Use of a wearable device to compare subjective and objective fatigue in lung cancer patients and cancer-free controls

Ting-Ling Chou; Chi-Huang Shih; Pai-Chien Chou; Jun-Hung Lai; Tsai-Wei Huang

doi:10.1016/j.ejon.2024.102587

Use of a wearable device to compare subjective and objective fatigue in lung cancer patients and cancer-free controls

Eur J Oncol Nurs. 2024 Apr 9:70:102587. doi: 10.1016/j.ejon.2024.102587. Online ahead of print.

Authors

Ting-Ling Chou¹, Chi-Huang Shih², Pai-Chien Chou³, Jun-Hung Lai⁴, Tsai-Wei Huang⁵

Affiliations

¹ School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
² Department of Computer Science and Information Engineering, National Chin-Yi University of Technology, Taichung, Taiwan.
³ Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan; Division of Thoracic Medicine, Department of Internal Medicine, School of Medicine, Taipei Medical University, Taipei, Taiwan.
⁴ Division of Gastroenterology & Hepatology, Department of Internal Medicine, Erlin Christian Hospital, Changhua, Taiwan.
⁵ School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan; Research Center in Nursing Clinical Application, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. Electronic address: tsaiwei@tmu.edu.tw.

PMID: 38652934
DOI: 10.1016/j.ejon.2024.102587

Abstract

Purpose: The study evaluates the use of heart rate variability (HRV), a measure of autonomic nervous system (ANS) modulation via wearable smart bands, to objectively assess cancer-related fatigue (CRF) levels. It aims to enhance understanding of fatigue by distinguishing between LF/HF ratios and LF/HF disorder ratios through HRV and photoplethysmography (PPG), identifying them as potential biomarkers.

Methods: Seventy-one lung cancer patients and 75 non-cancer controls wore smart bands for one week. Fatigue was assessed using Brief Fatigue Inventory, alongside sleep quality and daily interference. HRV parameters were analyzed to compare groups.

Results: Cancer patients showed higher fatigue and interference levels than controls (64.8% vs. 54.7%). Those with mild fatigue had elevated LF/HF disorder ratios during sleep (40% vs. 20%, P = 0.01), similar to those with moderate to severe fatigue (50% vs. 20%, P = 0.01), indicating more significant autonomic dysregulation. Notably, mild fatigue patients had higher mean LF/HF ratios than controls (1.9 ± 1.34 vs. 1.2 ± 0.6, P = 0.01), underscoring the potential of disorder ratios in signaling fatigue severity.

Conclusions: Utilizing wearable smart bands for HRV-based analysis is feasible for objectively assess CRF levels in cancer patients, especially during sleep. By distinguishing between LF/HF ratios and LF/HF disorder ratios, our findings suggest that wearable technology and detailed HRV analysis offer promising avenues for real-time fatigue monitoring. This approach has the potential to significantly improve cancer care by providing new methods for managing and intervening in CRF, particularly with a focus on autonomic dysregulation as a crucial factor.

Keywords: Cancer-related fatigue; Heart rate variability; Photoplethysmography; Smart band; Wearable device.