Sebastian Garcia-Saiso, Myrna Marti, Karina Pesce, Silvana Luciani, Oscar Mujica, Anselm Hennis, Marcelo D'Agostino
As we enter the era of digital interdependence, artificial intelligence (AI) emerges as a key instrument to transform health care and address disparities and barriers in access to services. This viewpoint explores AI's potential to reduce inequalities in cancer care by improving diagnostic accuracy, optimizing resource allocation, and expanding access to medical care, especially in underserved communities. Despite persistent barriers, such as socioeconomic and geographical disparities, AI can significantly improve health care delivery. Key applications include AI-driven health equity monitoring, predictive analytics, mental health support, and personalized medicine. This viewpoint highlights the need for inclusive development practices and ethical considerations to ensure diverse data representation and equitable access. Emphasizing the role of AI in cancer care, especially in low- and middle-income countries, we underscore the importance of collaborative and multidisciplinary efforts to integrate AI effectively and ethically into health systems. This call to action highlights the need for further research on user experiences and the unique social, cultural, and political barriers to AI implementation in cancer care.
{"title":"Artificial Intelligence as a Potential Catalyst to a More Equitable Cancer Care.","authors":"Sebastian Garcia-Saiso, Myrna Marti, Karina Pesce, Silvana Luciani, Oscar Mujica, Anselm Hennis, Marcelo D'Agostino","doi":"10.2196/57276","DOIUrl":"10.2196/57276","url":null,"abstract":"<p><p>As we enter the era of digital interdependence, artificial intelligence (AI) emerges as a key instrument to transform health care and address disparities and barriers in access to services. This viewpoint explores AI's potential to reduce inequalities in cancer care by improving diagnostic accuracy, optimizing resource allocation, and expanding access to medical care, especially in underserved communities. Despite persistent barriers, such as socioeconomic and geographical disparities, AI can significantly improve health care delivery. Key applications include AI-driven health equity monitoring, predictive analytics, mental health support, and personalized medicine. This viewpoint highlights the need for inclusive development practices and ethical considerations to ensure diverse data representation and equitable access. Emphasizing the role of AI in cancer care, especially in low- and middle-income countries, we underscore the importance of collaborative and multidisciplinary efforts to integrate AI effectively and ethically into health systems. This call to action highlights the need for further research on user experiences and the unique social, cultural, and political barriers to AI implementation in cancer care.</p>","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":"10 ","pages":"e57276"},"PeriodicalIF":3.3,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11347894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eleonore Baum, Christian Thiel, Andrea Kobleder, Daniela Bernhardsgrütter, Ramona Engst, Carola Maurer, Antje Koller
A digital diary in the form of a mobile messenger service offers a novel method for data collection in cancer research. Little is known about the things to consider when using this data collection method in clinical research for patients with cancer. In this Viewpoint paper, we discuss the lessons we learned from using a qualitative digital diary method via a mobile messenger service for data collection in oncology care. The lessons learned focus on three main topics: (1) data quality, (2) practical aspects, and (3) data protection. We hope to provide useful information to other researchers who consider this method for their research with patients. First, in this paper, we argue that the interactive nature of a digital diary via a messenger service is very well suited for the phenomenological approach and produces high-quality data. Second, we discuss practical issues of data collection with a mobile messenger service, including participant and researcher interaction. Third, we highlight corresponding aspects around technicalities, particularly those regarding data security. Our views on data privacy and information security are summarized in a comprehensive checklist to inform fellow researchers on the selection of a suitable messenger service for different scenarios. In our opinion, a digital diary via a mobile messenger service can provide high-quality data almost in real time and from participants' daily lives. However, some considerations must be made to ensure that patient data are sufficiently protected. The lessons we learned can guide future qualitative research using this relatively novel method for data collection in cancer research.
{"title":"Using a Mobile Messenger Service as a Digital Diary to Capture Patients' Experiences Along Their Interorganizational Treatment Path in Gynecologic Oncology: Lessons Learned.","authors":"Eleonore Baum, Christian Thiel, Andrea Kobleder, Daniela Bernhardsgrütter, Ramona Engst, Carola Maurer, Antje Koller","doi":"10.2196/52985","DOIUrl":"10.2196/52985","url":null,"abstract":"<p><p>A digital diary in the form of a mobile messenger service offers a novel method for data collection in cancer research. Little is known about the things to consider when using this data collection method in clinical research for patients with cancer. In this Viewpoint paper, we discuss the lessons we learned from using a qualitative digital diary method via a mobile messenger service for data collection in oncology care. The lessons learned focus on three main topics: (1) data quality, (2) practical aspects, and (3) data protection. We hope to provide useful information to other researchers who consider this method for their research with patients. First, in this paper, we argue that the interactive nature of a digital diary via a messenger service is very well suited for the phenomenological approach and produces high-quality data. Second, we discuss practical issues of data collection with a mobile messenger service, including participant and researcher interaction. Third, we highlight corresponding aspects around technicalities, particularly those regarding data security. Our views on data privacy and information security are summarized in a comprehensive checklist to inform fellow researchers on the selection of a suitable messenger service for different scenarios. In our opinion, a digital diary via a mobile messenger service can provide high-quality data almost in real time and from participants' daily lives. However, some considerations must be made to ensure that patient data are sufficiently protected. The lessons we learned can guide future qualitative research using this relatively novel method for data collection in cancer research.</p>","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":"10 ","pages":"e52985"},"PeriodicalIF":3.3,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11319886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yvonne W Leung, Elise Wouterloot, Achini Adikari, Jinny Hong, Veenaajaa Asokan, Lauren Duan, Claire Lam, Carlina Kim, Kai P Chan, Daswin De Silva, Lianne Trachtenberg, Heather Rennie, Jiahui Wong, Mary Jane Esplen
Background: Commonly offered as supportive care, therapist-led online support groups (OSGs) are a cost-effective way to provide support to individuals affected by cancer. One important indicator of a successful OSG session is group cohesion; however, monitoring group cohesion can be challenging due to the lack of nonverbal cues and in-person interactions in text-based OSGs. The Artificial Intelligence-based Co-Facilitator (AICF) was designed to contextually identify therapeutic outcomes from conversations and produce real-time analytics.
Objective: The aim of this study was to develop a method to train and evaluate AICF's capacity to monitor group cohesion.
Methods: AICF used a text classification approach to extract the mentions of group cohesion within conversations. A sample of data was annotated by human scorers, which was used as the training data to build the classification model. The annotations were further supported by finding contextually similar group cohesion expressions using word embedding models as well. AICF performance was also compared against the natural language processing software Linguistic Inquiry Word Count (LIWC).
