development, assessment, and adoption of novel surgical technologies. The FOS:TEST Commission was formed by the Association of Surgeons in Training (ASiT), The Royal College of Surgeons of England (RCS England) Robotics and Digital Surgery Group and representatives from all trainee specialty associations. Two national datasets provided by Health Education England were used to identify unmet surgical training needs through qualitative analysis against pre-defined coding frameworks. These unmet needs were prioritised at two virtual consensus hackathons and mapped to the patient and trainee pathway and the capabilities in practice (CiPs) framework. The commission received more than 120 evidence submissions from surgeons in training, consultant surgeons and training leaders. Following peer review, 32 were selected that covered a range of innovations. Contributors also highlighted several important key considerations, including the changing pedagogy of surgical training, the ethics and challenges of big data and machine learning, sustainability, and health economics. This summates to 7 Key Recommendations and 51 concluding statements. The FOS:TEST Commission was borne out of what is a pivotal point in the digital transformation of surgical training. Academic expertise and collaboration will be required to evaluate efficacy of any novel training solution. However, this must be coupled with pragmatic assessments of feasibility and cost to ensure that any intervention is scalable for national implementation. Currently, there is no replacement for hands-on operating. However, for future UK and ROI surgeons to stay relevant in a global market, our training methods must adapt. The Future of Surgery: Technology Enhanced Surgical Training Report provides a blueprint for how this can be achieved.

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“…The Fitbit Inspire HR and Fitbit Inspire 2 were chosen for its reliable use in children, 40,41,47,50 and because of our own experience showing high compliance in children. 51 All patients were approached immediately after being sent to their hospital room during daytime working hours (7am-5pm) or the next morning for those who underwent surgery at night. Recruitment occurred in the patient's room after return from the recovery unit and emergence from general anesthesia to maximize patient participation.…”

Section: Data Sources and Collectionmentioning

confidence: 99%

Applying Machine Learning to Consumer Wearable Data to Predict Complications After Pediatric Appendectomy

Ghomrawi¹,

Fanton

DeBoer

et al. 2022

Preprint

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When children are discharged from the hospital after surgery, caregivers rely mainly on subjective assessments (e.g., appetite, fatigue) to identify abnormal recovery symptoms since objective monitoring tools (e.g., thermometer) are very limited at home. Relying on such tools alone has resulted in unwarranted emergency department visits and delayed care. This study evaluated the ability of data from consumer-grade wearable devices, the Fitbit Inspire HR and Inspire 2, to predict abnormal symptoms and complications in children recovering after appendectomy. One hundred and sixty-two children, ages 3–17 years old, who underwent an appendectomy (76 simple and 86 complicated cases of appendicitis) wore a Fitbit device on their wrist for 21 days postoperatively. Symptoms and complications that arose during this monitoring period were gathered from medical records and patient report and used to label each postoperative day as either “abnormal recovery” or “normal recovery.” Fitbit-derived physical activity, heart rate, and sleep features and demographic and clinical characteristics were used to train balanced random forest classifiers to predict abnormal recovery days, separately for patients undergoing appendectomy for simple and complicated appendicitis. The classifiers accurately predicted 85% of abnormal recovery days up to the two days prior to the onset of a reported symptom/complication in complicated appendectomy patients and 70% of abnormal recovery days up to the two days prior in simple appendectomy patients. These results support the development of machine learning algorithms to predict onset of complications in children undergoing surgery and the role of the Fitbit as a monitoring tool for early detection of events.

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Utility of Wearable Sensors to Assess Postoperative Recovery in Pediatric Patients After Appendectomy

Cited by 25 publications

References 21 publications

Wireless monitoring devices in hospitalized children: a scoping review

Wireless monitoring devices in hospitalized children: a scoping review

Future of Surgery: Technology Enhanced Surgical Training: Report of the FOS:TEST Commission

Applying Machine Learning to Consumer Wearable Data to Predict Complications After Pediatric Appendectomy

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