ASO Author Reflections: Applications of Smartphone-Based Digital Phenotyping in Supplementing Recovery Assessment After
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ASO AUTHOR REFLECTIONS
ASO Author Reflections: Applications of Smartphone-Based Digital Phenotyping in Supplementing Recovery Assessment After Cancer Surgery Nikhil Panda, MD MPH1,2, Ian Solsky, MD MPH1,3, Jukka-Pekka Onnela, DSc1,4, and Alex B. Haynes, MD MPH1,5 Ariadne Labs, Brigham and Women’s Hospital, Harvard. T.H. School of Public Health, Boston, MA; 2Department of Surgery, Massachusetts General Hospital, Boston, MA; 3Department of Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; 4Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA; 5Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX 1
PAST Effective shared decision-making in oncologic surgery requires that patients, caregivers, and surgeons understand how treatment affects outcomes that matter most to patients.1,2 In order to strive toward this level of patientcentered care, surgeons no longer rely solely on short-term quality metrics and perioperative process measures as surrogates for high-quality care and have now incorporated tools, such as patient-reported outcomes, to prioritize patient health-related quality of life (HRQoL).3 There likely exist additional effects of cancer surgery on physical and psychosocial aspects of HRQoL that remain poorly characterized but nevertheless warrant objective measurement.
breast cancer (breast-conserving surgery [BCS] and mastectomy) downloaded an application that continuously collected smartphone global positioning system (GPS) data preoperatively and during recovery.6 Patients’ HRQoL also was assessed using the Short-Form-36 (SF36) survey delivered via smartphone before surgery and at 4 and 12 weeks postoperatively. In the first 12 postoperative weeks, analysis of GPS data revealed that mastectomy patients spent much more time at home and traveled shorter distances compared with BCS patients. These differences in GPS-derived metrics, which may represent important aspects of postoperative recovery, including gross motor and social functioning, existed despite no differences in self-reported HRQoL. FUTURE
PRESENT Smartphone-based digital phenotyping harnesses devices already in the hands of most patients to collect objective and subjective HRQoL data that can help to build a more nuanced patient-centered understanding of postoperative recovery.4,5 In a prospective, proof-of-principle study, adult smartphone-owners undergoing surgery for
Ó Society of Surgical Oncology 2020 First Received: 6 August 2020 Accepted: 15 August 2020 N. Panda, MD MPH e-mail: [email protected]
The current study among patients recovering from breast cancer surgery suggests that these data offer nuanced insights into behavioral patterns, which if validated in larger studies, may supplement traditional oncologic and HRQoL outcomes. These data may also inform and enhance goal-setting, expectation alignment, shared decision-making, and patient engagement. In an era where digital health innovations are beco
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