Results: AICF was trained on 80,000 messages obtained from Cancer Chat Canada. We tested AICF on 34,048 messages. Human experts scored 6797 (20%) of the messages to evaluate the ability of AICF to classify group cohesion. Results showed that machine learning algorithms combined with human input could detect group cohesion, a clinically meaningful indicator of effective OSGs. After retraining with human input, AICF reached an F1-score of 0.82. AICF performed slightly better at identifying group cohesion compared to LIWC.
Conclusions: AICF has the potential to assist therapists by detecting discord in the group amenable to real-time intervention. Overall, AICF presents a unique opportunity to strengthen patient-centered care in web-based settings by attending to individual needs.
International registered report identifier (irrid): RR2-10.2196/21453.
背景：由治疗师主导的在线支持小组（OSG）是为癌症患者提供支持的一种经济有效的方式，通常作为支持性护理提供。OSG会议成功与否的一个重要指标是小组凝聚力；然而，由于基于文本的OSG缺乏非语言线索和人际互动，监测小组凝聚力可能具有挑战性。基于人工智能的共同主持人（AICF）旨在从对话中识别治疗结果并进行实时分析：本研究旨在开发一种方法来训练和评估 AICF 监测群体凝聚力的能力：AICF 采用文本分类方法提取对话中提及的群体凝聚力。人类评分员对数据样本进行了注释，并将其作为建立分类模型的训练数据。此外，还使用单词嵌入模型查找上下文相似的群组内聚表达，为注释提供进一步支持。AICF 的性能还与自然语言处理软件 Linguistic Inquiry Word Count (LIWC) 进行了比较：AICF 在从加拿大癌症聊天室获取的 80,000 条信息上进行了训练。我们对 34,048 条信息进行了 AICF 测试。人类专家对 6797 条（20%）信息进行了评分，以评估 AICF 对群体凝聚力进行分类的能力。结果表明，机器学习算法与人工输入相结合，可以检测出群体凝聚力，这是有效 OSGs 的一个具有临床意义的指标。在使用人工输入进行再训练后，AICF 的 F1 分数达到了 0.82。与LIWC相比，AICF在识别群体凝聚力方面的表现略胜一筹：AICF 有可能通过检测群体中的不和谐因素来协助治疗师进行实时干预。总之，AICF 提供了一个独特的机会，通过关注个人需求，在基于网络的环境中加强以患者为中心的护理：RR2-10.2196/21453。
{"title":"Artificial Intelligence-Based Co-Facilitator (AICF) for Detecting and Monitoring Group Cohesion Outcomes in Web-Based Cancer Support Groups: Single-Arm Trial Study.","authors":"Yvonne W Leung, Elise Wouterloot, Achini Adikari, Jinny Hong, Veenaajaa Asokan, Lauren Duan, Claire Lam, Carlina Kim, Kai P Chan, Daswin De Silva, Lianne Trachtenberg, Heather Rennie, Jiahui Wong, Mary Jane Esplen","doi":"10.2196/43070","DOIUrl":"10.2196/43070","url":null,"abstract":"<p><strong>Background: </strong>Commonly offered as supportive care, therapist-led online support groups (OSGs) are a cost-effective way to provide support to individuals affected by cancer. One important indicator of a successful OSG session is group cohesion; however, monitoring group cohesion can be challenging due to the lack of nonverbal cues and in-person interactions in text-based OSGs. The Artificial Intelligence-based Co-Facilitator (AICF) was designed to contextually identify therapeutic outcomes from conversations and produce real-time analytics.</p><p><strong>Objective: </strong>The aim of this study was to develop a method to train and evaluate AICF's capacity to monitor group cohesion.</p><p><strong>Methods: </strong>AICF used a text classification approach to extract the mentions of group cohesion within conversations. A sample of data was annotated by human scorers, which was used as the training data to build the classification model. The annotations were further supported by finding contextually similar group cohesion expressions using word embedding models as well. AICF performance was also compared against the natural language processing software Linguistic Inquiry Word Count (LIWC).</p><p><strong>Results: </strong>AICF was trained on 80,000 messages obtained from Cancer Chat Canada. We tested AICF on 34,048 messages. Human experts scored 6797 (20%) of the messages to evaluate the ability of AICF to classify group cohesion. Results showed that machine learning algorithms combined with human input could detect group cohesion, a clinically meaningful indicator of effective OSGs. After retraining with human input, AICF reached an F<sub>1</sub>-score of 0.82. AICF performed slightly better at identifying group cohesion compared to LIWC.</p><p><strong>Conclusions: </strong>AICF has the potential to assist therapists by detecting discord in the group amenable to real-time intervention. Overall, AICF presents a unique opportunity to strengthen patient-centered care in web-based settings by attending to individual needs.</p><p><strong>International registered report identifier (irrid): </strong>RR2-10.2196/21453.</p>","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":"10 ","pages":"e43070"},"PeriodicalIF":3.3,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11301110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jincong Q Freeman, Fangyuan Zhao, Frederick M Howard, Rita Nanda, Olufunmilayo I Olopade, Dezheng Huo
<p><strong>Background: </strong>Since the COVID-19 pandemic began, we have seen rapid growth in telemedicine use. However, telehealth care and services are not equally distributed, and not all patients with breast cancer have equal access across US regions. There are notable gaps in existing literature regarding the influence of neighborhood-level socioeconomic status on telemedicine use in patients with breast cancer and oncology services offered through telehealth versus in-person visits.</p><p><strong>Objective: </strong>We assessed the relationship between neighborhood socioeconomic disadvantage and telemedicine use among patients with breast cancer and examined differential provisions of oncology services between telehealth and in-person visits.</p><p><strong>Methods: </strong>Neighborhood socioeconomic disadvantage was measured using the Area Deprivation Index (ADI), with higher scores indicating greater disadvantages. Telemedicine and in-person visits were defined as having had a telehealth and in-person visit with a provider, respectively, in the past 12 months. Multivariable logistic regression was performed to examine the association between ADI and telemedicine use. The McNemar test was used to assess match-paired data on types of oncology services comparing telehealth and in-person visits.