MCW Research Team Uses Fitbit Activity Information to Gauge Risks for Post-Surgery Complications
You can use wearable fitness devices, such as Fitbits, for a great number of things: tracking steps, measuring your heart rate or even logging sleep. For the most part the devices are used to help people track their activity as a way of improving their health and fitness.
A pair of researchers at the Medical College of Wisconsin (MCW) decided to stretch the benefits of Fitbit even further. Anai N. Kothari, MD, MS, an assistant professor who specializes in surgical oncology at MCW, and second-year medical student Carson Gehl utilized Fitbit data collected from surgical candidates to measure how physical activity impacted the risk for postoperative complications.
“We have an opportunity prior to patients undergoing surgery to really think through how to optimize their chance at having a good surgical outcome,” Dr. Kothari says. “It’s really crucial for not just the immediate postoperative period, but also longer term to make sure that they can continue their oncologic therapy without trouble that was related to their original operation.”
All of Us Research Program Study Determines Patients With Lower Number of Average Daily Steps Increases Risk for Postsurgical Complications
The data they used was available to them as part of Froedtert & the Medical College of Wisconsin health network’s partnership with the National Institutes of Health’s All of Us Research Program. All of Us was developed to enroll 1 million individuals in the United States to voluntarily share their health information and participate in studies through the use of Fitbits and other technology as a way to build diverse health databases that researchers can use to learn more about how biology, environment and lifestyles can impact health.
“We recognized that we had an opportunity because of our engagement at MCW with the All of Us Program and then paired that with an interest in improving surgical outcomes with cancer patients and also more broadly; that’s how we came up with the project idea,” Dr. Kothari says (pictured right).
For this study, Dr. Kothari and Gehl looked at each patient’s average daily steps prior to surgery as a general measure of activity. Using that data, the researchers were able to establish 7,500 steps as a predictor of postoperative complications. The key finding was that those that took more than 7,500 steps a day had a 51% lower risk of postoperative complications 90 days after surgery.
“I think it is a representation of their overall fitness and health,” says Dr. Kothari, who adds that other studies also had identified 7,500 steps as an inflection point for better or worse health outcomes.
What made this study unique, he shares, was that it looked at a wide variety of surgeries, both minor and major, and found that threshold to still be consistent. The study, which was presented at the American College of Surgeons (ACS) Clinical Congress 2023, has spurred interest to delve deeper into wearable data collected through the All of Us Program.
“They have a lot more data on the intensity of activity, like how many minutes where they vigorously exercised and how many minutes they spent not moving,” Gehl says. “I’m curious whether it makes a difference if somebody took 7,500 steps a day and it was just going for a long walk versus somebody who spent an hour biking or running or something substantially more intense.”
Using Biostatistics to Improve Future Surgical Outcomes
Dr. Kothari hopes that studying wearable device information from a diverse population could help lead to this type of health tracking becoming routine in perioperative care.
“When you come to them equipped with this information and data, and say, ‘OK,we’re going to put a wearable on you because it’s something that can help you as a patient and your family make decisions about your care,’ I think it empowers them to at least on a smaller scale implement the use of wearable devices more routinely,” Dr. Kothari says.
In addition to conducting a study that could have major implications on care in the future, Dr. Kothari greatly values the opportunity to mentor Gehl and other medical students at MCW.
“We’re in a really unique position here as an academic center and have the opportunity to train the future leaders in medicine, and Carson falls squarely in that category,” he says. “He’s so talented and has the ability to think about problems that he’s been able to identify as he’s been training, so he really brings a unique perspective.”
Gehl, who plans to pursue a career in surgery and academic medicine, says he greatly appreciates the opportunity to learn from Dr. Kothari.
“I really value having a mentor who invests a lot in me,” he says.
Together, they hope the research they’re working on together will lead to improved care.
“It’s mutually beneficial and at the end of the day; it’s good for patients and the populations we serve,” Dr. Kothari says.
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