A Novel Wearable Device for Continuous Temperature Monitoring & Fever Detection
Nishant Verma, Iman Haji-Abolhassani, Suhas Ganesh, Jesus Vera-Aguilera, Jonas Paludo, Roxana Heitz, Svetomir N Markovic, Kimary Kulig, Atiyeh Ghoreyshi, Nishant Verma, Iman Haji-Abolhassani, Suhas Ganesh, Jesus Vera-Aguilera, Jonas Paludo, Roxana Heitz, Svetomir N Markovic, Kimary Kulig, Atiyeh Ghoreyshi
Abstract
Objective: Continuous temperature monitoring in high-risk patients can enable healthcare providers to remotely track patients' temperatures, promptly detect fevers and timely intervene to improve clinical outcomes. We evaluated if a novel wearable, continuous temperature monitor (Verily Patch) can reliably estimate body temperature and early detect fevers in an outpatient setting in patients at a high risk of febrile neutropenia (FN) who recently underwent chemotherapy and autologous stem cell transplantation (ASCT). Methods: 86 patients at a high risk for FN were prospectively enrolled at Mayo Clinic, MN. Patients wore the device in their axilla region for 7 days post ASCT and recorded self-measured oral temperatures every 3 hours. Patients were also followed using clinical standard-of-care procedures with daily oral temperature assessment. The clinic- and patient-assessed oral temperatures were used to develop and evaluate Verily Patch's body temperature and early fever detection algorithms using a K-fold cross-validation approach. Results: The Verily Patch reliably measured body temperatures with an error of 0.35 ± 0.88°F in comparison to clinic- and patient-assessed oral temperatures. The sensitivity and specificity of the patch in detecting clinic-assessed fever episodes was 90.2% and 87.8%. The patch detected 14.3 times the number of clinic-assessed fever episodes with a median lead time of 4.3 hours. Conclusion: Patient self-monitoring of temperature and fever incidents suffers from low accuracy and is impractical for extended periods of time. Continuous temperature monitoring by a wearable device (such as Verily Patch) has the potential to overcome these challenges resulting in better patient clinical outcomes and more cost-effective care.
Keywords: Continuous temperature monitoring; early fever detection; febrile neutropenia; machine learning; wearable devices.
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References
- Zimmer A. J. and Freifeld A. G., “Optimal management of neutropenic fever in patients with cancer,” J. Oncol. Pract., vol. 15, no. 1, pp. 19–24, Jan. 2019.
- Wang al., “Non-contact infrared thermometers for measuring temperature in children: Primary care diagnostic technology update,” Brit. J. Gen. Pract., vol. 64, no. 627, pp. e681–e683, Oct. 2014.
- Shah C., Du X., Bishnoi R., and Bian J., “Risk of mortality in adult cancer febrile neutropenia patients with a machine learning approach,” J. Clin. Oncol., vol. 36, no. 15, May 2018, Art. no. e13562.
- Tai E., Guy G. P., Dunbar A., and Richardson L. C., “Cost of cancer-related neutropenia or fever hospitalizations, United States, 2012,” J. Oncol. Pract., vol. 13, no. 6, pp. e552–e561, Jun. 2017.
- Cost of Cancer-Related Neutropenia or Fever Hospitalizations, CDC, Atlanta, GA, USA, 2012.
- Baden L. al., “Prevention and treatment of cancer-related infections,” J. Natl. Compr. Canc. Netw., vol. 10, no. 11, pp. 1412–1445, 2012.
- Nesher L. and Rolston K. V. I., “The current spectrum of infection in cancer patients with chemotherapy related neutropenia,” Infection, vol. 42, no. 1, pp. 5–13, Feb. 2014.
- 3M. Product Clinical Data Summary: 3M Elastic Nonwoven Tape with Extended Wear Adhesive. Accessed: May 5, 2021. [Online]. Available:
- Oliver A. al., “Comparison of two different anti-infectious approaches after high-dose chemotherapy and autologous stem cell transplantation for hematologic malignancies in a 12-year period in British Hospital, Uruguay,” Ann. Hematol., vol. 99, no. 4, pp. 877–884, Apr. 2020.
- Owattanapanich W., Suphadirekkul K., Kunacheewa C., Ungprasert P., and Prayongratana K., “Risk of febrile neutropenia among patients with multiple myeloma or lymphoma who undergo inpatient versus outpatient autologous stem cell transplantation: A systematic review and meta-analysis,” BMC Cancer, vol. 18, no. 1, p. 1126, Dec. 2018.
- Levy M. M., Evans L. E., and Rhodes A., “The surviving sepsis campaign bundle: 2018 update,” Intensive Care Med., vol. 44, no. 6, pp. 925–928, Jun. 2018.
- Lindberg D. M., “The 1-hour bundle for sepsis: An update to the 2016 surviving sepsis guidelines,” New England J. Med., J. Watch Emergency Med., Massachusetts Med. Soc., Tech. Rep., 2018. [Online]. Available:
- Kimberger O., Thell R., Schuh M., Koch J., Sessler D. I., and Kurz A., “Accuracy and precision of a novel non-invasive core thermometer,” Brit. J. Anaesthesia, vol. 103, no. 2, pp. 226–231, Aug. 2009.
- Jensen B. N., “Accuracy of digital tympanic, oral, axillary, and rectal thermometers compared with standard rectal mercury thermometers,” Eur. J. Surg., vol. 166, no. 11, pp. 848–851, Oct. 2000.
- Lawson al., “Accuracy and precision of noninvasive temperature measurement in adult intensive care patients,” Amer. J. Crit. Care, vol. 16, no. 5, pp. 485–496, Sep. 2007.
- Latman N. S., Hans P., Nicholson L., Lewis K., and Shirey A., “Evaluation of clinical thermometers for accuracy and reliability,” Biomed. Instrum. Technol., vol. 35, no. 4, pp. 259–265, 2001.
Source: PubMed