</p><p><strong>Results: </strong>The mean age of the patients with breast cancer (n=1163) was 61.8 (SD 12.0) years; 4.58% (52/1161) identified as Asian, 19.72% (229/1161) as Black, 3.01% (35/1161) as Hispanic, and 72.78% (845/1161) as White. Overall, 35.96% (416/1157) had a telemedicine visit in the past 12 months. Of these patients, 65% (266/409) had a videoconference visit only, 22.7% (93/409) had a telephone visit only, and 12.2% (50/409) had visits by both videoconference and telephone. Higher ADI scores were associated with a lower likelihood of telemedicine use (adjusted odds ratio [AOR] 0.89, 95% CI 0.82-0.97). Black (AOR 2.38, 95% CI 1.41-4.00) and Hispanic (AOR 2.65, 95% CI 1.07-6.58) patients had greater odds of telemedicine use than White patients. Compared to patients with high school or less education, those with an associate's degree (AOR 2.67, 95% CI 1.33-5.35), a bachelor's degree (AOR 2.75, 95% CI 1.38-5.48), or a graduate or professional degree (AOR 2.57, 95% CI 1.31-5.04) had higher odds of telemedicine use in the past 12 months. There were no significant differences in providing treatment consultation (45/405, 11.1% vs 55/405, 13.6%; P=.32) or cancer genetic counseling (11/405, 2.7% vs 19/405, 4.7%; P=.14) between telehealth and in-person visits. Of the telemedicine users, 95.8% (390/407) reported being somewhat to extremely satisfied, and 61.8% (254/411) were likely or very likely to continue using telemedicine.</p><p><strong>Conclusions: </strong>In this study of a multiethnic cohort of patients with breast cancer, our findings suggest that neighborhood-level socioeconomic disparities exist in telemedicine use and that telehealt
背景：自 COVID-19 大流行以来，我们看到远程医疗的使用迅速增长。然而，远程医疗和服务的分布并不均衡，并非所有乳腺癌患者都能在美国各地区平等地获得远程医疗服务。关于邻里层面的社会经济状况对乳腺癌患者使用远程医疗的影响，以及通过远程医疗提供的肿瘤服务与亲自就诊的对比，现有文献存在明显的空白：我们评估了邻里社会经济劣势与乳腺癌患者使用远程医疗之间的关系，并研究了远程医疗与面对面就诊在提供肿瘤服务方面的差异：方法： 采用地区贫困指数（ADI）来衡量邻里的社会经济劣势，得分越高表示劣势越大。在过去 12 个月中，与医疗服务提供者进行过远程医疗和面对面就诊的人分别被定义为远程医疗和面对面就诊者。为研究 ADI 与远程医疗使用之间的关系，我们进行了多变量逻辑回归。采用 McNemar 检验来评估匹配配对的肿瘤服务类型数据，比较远程医疗和面对面就诊的情况：乳腺癌患者（n=1163）的平均年龄为 61.8 岁（SD 12.0）；4.58%（52/1161）为亚裔，19.72%（229/1161）为黑人，3.01%（35/1161）为西班牙裔，72.78%（845/1161）为白人。总体而言，35.96%（416/1157）的患者在过去 12 个月内接受过远程医疗就诊。在这些患者中，65%（266/409）仅通过视频会议就诊，22.7%（93/409）仅通过电话就诊，12.2%（50/409）同时通过视频会议和电话就诊。ADI 分数越高，使用远程医疗的可能性越低（调整后的几率比 [AOR] 0.89，95% CI 0.82-0.97）。黑人（AOR 2.38，95% CI 1.41-4.00）和西班牙裔（AOR 2.65，95% CI 1.07-6.58）患者使用远程医疗的几率高于白人患者。与高中或以下学历的患者相比，拥有副学士学位（AOR 2.67，95% CI 1.33-5.35）、学士学位（AOR 2.75，95% CI 1.38-5.48）或研究生或专业学位（AOR 2.57，95% CI 1.31-5.04）的患者在过去 12 个月中使用远程医疗的几率更高。在提供治疗咨询（45/405，11.1% vs 55/405，13.6%；P=.32）或癌症遗传咨询（11/405，2.7% vs 19/405，4.7%；P=.14）方面，远程医疗与面对面就诊没有明显差异。在远程医疗用户中，95.8%（390/407）的人表示比较满意到非常满意，61.8%（254/411）的人可能或非常可能继续使用远程医疗：在这项针对多种族乳腺癌患者的研究中，我们的发现表明，在远程医疗的使用方面存在着邻里层面的社会经济差异，而远程医疗就诊可用于提供治疗咨询和癌症遗传咨询。肿瘤学项目应解决这些差异和需求，以改善医疗服务，实现患者群体的远程医疗公平。
{"title":"Assessing the Relationship Between Neighborhood Socioeconomic Disadvantage and Telemedicine Use Among Patients With Breast Cancer and Examining Differential Provisions of Oncology Services Between Telehealth and In-Person Visits: Quantitative Study.","authors":"Jincong Q Freeman, Fangyuan Zhao, Frederick M Howard, Rita Nanda, Olufunmilayo I Olopade, Dezheng Huo","doi":"10.2196/55438","DOIUrl":"10.2196/55438","url":null,"abstract":"<p><strong>Background: </strong>Since the COVID-19 pandemic began, we have seen rapid growth in telemedicine use. However, telehealth care and services are not equally distributed, and not all patients with breast cancer have equal access across US regions. There are notable gaps in existing literature regarding the influence of neighborhood-level socioeconomic status on telemedicine use in patients with breast cancer and oncology services offered through telehealth versus in-person visits.</p><p><strong>Objective: </strong>We assessed the relationship between neighborhood socioeconomic disadvantage and telemedicine use among patients with breast cancer and examined differential provisions of oncology services between telehealth and in-person visits.</p><p><strong>Methods: </strong>Neighborhood socioeconomic disadvantage was measured using the Area Deprivation Index (ADI), with higher scores indicating greater disadvantages. Telemedicine and in-person visits were defined as having had a telehealth and in-person visit with a provider, respectively, in the past 12 months. Multivariable logistic regression was performed to examine the association between ADI and telemedicine use. The McNemar test was used to assess match-paired data on types of oncology services comparing telehealth and in-person visits.</p><p><strong>Results: </strong>The mean age of the patients with breast cancer (n=1163) was 61.8 (SD 12.0) years; 4.58% (52/1161) identified as Asian, 19.72% (229/1161) as Black, 3.01% (35/1161) as Hispanic, and 72.78% (845/1161) as White. Overall, 35.96% (416/1157) had a telemedicine visit in the past 12 months. Of these patients, 65% (266/409) had a videoconference visit only, 22.7% (93/409) had a telephone visit only, and 12.2% (50/409) had visits by both videoconference and telephone. Higher ADI scores were associated with a lower likelihood of telemedicine use (adjusted odds ratio [AOR] 0.89, 95% CI 0.82-0.97). Black (AOR 2.38, 95% CI 1.41-4.00) and Hispanic (AOR 2.65, 95% CI 1.07-6.58) patients had greater odds of telemedicine use than White patients. Compared to patients with high school or less education, those with an associate's degree (AOR 2.67, 95% CI 1.33-5.35), a bachelor's degree (AOR 2.75, 95% CI 1.38-5.48), or a graduate or professional degree (AOR 2.57, 95% CI 1.31-5.04) had higher odds of telemedicine use in the past 12 months. There were no significant differences in providing treatment consultation (45/405, 11.1% vs 55/405, 13.6%; P=.32) or cancer genetic counseling (11/405, 2.7% vs 19/405, 4.7%; P=.14) between telehealth and in-person visits. Of the telemedicine users, 95.8% (390/407) reported being somewhat to extremely satisfied, and 61.8% (254/411) were likely or very likely to continue using telemedicine.</p><p><strong>Conclusions: </strong>In this study of a multiethnic cohort of patients with breast cancer, our findings suggest that neighborhood-level socioeconomic disparities exist in telemedicine use and that telehealt","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":"10 ","pages":"e55438"},"PeriodicalIF":3.3,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11294759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shelby L Bachman, Emma Gomes, Suvekshya Aryal, David Cella, Ieuan Clay, Kate Lyden, Heather J Leach
