Acceptability and feasibility of a Fitbit physical activity monitor for endometrial cancer survivors.

OBJECTIVE: Endometrial cancer survivors are the least physically active of all cancer survivor groups and exhibit up to 70% obesity. While studies suggest lifestyle interventions result in improved health outcomes, recruitment and availability of these programs are limited. The purpose was to evaluate the acceptability and validity of the Fitbit Alta™ physical activity monitor (Fitbit) for socioculturally diverse endometrial cancer survivors. METHODS: Thirty endometrial cancer survivors were given wrist-worn Fitbits to wear for 30 days. Participants then returned the Fitbits, completed the Godin Leisure-Time Exercise Questionnaire (GLTEQ), Technology Acceptance Questionnaire, and answered qualitative prompts. Correlations between daily Fitbit step counts, demographic factors, body mass index (BMI), and GLTEQ Index, were analyzed using Stata 13.0. Concordance Correlation Coefficient using U statistics was used to examine convergent validity. RESULTS: Twenty-five participants completed the study. Mean age was 62 ±â€¯9 years. Mean BMI was 32 ±â€¯9 kg·m-2. Self-identified race/ethnicity was 36% Hispanic, 36% non-Hispanic white, 16% non-Hispanic black and 12% Asian. Participants wore the Fitbits a median of 93% of possible days. Median daily Fitbit step count was 5325 (IQR: 3761-8753). Mean Technology Acceptance score was 2.8 ±â€¯0.5 out of 4.0. Younger (<65 years) and employed participants were more likely to achieve at least 6000 daily steps (p < 0.05). There was no correlation (CCC = 0.00, p = 0.99) between step count and GLTEQ Index. Most free responses reflected positive experiences. CONCLUSIONS: The Fitbits were well accepted in this sample. Self-reported physical activity was not associated with steps recorded. The physical activity data indicate an insufficiently active population.

Systematic review and meta-analysis comparing cognitive vs. image-guided fusion prostate biopsy for the detection of prostate cancer.

OBJECTIVE: To perform a systematic review and meta-analysis comparing overall prostate cancer detection rate and clinically-significant prostate cancer detection rate between MRI-ultrasound image guided fusion biopsy (MRI-US FB) and cognitive biopsy (CB). METHODS: A systematic review of Pubmed, EMBASE, MEDLINE, and Cochrane library databases was performed. Identified studies were assessed for clinical relevance and excluded based on a set of predefined criteria. Final articles included in the analysis comprised only prospective trials that compared CB vs. MRI-US FB in men with MRI-identifiable lesions (Prostate Imaging Reporting and Data System score 2+). Articles were reviewed for patient demographics, MRI protocol, and rates of overall and clinically significant prostate cancer detection by both modalities. RESULTS: Nine studies were analyzed. A composite 1,714 men with mean age 64.6 years and mean PSA 8.2 ng/dL were reviewed. When comparing FB to CB, the odds ratio for overall and for clinically significant prostate cancer detection was 1.11 (95%CI 0.91-1.36, P = 0.30) and 1.13 (95%CI 0.89-1.44, P = 0.32), respectively. Heterogeneity among the studies was moderate but not significant for either overall (X2 = 14.67; I2 = 45%; P = 0.07) or clinically significant prostate cancer detection (X2 = 11.81; I2 = 49%; P = 0.07). CONCLUSION: MRI-US FB demonstrates a trend toward improved rates of prostate cancer detection compared to CB, although this is not statistically significant. Further comparative studies may help to further elucidate whether one of these modalities is superior over the other.