Remote Monitoring of Vital and Activity Parameters in Chronic Transfusion-Dependent Patients: A Feasibility Pilot Using Wearable Biosensors

Abstract

Introduction: Little is known if, and to what extent, outpatient red blood cell (RBC) transfusions benefit chronic transfusion-dependent patients. Costs, labour, and potential side effects of RBC transfusions cause a restrictive transfusion strategy to be the standard of care. However, effects on the actual performance and quality of life of patients who require RBCs on a regular basis are hardly studied. The aim of this study was to assess if new technologies and techniques like wearable biosensor devices and web-based testing can be used to measure physiological changes, functional activity, and hence eventually better assess quality of life in a cohort of transfusion-dependent patients. Methods: We monitored 5 patients who regularly receive transfusions during one transfusion cycle with the accelerateIQ biosensor platform, the Withings Steel HR, and web-based cognitive and quality of life testing. Results: Data collection by the deployed devices was shown to be feasible; the AccelerateIQ platform rendered data of which 97.8% was of high quality and usable; of the data the Withings Steel HR rendered, 98.9% was of high quality and usable. Furthermore, heart rate decreased and cognition improved significantly following RBC transfusions. Activity and quality of life measures did not show transfusion-induced changes. Conclusion: In a 5-patient cohort of transfusion-dependent patients, we found that the accelerateIQ, Withings Steel HR, and CANTAB platforms enable acquisition of high-quality data. The collected data suggest that RBC transfusions significantly and reversibly decrease heart rate and increase sustained attention in this cohort. This feasibility study justifies larger validation trials to confirm that these wearables can indeed help to determine personalized RBC transfusion strategies and thus optimization of each patient's quality of life.