<p><strong>Background: </strong>As the number of cancer survivors increases, maintaining health-related quality of life in cancer survivorship is a priority. This necessitates accurate and reliable methods to assess how cancer survivors are feeling and functioning. Real-world digital measures derived from wearable sensors offer potential for monitoring well-being and physical function in cancer survivorship, but questions surrounding the clinical utility of these measures remain to be answered.</p><p><strong>Objective: </strong>In this secondary analysis, we used 2 existing data sets to examine how measures of real-world physical behavior, captured with a wearable accelerometer, were related to aerobic fitness and self-reported well-being and physical function in a sample of individuals who had completed cancer treatment.</p><p><strong>Methods: </strong>Overall, 86 disease-free cancer survivors aged 21-85 years completed self-report assessments of well-being and physical function, as well as a submaximal exercise test that was used to estimate their aerobic fitness, quantified as predicted submaximal oxygen uptake (VO<sub>2</sub>). A thigh-worn accelerometer was used to monitor participants' real-world physical behavior for 7 days. Accelerometry data were used to calculate average values of the following measures of physical behavior: sedentary time, step counts, time in light and moderate to vigorous physical activity, time and weighted median cadence in stepping bouts over 1 minute, and peak 30-second cadence.</p><p><strong>Results: </strong>Spearman correlation analyses indicated that 6 (86%) of the 7 accelerometry-derived measures of real-world physical behavior were not significantly correlated with Functional Assessment of Cancer Therapy-General total well-being or linked Patient-Reported Outcomes Measurement Information System-Physical Function scores (Ps≥.08). In contrast, all but one of the physical behavior measures were significantly correlated with submaximal VO<sub>2</sub> (Ps≤.03). Comparing these associations using likelihood ratio tests, we found that step counts, time in stepping bouts over 1 minute, and time in moderate to vigorous activity were more strongly associated with submaximal VO<sub>2</sub> than with self-reported well-being or physical function (Ps≤.03). In contrast, cadence in stepping bouts over 1 minute and peak 30-second cadence were not more associated with submaximal VO<sub>2</sub> than with the self-reported measures (Ps≥.08).</p><p><strong>Conclusions: </strong>In a sample of disease-free cancer survivors, we found that several measures of real-world physical behavior were more associated with aerobic fitness than with self-reported well-being and physical function. These results highlight the possibility that in individuals who have completed cancer treatment, measures of real-world physical behavior may provide additional information compared with self-reported and performance measures. To advance the approp
{"title":"Do Measures of Real-World Physical Behavior Provide Insights Into the Well-Being and Physical Function of Cancer Survivors? Cross-Sectional Analysis.","authors":"Shelby L Bachman, Emma Gomes, Suvekshya Aryal, David Cella, Ieuan Clay, Kate Lyden, Heather J Leach","doi":"10.2196/53180","DOIUrl":"10.2196/53180","url":null,"abstract":"<p><strong>Background: </strong>As the number of cancer survivors increases, maintaining health-related quality of life in cancer survivorship is a priority. This necessitates accurate and reliable methods to assess how cancer survivors are feeling and functioning. Real-world digital measures derived from wearable sensors offer potential for monitoring well-being and physical function in cancer survivorship, but questions surrounding the clinical utility of these measures remain to be answered.</p><p><strong>Objective: </strong>In this secondary analysis, we used 2 existing data sets to examine how measures of real-world physical behavior, captured with a wearable accelerometer, were related to aerobic fitness and self-reported well-being and physical function in a sample of individuals who had completed cancer treatment.</p><p><strong>Methods: </strong>Overall, 86 disease-free cancer survivors aged 21-85 years completed self-report assessments of well-being and physical function, as well as a submaximal exercise test that was used to estimate their aerobic fitness, quantified as predicted submaximal oxygen uptake (VO<sub>2</sub>). A thigh-worn accelerometer was used to monitor participants' real-world physical behavior for 7 days. Accelerometry data were used to calculate average values of the following measures of physical behavior: sedentary time, step counts, time in light and moderate to vigorous physical activity, time and weighted median cadence in stepping bouts over 1 minute, and peak 30-second cadence.</p><p><strong>Results: </strong>Spearman correlation analyses indicated that 6 (86%) of the 7 accelerometry-derived measures of real-world physical behavior were not significantly correlated with Functional Assessment of Cancer Therapy-General total well-being or linked Patient-Reported Outcomes Measurement Information System-Physical Function scores (Ps≥.08). In contrast, all but one of the physical behavior measures were significantly correlated with submaximal VO<sub>2</sub> (Ps≤.03). Comparing these associations using likelihood ratio tests, we found that step counts, time in stepping bouts over 1 minute, and time in moderate to vigorous activity were more strongly associated with submaximal VO<sub>2</sub> than with self-reported well-being or physical function (Ps≤.03). In contrast, cadence in stepping bouts over 1 minute and peak 30-second cadence were not more associated with submaximal VO<sub>2</sub> than with the self-reported measures (Ps≥.08).</p><p><strong>Conclusions: </strong>In a sample of disease-free cancer survivors, we found that several measures of real-world physical behavior were more associated with aerobic fitness than with self-reported well-being and physical function. These results highlight the possibility that in individuals who have completed cancer treatment, measures of real-world physical behavior may provide additional information compared with self-reported and performance measures. To advance the approp","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":"10 ","pages":"e53180"},"PeriodicalIF":3.3,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11287100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vienna Cheng, Eric C Sayre, Vicki Cheng, Ria Garg, Sharlene Gill, Ameer Farooq, Mary A De Vera
Background: Colorectal cancer (CRC) is estimated to be the fourth most common cancer diagnosis in Canada (except for nonmelanoma skin cancers) and the second and third leading cause of cancer-related death in male and female individuals, respectively.
