Accuracy of a mobile sensor-based system for the detection of chemotherapy toxicity in older adults with cancer.
Notice bibliographique
Résumé
1515 Background: Older adults receiving chemotherapy (CT) are at a high risk of toxicity (Tox) and of functional decline. Promptly acting upon CT Tox in older adults is difficult, particularly in developing countries where triage systems and personnel are limited. We previously showed that monitoring older patients using an accelerometer-equipped smartphone is feasible, and that a decline in the number of steps/day may represent a marker of Tox. We aimed to evaluate the diagnostic accuracy of an objective patient-centered measure of physical function (steps/day) for the remote detection of Tox in older adults receiving CT. Methods: We included consecutive patients aged ≥65 years starting first line CT for solid tumors at a single center in Mexico City. Patients underwent a geriatric assessment and were provided with an accelerometer-equipped smartphone. Daily steps were recorded for ≥7 days pre-CT initiation, and median number of pre-CT steps/day was calculated. Patients with ≤600 median pre-CT steps/day, and those using walking aids, were excluded (16% of recruited patients). Steps were monitored daily, compared with median pre-CT steps/day, and % decline was calculated. Patients were called daily, and Tox was assessed using PRO-CTCAE questionnaires. The % decline in steps/day from pre-CT was considered as the index test for Tox, while patient report was considered the reference standard. The association between % step decline and moderate/severe Tox was examined using generalized linear-mixed models. AUC was calculated and Youden’s index used to choose cutoff points for Tox detection. Results: 116 patients were included (96 development cohort, 20 validation cohort). Median age was 73y (range 65-91), 55% were female, and 65% had ≤high school education. The most common tumors were colon (21.5%), pancreas (17.5%), and gastric (12%). 28% of participants had never used a smartphone. The median number of pre-CT steps/day was 2979. Patients were followed for 6764 days, with Tox detected on 64.4% of days. Moderate/severe self-reported toxicity was detected on 1245 days (22.1%), while mild/no toxicity was detected on 4378 days (77.9%). AUC analysis for the development cohort demonstrated that a 32% decrease in steps/day from pre-CT median showed a sensitivity of 77.6% and a specificity of 67.3% for detecting moderate/severe Tox. Sensitivity and specificity of the cutoff in the validation cohort were 75.8% and 69.6%, respectively. Tox associated with a decline in steps/day included fatigue, pain, and nausea. Conclusions: A decline in the number of steps/day measured using an accelerometer-equipped smartphone was useful for the remote detection of moderate/severe Tox in older adults with cancer receiving CT, with a high sensitivity and specificity. This patient-centric measure could be used in clinical practice and research to detect and act promptly on Tox and, potentially, improve outcomes.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,005 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».