Clinical OMICS

SEP-OCT 2018

Healthcare magazine for research scientists, labs, pathologists, hospitals, cancer centers, physicians and biopharma companies providing news articles, expert interviews and videos about molecular diagnostics in precision medicine

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22 Clinical OMICs September/October 2018 www.clinicalomics.com The wound-tracking app combines machine learning algo- rithms and computational photography, allowing patients or caregivers to photograph the wounds. The app compares the size, color, and other features of the wound over time— features that become digital biomarkers and ones familiar to physicians as being reliable indicators of wound heal- ing. Once these biomarkers are analyzed, the app generates a healing score that lets the patient know if the wound is getting better; is unchanged; or is worsening. It also gener- ates one of three messages: stay the course; consult a wound specialist; or seek immediate care. In a pilot study, Agu and his colleagues used the app to analyze 114 images over the course of a year that were taken at a University of Massachu- setts clinic. In February, the team was awarded a $1.6 mil- lion grant from the National Institutes of Health to continue the development of the app, expand the use to other kinds of wounds—such as pressure sores—and to address some of the app's shortcomings, such as inadequate lighting in pho- tos. "Wounds, wound management, and amputations have a huge cost, both financially and physically, for the people who suffer from them, as well as for their families. Wound management is a problem that imaging technology can help with," Agu said. In another use of wearable or remote monitoring tech- nology, researchers at the University of Texas Southwestern (UTSW) Medical Center, are testing whether physical activity monitors (PAMs) can accurately measure functional status in patients with cancer receiving chemotherapy and whether patients will comply with use instructions. "You see young people carrying Fitbits, but most patients with cancer may be older and technology illiterate. We didn't know if they would be able to do all of this," said Arjun Gupta, M.D., who was chief resident in internal med- icine at UTSW when the study was done. (Gupta is now an oncology fellow at Johns Hopkins University's Sidney Kimmel Comprehensive Can- cer Center.) To determine the feasibility of using PAMs with patients receiving chemother- apy, UTSW doctors gave PAMs to 24 patients with differ- ent kinds of cancer who had Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 to 2, mean- ing they were not bed-bound more than 50 percent of the time. The team reported in the May issue of Clinical Cancer Informatics that PAM-derived measures of physical activ- ity correlated with clinician-assessed ECOG scores. Only one patient was eliminated from the study. The rest used the PAMs as instructed, wearing the monitor more than 50 percent of the time over 10 weeks and uploading data to a smartphone weekly. Gupta said minimum steps taken per day was the most sensitive biomarker. "If a patient took less than 800 steps, it meant they were not getting out of bed much and not doing very well," Gupta said. This informa- tion is critical to caring for patients. Those with poor PS, as determined by clinical judgment and patient question- naires, have poorer survival, reduced response rates, and worse quality of life. Unfortunately, those who want more (continued from previous page) (continued on page 24) "You see young people carrying Fitbits, but most patients with cancer may be older and technology illiterate. We didn't know if they would be able to do all of this." — Arjun Gupta, M.D. Gerard Coté, a Texas A&M University professor of biomedical engineer- ing, tries on a wearable remote monitoring device. Chris Minihane / Getty Images

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