Objective: The rising incidence of early age-onset colorectal cancer (EAO-CRC; diagnosis at less than 50 years) calls for a better understanding of patients' pathway to diagnosis. Therefore, we evaluated patterns of prescription medication use before EAO-CRC diagnosis.
Methods: We used linked administrative health databases in British Columbia (BC), Canada, to identify individuals diagnosed with EAO-CRC between January 1, 2010, and December 31, 2016 (hereinafter referred to as "cases"), along with cancer-free controls (1:10), matched by age and sex. We identified all prescriptions dispensed from community pharmacies during the year prior to diagnosis and used the Anatomical Therapeutic Chemical Classification system Level 3 to group prescriptions according to the drug class. A parallel assessment was conducted for individuals diagnosed with average age-onset CRC (diagnosis at age 50 years and older).
Results: We included 1001 EAO-CRC cases (n=450, 45% female participants; mean 41.0, SD 6.1 years), and 12,989 prescriptions were filled in the year before diagnosis by 797 (79.7%) individuals. Top-filled drugs were antidepressants (first; n=1698, 13.1%). Drugs for peptic ulcer disease and gastroesophageal reflux disease (third; n=795, 6.1%) were more likely filled by EAO-CRC cases than controls (odds ratio [OR] 1.4, 95% CI 1.2-1.7) and with more frequent fills (OR 1.8, 95% CI 1.7-1.9). We noted similar patterns for topical agents for hemorrhoids and anal fissures, which were more likely filled by EAO-CRC cases than controls (OR 7.4, 95% CI 5.8-9.4) and with more frequent fills (OR 15.6, 95% CI 13.1-18.6).
Conclusions: We observed frequent prescription medication use in the year before diagnosis of EAO-CRC, including for drugs to treat commonly reported symptoms of EAO-CRC.
{"title":"Patterns of Prescription Medication Use Before Diagnosis of Early Age-Onset Colorectal Cancer: Population-Based Descriptive Study.","authors":"Vienna Cheng, Eric C Sayre, Vicki Cheng, Ria Garg, Sharlene Gill, Ameer Farooq, Mary A De Vera","doi":"10.2196/50402","DOIUrl":"10.2196/50402","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) is estimated to be the fourth most common cancer diagnosis in Canada (except for nonmelanoma skin cancers) and the second and third leading cause of cancer-related death in male and female individuals, respectively.</p><p><strong>Objective: </strong>The rising incidence of early age-onset colorectal cancer (EAO-CRC; diagnosis at less than 50 years) calls for a better understanding of patients' pathway to diagnosis. Therefore, we evaluated patterns of prescription medication use before EAO-CRC diagnosis.</p><p><strong>Methods: </strong>We used linked administrative health databases in British Columbia (BC), Canada, to identify individuals diagnosed with EAO-CRC between January 1, 2010, and December 31, 2016 (hereinafter referred to as \"cases\"), along with cancer-free controls (1:10), matched by age and sex. We identified all prescriptions dispensed from community pharmacies during the year prior to diagnosis and used the Anatomical Therapeutic Chemical Classification system Level 3 to group prescriptions according to the drug class. A parallel assessment was conducted for individuals diagnosed with average age-onset CRC (diagnosis at age 50 years and older).</p><p><strong>Results: </strong>We included 1001 EAO-CRC cases (n=450, 45% female participants; mean 41.0, SD 6.1 years), and 12,989 prescriptions were filled in the year before diagnosis by 797 (79.7%) individuals. Top-filled drugs were antidepressants (first; n=1698, 13.1%). Drugs for peptic ulcer disease and gastroesophageal reflux disease (third; n=795, 6.1%) were more likely filled by EAO-CRC cases than controls (odds ratio [OR] 1.4, 95% CI 1.2-1.7) and with more frequent fills (OR 1.8, 95% CI 1.7-1.9). We noted similar patterns for topical agents for hemorrhoids and anal fissures, which were more likely filled by EAO-CRC cases than controls (OR 7.4, 95% CI 5.8-9.4) and with more frequent fills (OR 15.6, 95% CI 13.1-18.6).</p><p><strong>Conclusions: </strong>We observed frequent prescription medication use in the year before diagnosis of EAO-CRC, including for drugs to treat commonly reported symptoms of EAO-CRC.</p>","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":"10 ","pages":"e50402"},"PeriodicalIF":3.3,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11282380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141601974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sharon H Baik, Karen Clark, Marisol Sanchez, Matthew Loscalzo, Ashley Celis, Marianne Razavi, Dershung Yang, William Dale, Niina Haas
<p><strong>Background: </strong>Using an iterative user-centered design process, our team developed a patient-centered adaptive supportive care system, PatientCareAnywhere, that provides comprehensive biopsychosocial screening and supportive cancer care to patients across the continuum of care adaptively. The overarching goal of PatientCareAnywhere is to improve health-related quality of life (HRQOL) and self-efficacy of patients with cancer by empowering them with self-management skills and bringing cancer care support directly to them at home. Such support is adaptive to the patient's needs and health status and coordinated across multiple sources in the forms of referrals, education, engagement of community resources, and secure social communication.</p><p><strong>Objective: </strong>This study aims to assess the usability of the new web-based PatientCareAnywhere system and examine the preliminary efficacy of PatientCareAnywhere to improve patient-reported outcomes compared with usual care.</p><p><strong>Methods: </strong>For phase 1, usability testing participants included patients with cancer (n=4) and caregivers (n=7) who evaluated the software prototype and provided qualitative (eg, interviews) and quantitative (eg, System Usability Scale) feedback. For phase 2, participants in the 3-month pilot randomized controlled trial were randomized to receive the PatientCareAnywhere intervention (n=36) or usual care control condition (n=36). HRQOL and cancer-relevant self-efficacy were assessed at baseline (preintervention assessment) and 12 weeks from baseline (postintervention assessment); mean differences between pre- and postintervention scores were compared between the 2 groups.</p><p><strong>Results: </strong>Participants were highly satisfied with the prototype and reported above-average acceptable usability, with a mean System Usability Scale score of 84.09 (SD 10.02). Qualitative data supported the overall usability and perceived usefulness of the intervention, with a few design features (eg, "help request" function) added based on participant feedback. With regard to the randomized controlled trial, patients in the intervention group reported significant improvements in HRQOL from pre- to postintervention scores (mean difference 6.08, SD 15.26) compared with the control group (mean difference -2.95, SD 10.63; P=.01). In contrast, there was no significant between-group difference in self-efficacy (P=.09).</p><p><strong>Conclusions: </strong>Overall, PatientCareAnywhere represents a user-friendly, functional, and acceptable supportive care intervention with preliminary efficacy to improve HRQOL among patients diagnosed with cancer. Future studies are needed to further establish the efficacy of PatientCareAnywhere as well as explore strategies to enhance user engagement and investigate the optimal intensity, frequency, and use of the intervention to improve patient outcomes.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT024
