chemoWave: Patients Data-Sharing With Clinicians

Nick Mulcahy

September 08, 2017

A new app helps clinicians and cancer patients keep track of biometric data during chemotherapy and beyond and is now available for downloading.

The app, chemoWave, debuted in late June, just weeks after a landmark clinical trial showed that data tracking of metastatic cancer patients' symptoms during and after chemotherapy significantly improved overall survival compared to usual care.

But that clinical trial, which was conducted at Memorial Sloan Kettering Cancer Center in New York City, used a proprietary Web-based tool. In short, the technology that facilitated a 5-month improvement in survival is not available yet.

But chemoWave, which includes tools for symptom tracking, is ready for downloading now at the Apple App Store, and it's free.

The tool works like this: Patients put the app into their mobile phones or tablets and self-report a wide variety of information, such as exercise, water intake, medication use, and, importantly, symptoms.

Patients can send daily or periodic data updates to their clinicians.

The symptom tracker lists a variety of common symptoms, such as nausea and fatigue, on a 5-point scale (indicating none, mild, moderate, bad, severe), said Matt Lashey, the Los Angeles–based developer of the app and cofounder of Treatment Technologies and Insights.

Lashey came up with chemoWave when his partner, Richard Grenell, was diagnosed with cancer in 2013 and was then treated at the City of Hope Comprehensive Cancer Center, in Duarte, California.

In addition to symptoms, patients can also record, keep track of, and report their overall condition (on a scale of 0 to 100) and any specific pain they experience, as well as positive and negative shifts in mood, Lashey told Medscape Medical News.

Physicians love the tool, especially for monitoring patient symptoms during chemotherapy, because it speeds up critical adjustments, said Lashey, who evidently is an inveterate tabulator and organizer.

"The inspiration to create chemoWave came after one such moment at the City of Hope," he said. "Our doctor changed a medication for my partner after we shared a [rough] graph with him, showing my partner struggling with constipation. He loved the information."

But will chemoWave improve outcomes for cancer patients?

That's not knowable, suggested Virginia Sun, PhD, RN, an assistant professor in the Division of Nursing Research and Education at the City of Hope, who is not affiliated with chemoWave.

"Simply collecting data will not necessarily change the quality of patient care and improve patient outcomes," Dr Sun told Medscape Medical News.

"The key, and challenge, for providers and healthcare systems is to develop and test ways to turn the biometrics/patient-reported outcomes into quality, actionable patient care," added Dr Sun, who is a researcher in this field.

But Lashey and Grennell are hopeful.

In fact, they have been in communication with Ethan Basch, MD, the lead investigator of the above-mentioned clinical trial, which showed that among metastatic cancer patients undergoing chemotherapy, median overall survival was 31.2 months for those who used a Web-based symptom reporting tool, compared with 26.0 months for patients who received the usual care (P = .03).

"The study is an amazing moment of clarity for patients who want to track and record their treatment experiences. It clearly has an effect on their care and even survival," Lashey said.

However, when Dr Basch presented the trial results at the annual meeting of American Society of Clinical Oncology (ASCO) in June, another expert in cancer patient-reported outcomes downplayed the importance of technology. Instead, Monika Krzyzanowska, MD, MPH emphasized the primacy of timely responsiveness.

"You don't need fancy technology to do this," said Dr Krzyzanowska, a medical oncologist at the Princess Margaret Cancer Center in Toronto, Ontario, Canada, who acted as discussant of the clinical trial at the ASCO meeting.

Dr Krzyzanowska has been an innovator of patient-reported symptom management at her Canadian center.

She said the key to capitalizing on patient reporting was having a "systematic" approach. A system allows for more thorough and quicker symptom management, which has many benefits, such as helping patients complete chemotherapy, said Dr Krzyzanowska and multiple other commentators at that meeting.

Like many apps, chemoWave has a lot of functions. In addition to tracking symptoms, it allows for scheduling of medications, physician visits, procedures, surgeries, and therapy sessions.

It also enables charting of mood, exercise, meals and water consumption, entertainment, and sleep.

The data recorded with chemoWave are protected, anonymous, and HIPPA compliant, but the developers, who are offering the tool at no cost, do plan to sell the data.

"We don't believe we have any competitors," said Lashey. "There are a few symptom trackers, but there isn't anyone doing real-time tracking of activities, food, etc, and providing opportunities for insights and analysis."

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