Assessing the accuracy of Seismofit® as an estimate of preoperative maximal oxygen consumption in patients with hepato-pancreato-biliary, colorectal, and gastro-oesophageal cancer

Background: Peak oxygen uptake (VO2 peak) measured during cardiopulmonary exercise testing (CPET) is commonly used to objectively assess fitness and inform risk stratification. Preoperative CPET is not always universally available. Seismofit® offers a noninvasive, non-exercise alternative for estima...

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Main Authors: Nicholas Tetlow, Philip Devendra, James Waiting, Maria Aresu, Abena Glover, Martin Rooms, Shaman Jhanji, Don Milliken
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:BJA Open
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Online Access:http://www.sciencedirect.com/science/article/pii/S277260962500019X
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author Nicholas Tetlow
Philip Devendra
James Waiting
Maria Aresu
Abena Glover
Martin Rooms
Shaman Jhanji
Don Milliken
author_facet Nicholas Tetlow
Philip Devendra
James Waiting
Maria Aresu
Abena Glover
Martin Rooms
Shaman Jhanji
Don Milliken
author_sort Nicholas Tetlow
collection DOAJ
description Background: Peak oxygen uptake (VO2 peak) measured during cardiopulmonary exercise testing (CPET) is commonly used to objectively assess fitness and inform risk stratification. Preoperative CPET is not always universally available. Seismofit® offers a noninvasive, non-exercise alternative for estimating VO2 peak, though it has not been validated in patients awaiting major abdominal cancer surgery. Methods: Prospective single-centre blinded observational study in patients with hepato-pancreato-biliary, colorectal, or gastro-oesophageal cancer undergoing preoperative assessment. Patients underwent Seismofit® assessment before routine CPET. Primary outcome was the relationship between Seismofit®-estimated VO2 peak and CPET-measured VO2 peak. Secondary outcomes explored the relationship between Seismofit® and CPET for (i) bias and agreement limits; (ii) surgical subgroup; (iii) commonly reported CPET variables; (iv) patient acceptance. Results: Thirty-three participants (median [interquartile range] age: 67 yr [58–75 yr]; 20 [61%] males) completed both CPET and Seismofit®. No linear association was found between Seismofit®-estimated VO2 peak and CPET-measured VO2 peak: Pearson r=0.111 (95% confidence interval −0.242 to 0.437), R2=0.012, P=0.539. Compared with CPET, Seismofit® demonstrated a large bias (standard deviation) 12.8 (8.8); 95% limits of agreement (−4.5 to 30.0). No association existed between Seismofit®-estimated VO2 peak and CPET-measured VO2 peak in the hepato-pancreato-biliary or gastro-oesophageal subgroup or between Seismofit®-estimated VO2 peak and commonly reported CPET variables. Conclusions: There was no evidence of linear association between Seismofit®-estimated VO2 peak and objectively measured VO2 peak by CPET in patients undergoing assessment for major abdominal cancer surgery. This finding was consistent across all subgroup and exploratory analyses. Seismofit® tended to overestimate VO2 peak with a high degree of bias. Clinical trial registration: NCT05831488.
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spelling doaj-art-eb363bfd777c4b29a9e39f8b477104fa2025-08-20T02:16:29ZengElsevierBJA Open2772-60962025-06-011410039510.1016/j.bjao.2025.100395Assessing the accuracy of Seismofit® as an estimate of preoperative maximal oxygen consumption in patients with hepato-pancreato-biliary, colorectal, and gastro-oesophageal cancerNicholas Tetlow0Philip Devendra1James Waiting2Maria Aresu3Abena Glover4Martin Rooms5Shaman Jhanji6Don Milliken7Department of Perioperative Medicine, Anaesthesia, Pain and Critical Care, The Royal Marsden NHS Foundation Trust, London, UK; Centre for Peri-operative Medicine, Department of Targeted Intervention, Division of Surgery and Interventional Science, University College London, London, UK; Corresponding author. Department of Perioperative Medicine, Anaesthesia, Pain and Critical Care, The Royal Marsden NHS Foundation Trust, London, UK.Department of Perioperative Medicine, Anaesthesia, Pain and Critical Care, The Royal Marsden NHS Foundation Trust, London, UK; Department of Anaesthetics, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UKDepartment of Perioperative Medicine, Anaesthesia, Pain and Critical Care, The Royal Marsden NHS Foundation Trust, London, UKResearch Data & Statistics