title: Assessing energy expenditure in cancer patients: a pilot validation of a new wearable device.
abstract: BACKGROUND
  Nutrition problems are common in cancer patients and are frequently due to metabolic derangements. Thus, accurately assessing energy expenditure (EE) is important in planning adequate nutrition support. Indirect calorimetry (IC) represents the gold standard method but is not always available or applicable to all settings. The purpose of this study was to preliminary compare a new wearable device, the SenseWear armband (SWA), to IC in cancer patients.
  
  
  METHODS
  Ten (6 M, 4 F) subjects (mean +/- SD: 56.6 +/- 13.3 years) affected by newly diagnosed acute myelogenous leukemia, undergoing induction chemotherapy, were prospectively enrolled. Resting EE (REE) was measured simultaneously by SWA and IC on admission (day 0) and at discharge (end). Total daily EE (TDEE) was determined by SWA 4 times during the stay (days 0, 7, 14, and end) and predicted values were calculated according to IC REE estimates (TDEE = IC x correction factor 1.2).
  
  
  RESULTS
  Mean length of stay was 27.1 +/- 6.2 days. Bland-Altman plots revealed no significant differences between overall REE estimates (day 0 + end) performed by IC and SWA (mean +/- SD; 1645 +/- 282 vs 1705 +/- 278 kcal/d) and the correlation was high (r = 0.84; p < .0001). SWA TDEE showed a progressive reduction during the stay. No bias was detected between overall SWA TDEE (1799 +/- 153 kcal/d) and IC predicted TDEE (1974 +/- 176 kcal/d), but there was a wide 95% confidence interval (-672; +321 kcal/d). Moreover, the correlation between these values was significant (r = 0.68; p = .001).
  
  
  CONCLUSIONS
  SWA seems to provide accurate and reliable estimation of REE and useful information on TDEE also in cancer patients. Its use appears promising. Validation studies on larger samples and different cancer types should be considered.
authors.affiliation: International Center for the Assessment of Nutritional Status (ICANS), University of Milan, Italy. emanuele.cereda@virgilio.it
authors.forename: Emanuele
authors.initials: E
authors.lastname: Cereda
authors.forename: Mauro
authors.initials: M
authors.lastname: Turrini
authors.forename: Denis
authors.initials: D
authors.lastname: Ciapanna
authors.forename: Laura
authors.initials: L
authors.lastname: Marbello
authors.forename: Angelo
authors.initials: A
authors.lastname: Pietrobelli
authors.forename: Ettore
authors.initials: E
authors.lastname: Corradi
mesh_terms: D001481:Basal Metabolism / Q000502:physiology*; D002153:Calorimetry, Indirect / Q000295:instrumentation / Q000379:methods / Q000592:standards; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D006801:Humans; D007902:Length of Stay; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000295:instrumentation / Q000379:methods / Q000592:standards; D010865:Pilot Projects; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity