Self-performed Five Times Sit-To-Stand test at home as (pre-)screening tool for frailty in cancer survivors: Reliability and agreement assessment.

AIMS AND OBJECTIVES: The self-performance of a Five-Times-Sit-To-Stand (FTSTS)-test, without the usual supervision by a medical professional, provides valuable opportunities for clinical practice and research. This study aimed: (1) to determine the validity of the self-performed FTSTS test in comparison to a supervised reference test and (2) to determine the reliability of a self-performed FTSTS test by cancer survivors. BACKGROUND: Early detection of frailty in cancer survivors may enable prehabilitation interventions before surgery or intensive treatment, improving cancer outcomes. DESIGN: A repeated measures reliability and agreement study, with one week in between measures, was performed. METHODS: Cancer survivors (n = 151) performed two FTSTS tests themselves. One additional reference FTSTS test was supervised by a physical therapist. The intraclass correlation coefficient (ICC), structural error of measurement (SEM) and minimally important clinical difference (MID) were calculated comparing a self-performed FTSTS test to the reference test, and comparing two self-performed FTSTS tests. The Guidelines for Reporting Reliability and Agreement Studies (GRASS) have been used. RESULTS: Mean age of cancer survivors was 65.6 years (SD = 9.3), 54.6% were female, median time since diagnosis was 2 years [IQR = 1], and tumour type varied (e.g., breast cancer (31.8%), prostate cancer (17.2%), gastrointestinal cancer (11.9%) and haematological cancer (11.9%)). Validity of the self-performed FTSTS test at home was acceptable in comparison with the reference test (ICC = .74; SEM = 3.2; MID = 3.6) as was the reliability of the self-performed FTSTS test (ICC = .70; SEM = 2.2; MID = 3.8). CONCLUSIONS: The self-performed FTSTS test is a valid and reliable measure to assess lower body function and has potential to be used as objective (pre-)screening tool for frailty in cancer survivors. RELEVANCE TO CLINICAL PRACTICE: The self-performed FTSTS test at home may indicate the cancer survivors in need of prehabilitation in advance of surgery or intensive treatment. The feasibility, short amount of time needed and potential cost-effectiveness of the self-performed FTSTS test can make it a valuable contribution to personalised care and precision medicine.

Pre-screening of patient-reported symptoms using the Edmonton Symptom Assessment System in outpatient palliative cancer care.

OBJECTIVES: Although early palliative care is associated with a better quality of life and improved outcomes in end-of-life cancer care, the criteria of palliative care referral are still elusive. METHODS: We collected patient-reported symptoms using the Edmonton Symptom Assessment System (ESAS) at the baseline, first and second follow-up visits. A total of 71 patients were evaluable, with a median age of 65 years, male (62%) and Eastern Cooperative Oncology Group (ECOG) performance status distribution of 1/2/3 (28%/39%/33%) respectively. RESULTS: Twenty (28%) patients had moderate/severe symptom burden with the mean ESAS ≥ 5. Interestingly, most of the patients with moderate/severe symptom burdens (ESAS ≥ 5) had globally elevated symptom expression. While the mean ESAS score was maintained in patients with mild symptom burden (ESAS < 5; 2.7 at the baseline; 3.4 at the first follow-up; 3.0 at the second follow-up; p = .117), there was significant symptom improvement in patients with moderate/severe symptom burden (ESAS ≥ 5; 6.5 at the baseline; 4.5 at the first follow-up; 3.6 at the second follow-up; p < .001). CONCLUSIONS: In conclusion, advanced cancer patients with ESAS ≥ 5 may benefit from outpatient palliative cancer care. Pre-screening of patient-reported symptoms using ESAS can be useful for identifying unmet palliative care needs in advanced cancer patients.

Smartphone app-based/portable sensor for the detection of fluoro-surfactant PFOA.

We developed a smartphone app-based monitoring tool for the detection of anionic surfactants (AS), including perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS). Akin to the methylene blue active substances (MBAS), liquid-phase extraction (LPE) is employed to extract the hydrophobic ion-pair of dye (ethyl violet)-AS to an organic phase (ethyl acetate). The colour (RGB) of the organic phase is read using a smartphone camera with the help of a reading kit. The value of RGB is carefully corrected and linked to the concentration of ASs with a standard deviation of <10% in the 10-1000 ppb (part per billion) range. In order to avoid the interference arising from inorganic anions (such as those found in tap water and groundwater), the water sample is pre-treated either by solid-phase extraction (SPE), which takes ∼30 min, or by dual liquid-phase extraction (dual-LPE, developed by us), which takes ∼5 min. In the latter case, the organic phase of the first LPE (equilibrium with water sample) is transferred and subjected to a second LPE (equilibrium with Milli-Q water) to remove any potential background interference. In the meantime, SPE can also pre-concentrate ASs at 100-1000 times (in volume) to benefit the sensitivity. Consequently, our smartphone app can detect PFOA spiked in tap/groundwater with an LOD of 10 ppb (∼12 nM, dual-LPE of ∼5 min), or 0.5 ppb (∼1.2 nM, SPE of ∼3 h), suggesting that it has the potential to succeed as a pre-screening tool for on-site application and in common laboratory tests.