Unit, Royal Marsden Clinical Trials Unit, The Royal Marsden NHS Foundation Trust, London, UKResearch Data & Statistics Unit, Royal Marsden Clinical Trials Unit, The Royal Marsden NHS Foundation Trust, London, UKDepartment of Perioperative Medicine, Anaesthesia, Pain and Critical Care, The Royal Marsden NHS Foundation Trust, London, UKDepartment of Perioperative Medicine, Anaesthesia, Pain and Critical Care, The Royal Marsden NHS Foundation Trust, London, UKDepartment of Perioperative Medicine, Anaesthesia, Pain and Critical Care, The Royal Marsden NHS Foundation Trust, London, UKBackground: Peak oxygen uptake (VO2 peak) measured during cardiopulmonary exercise testing (CPET) is commonly used to objectively assess fitness and inform risk stratification. Preoperative CPET is not always universally available. Seismofit® offers a noninvasive, non-exercise alternative for estimating VO2 peak, though it has not been validated in patients awaiting major abdominal cancer surgery. Methods: Prospective single-centre blinded observational study in patients with hepato-pancreato-biliary, colorectal, or gastro-oesophageal cancer undergoing preoperative assessment. Patients underwent Seismofit® assessment before routine CPET. Primary outcome was the relationship between Seismofit®-estimated VO2 peak and CPET-measured VO2 peak. Secondary outcomes explored the relationship between Seismofit® and CPET for (i) bias and agreement limits; (ii) surgical subgroup; (iii) commonly reported CPET variables; (iv) patient acceptance. Results: Thirty-three participants (median [interquartile range] age: 67 yr [58–75 yr]; 20 [61%] males) completed both CPET and Seismofit®. No linear association was found between Seismofit®-estimated VO2 peak and CPET-measured VO2 peak: Pearson r=0.111 (95% confidence interval −0.242 to 0.437), R2=0.012, P=0.539. Compared with CPET, Seismofit® demonstrated a large bias (standard deviation) 12.8 (8.8); 95% limits of agreement (−4.5 to 30.0). No association existed between Seismofit®-estimated VO2 peak and CPET-measured VO2 peak in the hepato-pancreato-biliary or gastro-oesophageal subgroup or between Seismofit®-estimated VO2 peak and commonly reported CPET variables. Conclusions: There was no evidence of linear association between Seismofit®-estimated VO2 peak and objectively measured VO2 peak by CPET in patients undergoing assessment for major abdominal cancer surgery. This finding was consistent across all subgroup and exploratory analyses. Seismofit® tended to overestimate VO2 peak with a high degree of bias. Clinical trial registration: NCT05831488.http://www.sciencedirect.com/science/article/pii/S277260962500019XAccuracyCPETmajor abdominal cancer surgerypeak oxygen uptakeseismocardiography
spellingShingle Nicholas Tetlow
Philip Devendra
James Waiting
Maria Aresu
Abena Glover
Martin Rooms
Shaman Jhanji
Don Milliken
Assessing the accuracy of Seismofit® as an estimate of preoperative maximal oxygen consumption in patients with hepato-pancreato-biliary, colorectal, and gastro-oesophageal cancer
BJA Open
Accuracy
CPET
major abdominal cancer surgery
peak oxygen uptake
seismocardiography
title Assessing the accuracy of Seismofit® as an estimate of preoperative maximal oxygen consumption in patients with hepato-pancreato-biliary, colorectal, and gastro-oesophageal cancer
title_full Assessing the accuracy of Seismofit® as an estimate of preoperative maximal oxygen consumption in patients with hepato-pancreato-biliary, colorectal, and gastro-oesophageal cancer
title_fullStr Assessing the accuracy of Seismofit® as an estimate of preoperative maximal oxygen consumption in patients with hepato-pancreato-biliary, colorectal, and gastro-oesophageal cancer
title_full_unstemmed Assessing the accuracy of Seismofit® as an estimate of preoperative maximal oxygen consumption in patients with hepato-pancreato-biliary, colorectal, and gastro-oesophageal cancer
title_short Assessing the accuracy of Seismofit® as an estimate of preoperative maximal oxygen consumption in patients with hepato-pancreato-biliary, colorectal, and gastro-oesophageal cancer
title_sort assessing the accuracy of seismofit r as an estimate of preoperative maximal oxygen consumption in patients with hepato pancreato biliary colorectal and gastro oesophageal cancer
topic Accuracy
CPET
major abdominal cancer surgery
peak oxygen uptake
seismocardiography
url http://www.sciencedirect.com/science/article/pii/S277260962500019X
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