Monitoring Adolescent and Young Adult Patients With Cancer via a Smart T-Shirt: Prospective, Single-Cohort, Mixed Methods Feasibility Study (OncoSmartShirt Study)

Abstract

Background: Wearables measuring vital parameters can be potential tools for monitoring patients at home during cancer treatment. One type of wearable is a smart t-shirt with embedded sensors. Initially, the smart t-shirts were designed to aid athletes in their performance analysis but with an ambition to be a supportive tool in health care. In general, the knowledge of the use of wearables for symptom monitoring during cancer treatment is limited, and consensus and awareness about compliance or adherence are sparse. Objective: The aim of this study was to evaluate the adherence and patient experience of using a smart t-shirt for home monitoring of biometric sensor data in adolescents and young adults (AYA) undergoing cancer treatment during a two-week period. Methods Methods: The study was a prospective, single-cohort, mixed-method feasibility study. Inclusion criteria were patients ≥18-39 years receiving treatment at Copenhagen University Hospital, Rigshospitalet, D.K. Consenting patients were asked to wear the ChronolifeTM smart t-shirt for a period of two weeks. The smart t-shirt has multiple sensors and electrodes, which engender six measurements: ECG, thoracic and abdominal respiration, thoracic impedance, physical activity (steps), and skin temperature. The primary endpoint was adherence, defined as wear time > 8 hours/day. The patient experience was investigated in individual semi-structured telephone interviews and a paper questionnaire. Results: Ten patients were included. Wear time >8 h/d during the study period (14 days) varied between 0-6 days, mean 2 days. Three patients had a mean wear time >8 h/d during their days with data registration. Days with any data registration were 0-10, mean 6.4 days. The thematic analysis of interviews pointed to three main themes: 1) The smart t-shirt is cool but does not fit cancer patients; 2) The technology limits the use of the smart t-shirt; and 3) Monitoring of data increases the safety feeling. Results from the questionnaire showed that the patients generally had confidence in the device. Conclusions: Although the primary endpoint was not reached, the patients’ experience using the smart t-shirt led to the knowledge that patients acknowledged the need for new technologies for improved supportive care in cancer. The patients were positive when asked to wear the smart t-shirt. However, technical and practical challenges in using the device led to low adherence. Although wearables might have a potential for home monitoring, the present technology is immature for clinical use.