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CompletedNCT03283683AIPACaUpdated Mar 28, 2019

A Feasibility Study of the Use of Actigraphy to Determine Prognosis in Patients With Advanced Cancer

An observational study in Cancer and Sleep, sponsored by Royal Surrey County Hospital NHS Foundation Trust. Completed at 1 site in United Kingdom. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2019-03-28.

Sponsored by Royal Surrey County Hospital NHS Foundation Trust · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
50
Ages
18 Years and older
Sex
All
01

Study summary

This study evaluates the use of actigraphy-derived measures to improve prognostication in patients with advanced cancer.

Read the detailed description

An accurate assessment of prognosis (life expectancy) is important for cancer patients, their carers, and their health care professionals. In the case of patients / their carers, it allows them to plan for the future, and to make more informed decisions about further anti-cancer treatments, and about referral to supportive and palliative care services. However, previous research suggests that health care professionals are not particularly good at estimating prognosis, and frequently over-estimate prognosis.

The aim of this project is to assess the usefulness of measuring physical activity, and differences between daytime and nighttime physical activity, in determining prognosis in patients with cancer. Studies suggest that these measures may be useful in determining prognosis in certain groups of patients with cancer (e.g. patients receiving chemotherapy for colon / rectum cancer). However, these studies need to be repeated in patients with different types of cancer, and also patients receiving other types of treatment (including supportive and palliative care). The aim of this small scale ("feasibility") study is to determine whether or not a large scale ("definitive") study can be done.

The feasibility study will include 50 patients with cancer, who will be asked to rate their performance status (physical activity) on a well-used scale, and then to wear a watch-like device for one week that measures physical activity and sleep patterns. The researcher will collect a blood sample: some of which will be used for analysis of parameters, which have previously been identified as prognostic indicators and will collect and store some blood for future transcriptome analysis. Participants will also be asked to complete a sleep diary during the week, and a questionnaire about their symptoms at the beginning and end of the week. The study will last one week in total and is collaboration between the Royal Surrey County Hospital, and the University of Surrey (Surrey Sleep Research Centre).

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Conditions studied

  • Cancer
  • Sleep

Keywords

  • rest-activity rhythm
  • survival
  • actigraphy
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

The number of participants in the feasibility study will be 50. Participants will be outpatients at the site, who meet all of the inclusion criteria and none of the exclusion criteria of the study (see above).

Inclusion criteria

  • Outpatients.
  • Age ≥ 18 years.
  • Diagnosis of locally advanced / metastatic cancer.
  • No curative treatment available.
  • Patient receiving supportive and palliative care.
  • Negative response from palliative medicine physician to the "surprise" question (i.e. "would you be surprised if this patient were to die in the next 12 months").
  • (Estimated) prognosis of > 2 weeks.

Exclusion criteria

Exclusion Criteria:

  • Inpatients.
  • Age \< 18 years.
  • Diagnosis of local (non-advanced) cancer.
  • Curative treatment available.
  • Presence of a physical disability that affects daytime activity (e.g. metastatic spinal cord compression).
  • Presence of a physical disability that affects movement of the non-dominant arm (e.g. lymphoedema).
  • Cognitive impairment (clinical judgement).
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Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
50 participants (actual)
Patient registry
No
Biospecimen retention
Samples without dna
05

What researchers measure

Primary outcomes

  1. Dichotomy Index (I<O)

    Compares the amount of activity of the patient when in bed to when the patient is out of bed. An actigraphy-derived percentage of the activity counts, measured when the patient is in bed, that are inferior to (lower than) the median of the activity counts measured when the patient is out of bed.

    Time frame: 7 days.

Secondary outcomes

  1. r24

    An actigraphy-derived 24hr correlation coefficient that reports on how reproducible the patient's activity is every 24 hours.

    Time frame: upto 7 days

  2. mean or average activity

    calculated as the average number of wrist movements per minute throughout the recording time

    Time frame: 7 days.

Other outcomes

  1. Actigraphy-derived sleep parameters

    Parameters during the presumed sleep phase of the circadian cycle; eg: Time in bed, sleep efficiency e.t.c

    Time frame: 7 days

  2. Physician ECOG-PS

    Physician's assessment of the patient's ECOG-Performance Status. The Eastern Cooperative Oncology Group performance scale (ECOG-PS) is a standardised measure for quantifying the functional status of patients with cancer and includes a numerical / categorical scale

    Time frame: Day 0 actigraphy and Day 8 actigraphy

  3. Patient ECOG-PS

    Patient's assessment of their own ECOG-Performance Status

    Time frame: Day 0 actigraphy and Day 8 actigraphy

  4. Memorial Symptom Assessment Scale - Short Form (MSAS-SF)

    The MSAS-SF is a validated symptom assessment tool that has been used extensively in oncology / palliative care research and includes questions on both physical and psychological symptoms.

    Time frame: Day 0 actigraphy and Day 8 actigraphy

  5. Pittsburgh Sleep Quality Index (PSQI)

    This is a validated, self-rated questionnaire, which measures sleep quality and disturbances over a 1-month time period

    Time frame: Day 8 actigraphy

  6. Prognosis in Palliative Care Study predictor model (PiPS-B model)

    Compare actigraphy-derived circadian / sleep parameters against other validated prognostic indicators

    Time frame: Day 0 actigraphy

  7. modified Glasgow Prognostic Score (mGPS)

    Compare actigraphy-derived circadian / sleep parameters against other validated prognostic indicators

    Time frame: Day 0 actigraphy

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Study locations

1 site
  • Royal Surrey County Hospital
    Guildford, Surrey GU2 7XX, United Kingdom
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03283683
Lead sponsor
Royal Surrey County Hospital NHS Foundation Trust
Responsible party
Shuchita Dhwiren Patel (Dr Shuchita Dhwiren Patel, Royal Surrey County Hospital NHS Foundation Trust) — Principal investigator
First posted
Sep 14, 2017
Start date
May 25, 2016
Primary completion
Oct 19, 2017
Completion
Oct 19, 2018
Last update
Mar 28, 2019

Study contacts

Derk-Jan Dijk
study director · Supervisor
Andrew Davies
study director · Supervisor
Shuchita D Patel
principal investigator · PhD student

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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