# Evaluation of the ALIBIRD mHealth Platform for Care of Patients With Lung Cancer: Prospective Pilot Study

## TL;DR

A mobile health platform called ALIBIRD was tested for lung cancer patients, showing it helps manage symptoms and improve lifestyle habits through digital monitoring and personalized recommendations.

## Contribution

The study introduces ALIBIRD, an mHealth platform that integrates patient-reported outcomes, wearable data, and personalized recommendations to support oncology care.

## Key findings

- The ALIBIRD platform achieved high usability scores and strong adherence to patient-reported outcomes and wearable monitoring.
- Personalized recommendations led to improved adherence to the Mediterranean diet and increased physical activity in some patients.
- Clinical alerts were resolved quickly, enabling early detection of disease progression and timely referrals.

## Abstract

Mobile health (mHealth) represents a promising instrument for optimizing symptom management and important lifestyle strategies that enhance self-care and the quality of health care for patients with cancer. The ALIBIRD mHealth platform is a digital health solution specifically designed for the telemonitoring of oncology patients, fostering patient empowerment and supporting clinical decision-making.

The primary objective of this study was to evaluate the patient experience with the ALIBIRD platform. In addition, the study aimed to assess clinical outcomes, particularly in symptom management, nutritional status, and lifestyle, using patient-reported outcome measures (PROMs).

The evaluation was conducted over a 30-week period in patients with advanced lung cancer receiving active treatment. Outcome variables included usability, patient experience, symptom burden, lifestyle behaviors (diet, physical activity, and sleep), nutritional status, PROMs, and system-generated clinical alerts. Through the mobile app, patients reported symptoms and completed integrated REDCap (Research Electronic Data Capture) questionnaires assessing lifestyle behaviors and PROMs, while receiving personalized recommendations informed by nutrigenetic and gut microbiota assessments. Daily activity and sleep data were automatically captured using the Fitbit Inspire wearable. Clinicians remotely monitored patient data using a web-based dashboard and performed clinical actions when required, including phone calls, therapeutic adjustments, referrals, and appointment rescheduling. Statistical analysis included descriptive summaries and pre-post comparisons of clinical and patient-reported outcomes.

Out of 20 patients recruited for the study, 14 completed the intervention. The System Usability Scale yielded a score of 90, indicating high usability. Among the 14 completers, adherence to scheduled questionnaires ranged from 94% to 100% for several instruments, and wearable-based monitoring ranged from 66% to 96% across visits. Overall, the ALIBIRD platform collected and processed 3589 patient-reported outcomes related to physical activity, 3468 related to sleep, 679 on-demand symptom entries, and 1524 completed questionnaires. Clinically, 143 alerts were resolved within an average of 2.05 days, resulting in 2 referrals to emergency rooms and 2 early detections of disease progressions. Furthermore, more than 2100 personalized recommendations contributed to a 21% (3/14 patients) increase in adherence to the Mediterranean diet and a 14% (2/14 patients) increase in moderate physical activity.

The evaluation of the ALIBIRD implementation yielded promising results in that it facilitated the adoption of healthier lifestyle habits while enhancing health self-management among oncology patients. The ALIBIRD mHealth platform emerges as an effective digital health tool that enables closer monitoring of patients and thereby more informed clinical decision-making.