An App-Based Remote Patient Monitoring System With Wrist and In-Ear Wearables in Gastrointestinal Oncology: Prospective Feasibility Pilot Study
Bibliographic record
Abstract
Background: Outpatient treatments, including targeted therapies, in oncology are on the rise. The implementation of remote patient monitoring (RPM) between therapy sessions has the potential to enhance patient care and therapy outcomes in the future. Objective: This pilot study assessed the feasibility of a new, app-based RPM system (bwHealthApp) by capturing patient-reported outcomes (PROs) and vital parameters using a wrist- or in-ear wearable. The study examined adherence, acceptance, and satisfaction, as well as the differences between the two types of wearables. Methods: Outpatients with gastrointestinal cancer receiving systemic therapies were invited to use and evaluate the bwHealthApp system for 1 month. The system was set up as an Android smartphone app to assess electronic PROs (ePROs) and connect to wearables for continuous vital sign measurements. A wrist wearable (Beurer AS99) that measured activity and heart rate or an in-ear wearable (Cosinuss Two) that measured heart rate, oxygen saturation, and temperature was used. The data were synchronized remotely to a web client. Outpatients were randomly assigned to the wrist wearable (n=17) or in-ear wearable (n=14) group. At the beginning, middle, and end of the study, patients (N=31) completed questionnaires on various feasibility aspects. Adherence to ePRO completion; wearable use, acceptance, and satisfaction; wearable data quantity and quality; and differences between the wearables were evaluated. Results: The mean adherence to bwHealthApp including dropouts was 46% (449/971 days) for ePRO completion and 61% (593/971 days) for wearable use. The system was most frequently used during everyday activities. More than half of the participants were satisfied with bwHealthApp (18/30, 60%) and could imagine continued use (21/30, 70%). Notably, 70% (21/30) rated the system as easy to use. Participants recorded more than 20 million wearable measures; however, 29% (SD 22%, range 3%-76%) of temperature values and 33% (SD 25%, range 10%-92%) of oxygen saturation values were outside the physiological range. For heart rate, the mean proportion of excluded values was 10% (SD 11%, range 4%-48%; in-ear) and 11% (SD 8%, range 4%-33%; wrist). The frequency of use of the two wearables did not differ significantly (t29=1.81; P=.08). The wrist wearable scored significantly better than the in-ear wearable regarding wearing comfort (t28=-11.17; P=.03). Conclusions: This bwHealthApp pilot study demonstrates the feasibility of RPM via a mobile app and wearable devices during outpatient systemic cancer therapy, including targeted therapies. The adherence level was moderate, and patients were generally satisfied with the system, although the wrist wearable received a higher rating. The system's functionality may be enhanced through the integration of additional wearables. This pilot study serves as a foundational framework for long-term assessments examining RPM and clinical data to improve cancer treatments.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".