JMIR Publications

ABSTRACT

Background:

Frequent, sensor-assisted monitoring of changes in swallowing function may help improve detection of radiation-associated dysphagia before it becomes permanent. While our group has prototyped an epidermal strain/sEMG sensor that can detect minute changes in swallowing muscle movement, it is unknown whether head and neck cancer patients would be willing to wear such a device at home after radiation for several months. We iteratively assessed patients’ design preferences and perceived barriers to long-term use of the prototype sensor.

Objective:

N/A

Methods:

Study 1: Questionnaire only. Pharyngeal cancer survivors who were 3-5 years post-treatment and part of a larger prospective study were asked their design preferences for a hypothetical throat sensor and rate their willingness to use the sensor at home during the first year after radiation. Studies 2-3: Iterative user-testing. Head and neck cancer patients/survivors attending visits at MD Anderson’s Head and Neck Center were recruited for two rounds of on-throat testing with prototype sensors while completing a series of swallowing tasks. Afterward, participants were asked about willingness to use the sensor during the first-year post-radiation; In study 2, patients also rated the sensor’s ease of use, and comfort whereas in study 3, preferences were elicited regarding haptic feedback.

Results:

Willingness to wear the sensor for 9 months: The majority of respondents in Study 1 (83%; n=138) were willing to wear the sensor 9 months after radiation and participant willingness rates were similar in studies 2 (71.4%; n=14) and Study 3 (85.7%; n=14). Reasons for unwillingness: The most prevalent reasons for participant unwillingness were 9 months being excessive, unwanted increase in responsibility, and feeling self-conscious. Most persuasive design features: Across all three studies, the sensor’s ability to detect developing dysphagia increased willingness the most compared to its appearance and ability to increase adherence to preventive speech pathology exercises. Direct haptic signaling was also rated highly, especially to indicate correct sensor placement and swallowing exercise performance.

Conclusions:

Patients and survivors were receptive to the idea of wearing a personalized risk sensor for an extended period during the first year after radiation, although this may have been limited to well-educated, non-Hispanic participants. A significant minority of patients expressed concern with various aspects of the sensor’s burden and its appearance. Clinical Trial: ClinicalTrials.gov NCT03010150