ideasIdea
Catch wasting early with a smart scale and a step counter
Slow weight loss and falling daily activity are the first signs of cancer wasting, and both can be measured at home. An alert could bring help months earlier.
Home weight and activity monitoring is cheap and acceptable, and remote symptom monitoring has already improved survival and quality of life in randomised oncology trials. Trajectory-based alerts on weight and step count would detect functional decline weeks to months before clinic visits, at which point nutrition and exercise interventions still work.
Hypothesis
Trajectory-triggered alerts from home weight and activity data lead to supportive care intervention a median of two months earlier and reduce unplanned admissions compared with clinic-based assessment.
Rationale
Patient-reported outcome monitoring with alerts improved survival in randomised trials, showing that earlier detection of deterioration changes outcomes. Weight and steps are objective, continuous and require no patient effort beyond wearing a device.
What would test it
A randomised trial of monitored versus usual follow-up in patients starting palliative-intent chemotherapy, with time to supportive care intervention and unplanned admissions as endpoints.
Maturity
speculative
Who has to act
patients
Cost to try
Small (under $1M)
Years to first evidence
3
Bottlenecks it attacks
- Cachexia, toxicity and the limits of the patient · Patients often die of wasting or cannot tolerate the doses that would work. Treating the patient, not just the tumour, lags far behind.
- Patients lack understanding, navigation and agency · Most patients cannot understand their options, find trials, or push back, so decisions are made for them.
- Toxicity and quality of life are undervalued · Trials measure how long people live, not how they live. Side-effects are under-reported and under-treated.