PURPOSE Efficiency status (PS) is a key factor in oncologic decision making, but conventional scales used to measure PS vary among observers
PURPOSE Efficiency status (PS) is a key factor in oncologic decision making, but conventional scales used to measure PS vary among observers. from chair to table were ML264 the best predictors for unexpected health care encounters (area under the curve, 0.775 0.029) and physical activity (area under the curve, 0.830 0.080). Chair-to-table ML264 acceleration of the nonpivoting knee (= 3.39; = .002) was most correlated with unexpected health care encounters. Get-up-and-walk kinematics were most correlated with physical activity, particularly the right knee acceleration (= ?2.95; = .006) and left arm angular velocity (= ?2.4; = .025). CONCLUSION Chair-to-table kinematics are good predictors of unexpected hospitalizations, whereas the get-up-and-walk kinematics are good predictors of low physical activity. INTRODUCTION Accurate assessment of an oncology patients performance status (PS) is paramount for informing therapeutic decision making, whether it be to predict response and tolerability to treatment or determine eligibility for clinical trials. However, the 2 2 conventional scales used to measure PSthe Karnofsky Performance Status (KPS) scale and ML264 the Eastern Cooperative Oncology Group (ECOG) rankingare observational and thus inherently limited in their precision. KPS and ECOG scales show discordance between health care professional observers, as well as between health care professionals and patients.1,2 In cases with patient-physician disagreement, physicians are likely to rate patients as better performing than patients are likely ML264 to rate themselves.2-4 Moreover, patients who have discordant ratings with their physicians have a 16% increase ML264 in risk of death, underscoring the importance of identifying a high-resolution means of assigning PS.4 CONTEXT Key Objective: Can oncologists use a motion sensor system in a clinic visit to predict treatment tolerability in patients with solid tumors receiving highly emetogenic chemotherapy? Knowledge Generated: Chair-to-table kinematics, as measured by Microsoft Kinect, are good predictors of unexpected hospitalizations, whereas get-up-and-walk kinematics, as measured by Microsoft Kinect, are good predictors of low physical activity. Relevance: Our findings suggest a motion-capture system as one tool with which oncologists can make more precise assessments of treatment tolerability in the clinical setting. This will better inform oncologists about clinical decision making, improve patient treatment options and outcomes, and expand eligibility criteria in oncologic clinical trials. In addition, a patients PS plays a key role in his or her treatment trajectory. Reduced PS is usually associated with poor prognosis, diminished quality of life, and increased risk of sepsis and chemotherapy-induced nausea and vomiting, two conditions that can cause unexpected hospitalizations.5-7 Randomized clinical trials (RCTs) for anticancer treatment commonly use PS as an inclusion criterion, with few stratifying by PS. Although systematic reviews do not show Rabbit polyclonal to ACBD5 PS to confer direct benefit in treatment efficacy, there is evidence that patients with reduced PS suffer greater toxicities that effectively diminish the clinical utility of the drug.8,9 Pooled analyses of patients with metastatic colorectal cancer show that reduced PS is associated with poorer survival and that patients with an ECOG PS of 2 are more likely to experience nausea, vomiting, and 60-day all-cause mortality.10,11 Patients with lung cancer with reduced PS receiving cisplatin-based treatment overwhelmingly suffer disease-related grade III to IV hematologic toxicities.12 This pattern is paralleled in newer immunotherapy trials: More than 50% of patients with melanoma were not eligible for major RCTs on the basis of ECOG PS 2, but those with reduced PS who do receive immunotherapy outside of prospective trials have reduced median survival and are more likely to be hospitalized within the.