{"title":"Usability and Preliminary Efficacy of an Adaptive Supportive Care System for Patients With Cancer: Pilot Randomized Controlled Trial.","authors":"Sharon H Baik, Karen Clark, Marisol Sanchez, Matthew Loscalzo, Ashley Celis, Marianne Razavi, Dershung Yang, William Dale, Niina Haas","doi":"10.2196/49703","DOIUrl":"10.2196/49703","url":null,"abstract":"<p><strong>Background: </strong>Using an iterative user-centered design process, our team developed a patient-centered adaptive supportive care system, PatientCareAnywhere, that provides comprehensive biopsychosocial screening and supportive cancer care to patients across the continuum of care adaptively. The overarching goal of PatientCareAnywhere is to improve health-related quality of life (HRQOL) and self-efficacy of patients with cancer by empowering them with self-management skills and bringing cancer care support directly to them at home. Such support is adaptive to the patient's needs and health status and coordinated across multiple sources in the forms of referrals, education, engagement of community resources, and secure social communication.</p><p><strong>Objective: </strong>This study aims to assess the usability of the new web-based PatientCareAnywhere system and examine the preliminary efficacy of PatientCareAnywhere to improve patient-reported outcomes compared with usual care.</p><p><strong>Methods: </strong>For phase 1, usability testing participants included patients with cancer (n=4) and caregivers (n=7) who evaluated the software prototype and provided qualitative (eg, interviews) and quantitative (eg, System Usability Scale) feedback. For phase 2, participants in the 3-month pilot randomized controlled trial were randomized to receive the PatientCareAnywhere intervention (n=36) or usual care control condition (n=36). HRQOL and cancer-relevant self-efficacy were assessed at baseline (preintervention assessment) and 12 weeks from baseline (postintervention assessment); mean differences between pre- and postintervention scores were compared between the 2 groups.</p><p><strong>Results: </strong>Participants were highly satisfied with the prototype and reported above-average acceptable usability, with a mean System Usability Scale score of 84.09 (SD 10.02). Qualitative data supported the overall usability and perceived usefulness of the intervention, with a few design features (eg, \"help request\" function) added based on participant feedback. With regard to the randomized controlled trial, patients in the intervention group reported significant improvements in HRQOL from pre- to postintervention scores (mean difference 6.08, SD 15.26) compared with the control group (mean difference -2.95, SD 10.63; P=.01). In contrast, there was no significant between-group difference in self-efficacy (P=.09).</p><p><strong>Conclusions: </strong>Overall, PatientCareAnywhere represents a user-friendly, functional, and acceptable supportive care intervention with preliminary efficacy to improve HRQOL among patients diagnosed with cancer. Future studies are needed to further establish the efficacy of PatientCareAnywhere as well as explore strategies to enhance user engagement and investigate the optimal intensity, frequency, and use of the intervention to improve patient outcomes.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT024","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":"10 ","pages":"e49703"},"PeriodicalIF":3.3,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11269963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nelson C Y Yeung, Stephanie T Y Lau, Winnie W S Mak, Cecilia Cheng, Emily Y Y Chan, Judy Y M Siu, Polly S Y Cheung
<p><strong>Background: </strong>Many supportive cancer care (SCC) services were teledelivered during COVID-19, but what facilitates patients' intentions to use teledelivered SCC is unknown.</p><p><strong>Objective: </strong>The study aimed to use the unified theory of acceptance and use of technology to investigate the factors associated with the intentions of breast cancer survivors (BCS) in Hong Kong to use various types of teledelivered SCC (including psychosocial care, medical consultation, complementary care, peer support groups). Favorable telehealth-related perceptions (higher performance expectancy, lower effort expectancy, more facilitating conditions, positive social influences), less technological anxiety, and greater fear of COVID-19 were hypothesized to be associated with higher intentions to use teledelivered SCC. Moreover, the associations between telehealth-related perceptions and intentions to use teledelivered SCC were hypothesized to be moderated by education level, such that associations between telehealth-related perceptions and intentions to use teledelivered SCC would be stronger among those with a higher education level.</p><p><strong>Methods: </strong>A sample of 209 (209/287, 72.8% completion rate) women diagnosed with breast cancer since the start of the COVID-19 outbreak in Hong Kong (ie, January 2020) were recruited from the Hong Kong Breast Cancer Registry to complete a cross-sectional survey between June 2022 and December 2022. Participants' intentions to use various types of teledelivered SCC (dependent variables), telehealth-related perceptions (independent variables), and sociodemographic variables (eg, education, as a moderator variable) were measured using self-reported, validated measures.</p><p><strong>Results: </strong>Hierarchical regression analysis results showed that greater confidence using telehealth, performance expectancy (believing telehealth helps with daily tasks), social influence (important others encouraging telehealth use), and facilitating conditions (having resources for telehealth use) were associated with higher intentions to use teledelivered SCC (range: β=0.16, P=.03 to β=0.34, P<.001). Moreover, 2-way interactions emerged between education level and 2 of the telehealth perception variables. Education level moderated the associations between (1) performance expectancy and intention to use teledelivered complementary care (β=0.34, P=.04) and (2) facilitating conditions and intention to use teledelivered peer support groups (β=0.36, P=.03). The positive associations between those telehealth perceptions and intentions were only significant among those with a higher education level.</p><p><strong>Conclusions: </strong>The findings of this study implied that enhancing BCS' skills at using telehealth, BCS' and their important others' perceived benefits of telehealth, and providing assistance for telehealth use could increase BCS' intentions to use teledelivered SCC. For intentions to use speci
