The expanding armamentarium of wearable devices offers new opportunities to supplement physician-assessed performance status (PS) with continuously acquired real-life patient data. It is relevant to identify and characterize the level of association between wearable device physical activity (PA) metrics and PS in cancer patients as a first step into evaluating their potential combined utility in evaluating treatment outcomes and clinical decisions. Therefore, we conducted a systematic review to examine the association between wearable device PA metrics and PS in cancer patients.
We searched PubMed and EMBASE for studies that were conducted among adults with cancer, quantitatively assessed a relation between wearable device PA metrics and PS, and had a full text available in English. We extracted information on study design and population, wearable device type and PA metrics, outcome definitions, and results. Included studies were subjected to methodological quality assessment.
Nine studies with a total of 574 patients were included in this review. Eight studies had a prospective observational study design and all studies reported on a different combination of wearable device PA metrics including: steps per day (n = 5), sedentary behavior (n = 5), and PA volume/intensity (n = 4). Much heterogeneity was observed regarding study population, wearable devices used, and reporting of results. None of the studies could be defined to be of ‘high methodological quality’ (≥ 70%): mean methodological quality was 47% and ranged from 40-60%. We found moderate evidence for a positive association between steps per day and PS, and for a negative association between sedentary behavior and PS.
Much heterogeneity was identified between studies with regards to study population, reported PA metrics, and used devices. Nevertheless, results of this study indicate that higher daily step count is associated with better PS in cancer patients. Whereas sedentary behavior is associated with worse PS. The next step into determining their potential combined utility in evaluating treatment outcomes and clinical decisions is to investigate the association between wearable device PA metrics and cancer outcomes.
The authors.
Has not received any funding.
H.W. Wilmink: Advisory / Consultancy: Shire; Advisory / Consultancy, Research grant / Funding (institution): Celgene; Research grant / Funding (institution): Servier; Research grant / Funding (institution): Halozyme; Research grant / Funding (institution): Novartis; Research grant / Funding (institution): AstraZeneca; Research grant / Funding (institution): Pfizer; Research grant / Funding (institution): Roche; Research grant / Funding (institution): Merck. H.W.M. van Laarhoven: Research grant / Funding (institution): Roche; Research grant / Funding (institution): Bayer; Advisory / Consultancy, Research grant / Funding (institution): BMS; Advisory / Consultancy, Research grant / Funding (institution): Celgene; Advisory / Consultancy, Research grant / Funding (institution): Lilly; Research grant / Funding (institution): Merck Serono; Research grant / Funding (institution): MSD; Advisory / Consultancy, Research grant / Funding (institution): Nordic; Research grant / Funding (institution): Philips. M. van Oijen: Research grant / Funding (institution): Roche; Research grant / Funding (institution): Lilly; Research grant / Funding (institution): Servier; Research grant / Funding (institution): Nordic; Research grant / Funding (institution): Amgen. All other authors have declared no conflicts of interest.