SMARTPHONE-BASED OBJECTIVE OUTCOME MEASURES IN CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY: A SYSTEMATIC REVIEW OF VALIDITY AND CLINICAL UTILITY
Main Article Content
Keywords
chemotherapy-induced peripheral neuropathy, smartphone, digital health, mHealth, accelerometer, photoplethysmography, balance, heart rate variability, outcome assessment
Abstract
Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating sequela of cancer treatment, traditionally assessed through subjective patient-reported outcomes (PROs) and clinical examinations. These methods are susceptible to bias and may lack sensitivity. Smartphone sensor technology offers a promising alternative for objective, quantifiable, and accessible monitoring of CIPN symptoms, particularly balance and autonomic dysfunction.
Objective: This systematic review aimed to critically evaluate the validity, reliability, and clinical utility of smartphone-based objective outcome measures for assessing balance and autonomic function in patients with CIPN.
Methods: A systematic search was conducted in PubMed, Scopus, CINAHL, IEEE Xplore, and Cochrane Library databases from inception to December 2018. Studies were included if they evaluated the use of smartphone sensors (accelerometers, gyroscopes, cameras) to assess balance, gait, or heart rate variability (HRV) in adults with CIPN or related peripheral neuropathies. Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool.
Results: Out of 327 records identified, five studies met the inclusion criteria. No studies were found that validated smartphone sensors exclusively in a CIPN population; thus, studies in diabetic peripheral neuropathy (DPN) and other neuropathies were included. The reviewed studies demonstrated strong concurrent validity of smartphone accelerometry for measuring postural sway against laboratory-grade force plates (correlation coefficients r = 0.82–0.94). Smartphone photoplethysmography (PPG) for HRV assessment showed excellent agreement with electrocardiography (ECG) for time-domain parameters (RMSSD ICC > 0.85) in controlled, resting conditions. Evidence for reliability and validity in home-based settings was limited.
Conclusion: Pre-2018 evidence, primarily from non-CIPN neuropathies, strongly supports the criterion validity of smartphone-based accelerometry for balance assessment and PPG for HRV measurement in controlled environments. However, a significant evidence gap exists regarding the application and validation of these digital biomarkers specifically in CIPN populations. Future research must validate these tools in CIPN cohorts and explore their feasibility for remote monitoring and integration into clinical practice to improve assessment precision and patient outcomes.
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Dr. Tanigaiselvane D.J
Chief Physiotherapist, Therapeutic and Neeling Interventions,Puducherry Therapeutic and Needling interventions, No. 10, First cross, Anandha Nagar, Thavlakuppam,Puducherry,605007
Dr. Muthukumaran Calyanasundaram
PT, Senior Specialist Physiotherapist, Therapeutic and 3 Neeling Interventions,Puducherry
Dr. Mohan Nallathambi PT
Senior Specialist Physiotherapist , Therapeutic and Neeling Interventions,Puducherry Therapeutic and Needling interventions, No. 10, First cross, Anandha Nagar, Thavlakuppam,Puducherry,605007
Dr. Neethi
M,Professor,Venkateshwara Physiotherapy College,Puducherry Therapeutic and Needling interventions, No. 10, First cross, Anandha Nagar, Thavlakuppam,Puducherry,605007
Dr Sharmila.B
Asst.Prof.,MTPG&RIHS,Puducherry Therapeutic and Needling interventions, No. 10, First cross, Anandha Nagar, Thavlakuppam,Puducherry,605007
Mrs. Jeyanthi
Nursing Superintendent, BLDE(DU)SBMPMCH&RC,Karnataka Therapeutic and Needling interventions, No. 10, First cross, Anandha Nagar, Thavlakuppam,Puducherry,605007