{"title":"Applying the Unified Theory of Acceptance and Use of Technology to Identify Factors Associated With Intention to Use Teledelivered Supportive Care Among Recently Diagnosed Breast Cancer Survivors During COVID-19 in Hong Kong: Cross-Sectional Survey.","authors":"Nelson C Y Yeung, Stephanie T Y Lau, Winnie W S Mak, Cecilia Cheng, Emily Y Y Chan, Judy Y M Siu, Polly S Y Cheung","doi":"10.2196/51072","DOIUrl":"10.2196/51072","url":null,"abstract":"<p><strong>Background: </strong>Many supportive cancer care (SCC) services were teledelivered during COVID-19, but what facilitates patients' intentions to use teledelivered SCC is unknown.</p><p><strong>Objective: </strong>The study aimed to use the unified theory of acceptance and use of technology to investigate the factors associated with the intentions of breast cancer survivors (BCS) in Hong Kong to use various types of teledelivered SCC (including psychosocial care, medical consultation, complementary care, peer support groups). Favorable telehealth-related perceptions (higher performance expectancy, lower effort expectancy, more facilitating conditions, positive social influences), less technological anxiety, and greater fear of COVID-19 were hypothesized to be associated with higher intentions to use teledelivered SCC. Moreover, the associations between telehealth-related perceptions and intentions to use teledelivered SCC were hypothesized to be moderated by education level, such that associations between telehealth-related perceptions and intentions to use teledelivered SCC would be stronger among those with a higher education level.</p><p><strong>Methods: </strong>A sample of 209 (209/287, 72.8% completion rate) women diagnosed with breast cancer since the start of the COVID-19 outbreak in Hong Kong (ie, January 2020) were recruited from the Hong Kong Breast Cancer Registry to complete a cross-sectional survey between June 2022 and December 2022. Participants' intentions to use various types of teledelivered SCC (dependent variables), telehealth-related perceptions (independent variables), and sociodemographic variables (eg, education, as a moderator variable) were measured using self-reported, validated measures.</p><p><strong>Results: </strong>Hierarchical regression analysis results showed that greater confidence using telehealth, performance expectancy (believing telehealth helps with daily tasks), social influence (important others encouraging telehealth use), and facilitating conditions (having resources for telehealth use) were associated with higher intentions to use teledelivered SCC (range: β=0.16, P=.03 to β=0.34, P<.001). Moreover, 2-way interactions emerged between education level and 2 of the telehealth perception variables. Education level moderated the associations between (1) performance expectancy and intention to use teledelivered complementary care (β=0.34, P=.04) and (2) facilitating conditions and intention to use teledelivered peer support groups (β=0.36, P=.03). The positive associations between those telehealth perceptions and intentions were only significant among those with a higher education level.</p><p><strong>Conclusions: </strong>The findings of this study implied that enhancing BCS' skills at using telehealth, BCS' and their important others' perceived benefits of telehealth, and providing assistance for telehealth use could increase BCS' intentions to use teledelivered SCC. For intentions to use speci","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":"10 ","pages":"e51072"},"PeriodicalIF":3.3,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11240077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lindsey L Page, Jason Fanning, Connor Phipps, Ann Berger, Elizabeth Reed, Diane Ehlers
<p><strong>Background: </strong>Exercise intensity (eg, target heart rate [HR]) is a fundamental component of exercise prescription to elicit health benefits in cancer survivors. Despite the validity of chest-worn monitors, their feasibility in community and unsupervised exercise settings may be challenging. As wearable technology continues to improve, consumer-based wearable sensors may represent an accessible alternative to traditional monitoring, offering additional advantages.</p><p><strong>Objective: </strong>The purpose of this study was to examine the agreement between the Polar H10 chest monitor and Fitbit Inspire HR for HR measurement in breast cancer survivors enrolled in the intervention arm of a randomized, pilot exercise trial.</p><p><strong>Methods: </strong>Participants included breast cancer survivors (N=14; aged 38-72 years) randomized to a 12-week aerobic exercise program. This program consisted of three 60-minute, moderate-intensity walking sessions per week, either in small groups or one-on-one, facilitated by a certified exercise physiologist and held at local community fitness centers. As originally designed, the exercise prescription included 36 supervised sessions at a fitness center. However, due to the COVID-19 pandemic, the number of supervised sessions varied depending on whether participants enrolled before or after March 2020. During each exercise session, HR (in beats per minute) was concurrently measured via a Polar H10 chest monitor and a wrist-worn Fitbit Inspire HR at 5 stages: pre-exercise rest; midpoint of warm-up; midpoint of exercise session; midpoint of cool-down; and postexercise recovery. The exercise physiologist recorded the participant's HR from each device at the midpoint of each stage. HR agreement between the Polar H10 and Fitbit Inspire HR was assessed using Lin concordance correlation coefficient (r<sub>c</sub>) with a 95% CI. Lin rc ranges from 0 to 1.00, with 0 indicating no concordance and 1.00 indicating perfect concordance. Relative error rates were calculated to examine differences across exercise session stages.</p><p><strong>Results: </strong>Data were available for 200 supervised sessions across the sample (session per participant: mean 13.33, SD 13.7). By exercise session stage, agreement between the Polar H10 monitor and the Fitbit was highest during pre-exercise seated rest (rc=0.76, 95% CI 0.70-0.81) and postexercise seated recovery (rc=0.89, 95% CI 0.86-0.92), followed by the midpoint of exercise (rc=0.63, 95% CI 0.55-0.70) and cool-down (rc=0.68, 95% CI 0.60-0.74). The agreement was lowest during warm-up (rc=0.39, 95% CI 0.27-0.49). Relative error rates ranged from -3.91% to 3.09% and were greatest during warm-up (relative error rate: mean -3.91, SD 11.92%).</p><p><strong>Conclusions: </strong>The Fitbit overestimated HR during peak exercise intensity, posing risks for overexercising, which may not be safe for breast cancer survivors' fitness levels. While the Fitbit Inspire HR may
