Hospital Universitario 12 de Octubre, Madrid, Spain.
Adhera Health, Inc, Santa Cruz, CA.
JCO Clin Cancer Inform. 2023 Sep;7:e2300016. doi: 10.1200/CCI.23.00016.
Performance status (PS) is a crucial assessment for research and clinical practice in lung cancer (LC), including its usage for the assessment of the suitability and toxicity of treatment or eligibility for clinical trials of patients with LC. These PS assessments are subjective and lead to substantial discrepancies between observers. To improve the objectivity of PS assessments, Electronic Activity Monitoring devices (EAMs) are increasingly used in oncology, but how these devices are used for PS assessments in LC is an issue that remains unclear. The goal of this study is to address the challenges and opportunities of the use of digital tools to support PS assessments in patients with LC.
The literature review followed PRISMA-ScR methodology. Searches were performed in the ScienceDirect, PsycInfo, ACM, IEEE Xplore, and PubMed databases. Furthermore, a panel discussion was performed to address the clinical use cases.
Thirty-two publications were found. Most of the studies used wrist accelerometry-based wearables (59%) and monitored sleep activity (SA; 28%) or physical activity (PA; 72%). Critical findings include positive usefulness of the use of wearables to categorize moderate-to-vigorous/light PA, which was associated with better sleep and health. In addition, steps and time awake immobile were found to be associated with risk of hospitalization and survival. Use cases identified included the health assessment of patients and clinical research.
There are positive experiences in the use of EAM to complement PS assessment in LC. However, there is a need for adapting thresholds to the particularities of patients with LC, for example, differentiating moderate-to-vigorous and light. Moreover, developing methodologies combining PS assessments and the use of EAM adapted to clinical and research practice is needed.
体能状态(PS)是肺癌(LC)研究和临床实践的关键评估指标,包括用于评估 LC 患者治疗的适宜性和毒性以及是否有资格参加临床试验。这些 PS 评估是主观的,导致观察者之间存在很大差异。为了提高 PS 评估的客观性,电子活动监测设备(EAMs)在肿瘤学中越来越多地被使用,但这些设备如何用于 LC 的 PS 评估仍是一个尚未明确的问题。本研究的目的是解决使用数字工具支持 LC 患者 PS 评估的挑战和机遇。
文献综述遵循 PRISMA-ScR 方法进行。在 ScienceDirect、PsycInfo、ACM、IEEE Xplore 和 PubMed 数据库中进行了搜索。此外,还进行了小组讨论以解决临床应用案例。
共发现 32 篇文献。大多数研究使用基于手腕加速度计的可穿戴设备(59%),监测睡眠活动(SA;28%)或身体活动(PA;72%)。关键发现包括使用可穿戴设备对中等到剧烈/轻度 PA 进行分类的有用性,这与更好的睡眠和健康相关。此外,发现步数和清醒时不动的时间与住院和生存风险相关。确定的用例包括患者健康评估和临床研究。
在使用 EAM 补充 LC 的 PS 评估方面有积极的经验。然而,需要根据 LC 患者的特点来调整阈值,例如区分中等到剧烈和轻度。此外,还需要开发将 PS 评估与适应临床和研究实践的 EAM 相结合的方法学。