Smartphone GPS signatures of patients undergoing spine surgery correlate with mobility and current gold standard outcome measures.
Smartphone GPS signatures of patients undergoing spine surgery correlate with mobility and current gold standard outcome measures.
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DOI：
10.3171/2021.2.spine202181
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发表时间：
2021-12-01
影响因子：
2.8
通讯作者：
Smith, Timothy R.
中科院分区：
文献类型：
--
作者：
Boaro, Alessandro;Leung, Jeffrey;Reeder, Harrison T.;Siddi, Francesca;Mezzalira, Elisabetta;Liu, Gang;Mekary, Rania A.;Lu, Yi;Groff, Michael W.;Onnela, Jukka-Pekka;Smith, Timothy R.
患者报告结果测量（PROMs）是目前评估患者身体表现和脊柱手术后恢复能力的金标准。然而，由于所报告的信息的定性和主观性，以及不可能以连续的方式使用它们，prom具有显著的局限性。智能手机GPS可用于提供连续、定量和客观的患者活动信息。本研究的目的是利用智能手机GPS的日常活动特征来描述脊柱手术患者的围手术期，并将这些客观测量结果与当前的金标准、患者报告的结果测量结果进行比较。从39名接受脊柱手术的患者的智能手机GPS数据中获得了8个日常活动特征，从手术前三周开始为期2个月。同时，连续测量三种不同的疼痛评分（VAS）、残疾评分（ODI）和功能状态评分（PROMIS）。采用分段线性回归分析评估手术前后的趋势。采用配对t检验比较术前和术后PROM评分。计算恢复期间各基于gps的移动性特征的日平均值与各PROM分数的日平均值之间的Pearson相关性。智能手机GPS特征描述了术后立即行动能力下降，随后在手术后一个月逐渐稳定地增加到基线值。与术前两周相比，术后一个月测量疼痛、身体表现和残疾的PROMs有显著差异。基于gps的特征与恢复期疼痛VAS和PROMIS生理评分呈中~强线性相关（Pearson r = 0.7）， ODI与PROMIS心理评分呈弱相关（Pearson r = 0.4）。智能手机衍生的GPS功能被证明可以准确地描述脊柱相关疾病手术患者的围手术期活动趋势。与时间相关的特征（而不是距离）更能描述患者的身体和运动状态。智能手机GPS有潜力用于开发精确、非侵入性和个性化的手术后患者活动监测工具。
Patient reported outcome measures (PROMs) are currently the gold standard to evaluate patient’s physical performance and ability to recover after spine surgery. However, PROMs have significant limitations due to the qualitative and subjective nature of the information reported as well as the impossibility of using them in a continuous manner. Smartphone GPS can be used to provide continuous, quantitative, and objective information on patients’ mobility. The aim of this study was to use daily mobility features derived from smartphone GPS to characterize the peri-operative period of patients undergoing spine surgery and to compare these objective measurements to the current, gold standard, patient reported outcome measures. Eight daily mobility features were derived from smartphone GPS data in a population of 39 patients undergoing spine surgery for a period of 2 months starting three weeks before surgery. In parallel, three different PROMs for pain (VAS), disability (ODI) and functional status (PROMIS) were serially measured. Segmented linear regression analysis was used to assess the trend before and after surgery. Student’s paired t-test was used to compare pre- and post-operative PROM scores. Pearson’s correlation was calculated between the daily average of each GPS-based mobility feature and the daily average of each PROM score during the recovery period. Smartphone GPS features described a reduction in mobility during immediate post-operative period, followed by a progressive and steady increase with a return to baseline values one month after surgery. PROMs measuring pain, physical performance, and disability were significantly different one month after surgery compared to the two immediate pre-operative weeks. The GPS-based features presented moderate to strong linear correlation with pain VAS and PROMIS physical score during the recovery period (Pearson r > 0.7), whereas ODI and PROMIS mental score presented a weak correlation (Pearson r ~0.4). Smartphone-derived GPS features were shown to accurately characterize peri-operative mobility trends in patients undergoing surgery for spine-related diseases. Features related to time (rather than distance) were better at describing patient physical and performance status. Smartphone GPS has the potential to be used for the development of accurate, non-invasive and personalized tools for patient mobility monitoring after surgery.