JMIR Publications

ABSTRACT

Background:

Glioblastoma multiforme (GBM) is the most common and aggressive primary brain tumour in adults, with poor prognosis despite standard treatment with the Stupp protocol (surgical resection followed by concomitant temozolomide-based chemoradiotherapy and adjuvant temozolomide). Given the substantial clinical, functional and psychosocial burden of both the disease and its therapies, monitoring health-related quality of life (HRQoL) is essential. Smartphone-based approaches may enable continuous, low-burden monitoring; however, most existing tools rely mainly on self-reported outcomes and make limited use of passive digital phenotyping.

Objective:

To evaluate the feasibility and usability of Lalaby-Glio for monitoring HRQoL in patients with GBM, and to explore associations between subjective global QoL derived from patient-reported outcomes and objective sensor data.

Methods:

The study comprised four phases: (1) adaptation of the Lalaby platform for GBM-specific monitoring by combining passive smartphone sensor acquisitions (movement, step count, location, sound level/frequency, light exposure, internet use and call activity) with a clinician-designed daily 5-item questionnaire and weekly EORTC QLQ-C30 and QLQ-BN20 instruments; (2) a 6-week feasibility study in four adults (≥18 years) initiating Stupp treatment; (3) usability testing in GBM patients and a complementary non-patient sample of 103 healthy adults using either screenshot mock-ups or the installed app; and (4) exploratory analyses of associations between passive sensor data and subjective global QoL using Spearman correlations with patient-level bootstrap.

Results:

Four patients (3 men, 1 woman; mean age 54.3 years) were enrolled; three completed all six weeks and one died after two weeks. Engagement was high, with 168 questionnaires completed (22 QLQ-C30, 19 QLQ-BN20 and 127 Daily Status entries). Mean app use was 1.8 (SD 2.7) minutes/day, and mean completion time for the weekly questionnaires was 7.2 (SD 3.3) minutes. Weekly PROMs revealed substantial inter- and intra-individual variability in functioning, symptoms and global QoL during treatment. Usability among GBM patients was favorable (overall mean 3.7/5). Among healthy participants (mean age 20.9 years; 69.9% women), those who installed the app (n=46) achieved a mean System Usability Scale score of 72.9, above the standard benchmark, and 91.3% judged the nature-inspired design appropriate for oncology (n=103). Passive sensing yielded 91.7 MB of data; global QoL correlated negatively with call activity (ρ=−0.598, P=.012) and movement (ρ=−0.604, P<.001), while steps showed a positive but non-significant association (ρ=0.392, P=.63).

Conclusions:

Lalaby-Glio appears feasible and usable for monitoring HRQoL in patients with GBM and can capture clinically meaningful fluctuations over time. Passive smartphone sensing shows promise for supporting digital phenotyping and identifying objective behavioral correlates of QoL. Future work should evaluate these findings in larger, multicenter cohorts and refine sensor data collection and processing to enable robust digital biomarkers for neuro-oncology monitoring and potential clinical integration.