{"title":"Heart Rate Monitoring Among Breast Cancer Survivors: Quantitative Study of Device Agreement in a Community-Based Exercise Program.","authors":"Lindsey L Page, Jason Fanning, Connor Phipps, Ann Berger, Elizabeth Reed, Diane Ehlers","doi":"10.2196/51210","DOIUrl":"10.2196/51210","url":null,"abstract":"<p><strong>Background: </strong>Exercise intensity (eg, target heart rate [HR]) is a fundamental component of exercise prescription to elicit health benefits in cancer survivors. Despite the validity of chest-worn monitors, their feasibility in community and unsupervised exercise settings may be challenging. As wearable technology continues to improve, consumer-based wearable sensors may represent an accessible alternative to traditional monitoring, offering additional advantages.</p><p><strong>Objective: </strong>The purpose of this study was to examine the agreement between the Polar H10 chest monitor and Fitbit Inspire HR for HR measurement in breast cancer survivors enrolled in the intervention arm of a randomized, pilot exercise trial.</p><p><strong>Methods: </strong>Participants included breast cancer survivors (N=14; aged 38-72 years) randomized to a 12-week aerobic exercise program. This program consisted of three 60-minute, moderate-intensity walking sessions per week, either in small groups or one-on-one, facilitated by a certified exercise physiologist and held at local community fitness centers. As originally designed, the exercise prescription included 36 supervised sessions at a fitness center. However, due to the COVID-19 pandemic, the number of supervised sessions varied depending on whether participants enrolled before or after March 2020. During each exercise session, HR (in beats per minute) was concurrently measured via a Polar H10 chest monitor and a wrist-worn Fitbit Inspire HR at 5 stages: pre-exercise rest; midpoint of warm-up; midpoint of exercise session; midpoint of cool-down; and postexercise recovery. The exercise physiologist recorded the participant's HR from each device at the midpoint of each stage. HR agreement between the Polar H10 and Fitbit Inspire HR was assessed using Lin concordance correlation coefficient (r<sub>c</sub>) with a 95% CI. Lin rc ranges from 0 to 1.00, with 0 indicating no concordance and 1.00 indicating perfect concordance. Relative error rates were calculated to examine differences across exercise session stages.</p><p><strong>Results: </strong>Data were available for 200 supervised sessions across the sample (session per participant: mean 13.33, SD 13.7). By exercise session stage, agreement between the Polar H10 monitor and the Fitbit was highest during pre-exercise seated rest (rc=0.76, 95% CI 0.70-0.81) and postexercise seated recovery (rc=0.89, 95% CI 0.86-0.92), followed by the midpoint of exercise (rc=0.63, 95% CI 0.55-0.70) and cool-down (rc=0.68, 95% CI 0.60-0.74). The agreement was lowest during warm-up (rc=0.39, 95% CI 0.27-0.49). Relative error rates ranged from -3.91% to 3.09% and were greatest during warm-up (relative error rate: mean -3.91, SD 11.92%).</p><p><strong>Conclusions: </strong>The Fitbit overestimated HR during peak exercise intensity, posing risks for overexercising, which may not be safe for breast cancer survivors' fitness levels. While the Fitbit Inspire HR may ","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":"10 ","pages":"e51210"},"PeriodicalIF":3.3,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11224697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141427915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rosa Andree, Ajla Mujcic, Wouter den Hollander, Margriet van Laar, Brigitte Boon, Rutger Engels, Matthijs Blankers
Background: Recent studies have shown positive, though small, clinical effects of digital smoking cessation (SC) interventions for cancer survivors. However, research on associations among participant characteristics, intervention engagement, and outcomes is limited.
Objective: This study aimed to explore the predictors and moderators of engagement and outcome of MyCourse-Quit Smoking (in Dutch: "MijnKoers-Stoppen met Roken"), a digital minimally guided intervention for cancer survivors.
Methods: A secondary analysis of data from the randomized controlled trial was performed. The number of cigarettes smoked in the past 7 days at 6-month follow-up was the primary outcome measure. We analyzed interactions among participant characteristics (11 variables), intervention engagement (3 variables), and outcome using robust linear (mixed) modeling.
Results: In total, 165 participants were included in this study. Female participants accessed the intervention less often than male participants (B=-11.12; P=.004). A higher Alcohol Use Disorders Identification Test score at baseline was associated with a significantly higher number of logins (B=1.10; P<.001) and diary registrations (B=1.29; P<.001). A higher Fagerström Test for Nicotine Dependence score at baseline in the intervention group was associated with a significantly larger reduction in tobacco use after 6 months (B=-9.86; P=.002). No other associations and no moderating effects were found.
Conclusions: Overall, a limited number of associations was found between participant characteristics, engagement, and outcome, except for gender, problematic alcohol use, and nicotine dependence. Future studies are needed to shed light on how this knowledge can be used to improve the effects of digital SC programs for cancer survivors.
{"title":"Digital Smoking Cessation Intervention for Cancer Survivors: Analysis of Predictors and Moderators of Engagement and Outcome Alongside a Randomized Controlled Trial.","authors":"Rosa Andree, Ajla Mujcic, Wouter den Hollander, Margriet van Laar, Brigitte Boon, Rutger Engels, Matthijs Blankers","doi":"10.2196/46303","DOIUrl":"10.2196/46303","url":null,"abstract":"<p><strong>Background: </strong>Recent studies have shown positive, though small, clinical effects of digital smoking cessation (SC) interventions for cancer survivors. However, research on associations among participant characteristics, intervention engagement, and outcomes is limited.</p><p><strong>Objective: </strong>This study aimed to explore the predictors and moderators of engagement and outcome of MyCourse-Quit Smoking (in Dutch: \"MijnKoers-Stoppen met Roken\"), a digital minimally guided intervention for cancer survivors.</p><p><strong>Methods: </strong>A secondary analysis of data from the randomized controlled trial was performed. The number of cigarettes smoked in the past 7 days at 6-month follow-up was the primary outcome measure. We analyzed interactions among participant characteristics (11 variables), intervention engagement (3 variables), and outcome using robust linear (mixed) modeling.</p><p><strong>Results: </strong>In total, 165 participants were included in this study. Female participants accessed the intervention less often than male participants (B=-11.12; P=.004). A higher Alcohol Use Disorders Identification Test score at baseline was associated with a significantly higher number of logins (B=1.10; P<.001) and diary registrations (B=1.29; P<.001). A higher Fagerström Test for Nicotine Dependence score at baseline in the intervention group was associated with a significantly larger reduction in tobacco use after 6 months (B=-9.86; P=.002). No other associations and no moderating effects were found.</p><p><strong>Conclusions: </strong>Overall, a limited number of associations was found between participant characteristics, engagement, and outcome, except for gender, problematic alcohol use, and nicotine dependence. Future studies are needed to shed light on how this knowledge can be used to improve the effects of digital SC programs for cancer survivors.</p><p><strong>Trial registration: </strong>Netherlands Trial register NTR6011/NL5434; https://onderzoekmetmensen.nl/nl/trial/22832.</p>","PeriodicalId":45538,"journal":{"name":"JMIR Cancer","volume":"10 ","pages":"e46303"},"PeriodicalIF":3.3,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11229662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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