Novel Wearable-Based Real-Time Temperature Monitoring in Hospitals for Febrile Adverse Events in Patients with Cancer: A Prospective Feasibility Study

Abstract

Cancer remains a leading cause of mortality worldwide. Chemotherapy is effective but can cause febrile neutropenia, deplete neutrophils, and increase infection risk. Although timely fever detection is critical to prevent complications, periodic temperature monitoring has inherent limitations. Wearable devices (WDs) for real-time body temperature (RBT) monitoring are emerging as tools for early fever detection, though their clinical feasibility and usability remain unverified. This study assessed the clinical feasibility of a novel WD by comparing its temperature concordance and fever detection capability against a standard reference in patients with cancer. The RBT system's clinical maturity, including its capacity for early fever detection and monitoring treatment-related changes, was evaluated. Furthermore, satisfaction among clinicians and patients was analyzed in a hospital setting. In this prospective study, patients with hematologic malignancies at high infection risk admitted to the Chonnam National University in Hwasun Hospital, South Korea, were enrolled. Data from 47 patients were analyzed to compare MT100D as WD (SEERS Technology Co., Ltd., South Korea) readings with axillary thermometers. Temperature concordance was evaluated using the intraclass correlation coefficient (ICC), and diagnostic performance was compared with the reference thermometer. The early fever detection performance of the MT100D was analyzed to evaluate the clinical effectiveness of the early response system. Usability was evaluated through a five-point Likert scale survey completed by clinical nurses. The MT100D demonstrated good agreement with the reference thermometer (mean difference: -0.19 ± 0.35 °C; ICC: 0.78). The RBT system achieved sensitivity, specificity, and area under the receiver operating characteristic curve values of 81.50%, 96.32%, and 96.60%, respectively. The early fever detection rate was 77.1%, with the RBT system detecting fever an average of 1.13 ± 1.28 h earlier than the reference. Usability and satisfaction assessments showed high patient satisfaction (mean 4.69 ± 0.5; range 4.57-4.80) and moderate clinician satisfaction (mean 3.63 ± 0.75; range 2.89-4.11). Among patients with cancer, including those at risk of febrile neutropenia, the MT100D demonstrated strong concordance with standard thermometry, enabling early fever detection. The RBT system shows promise for the early identification of neutropenic risk during chemotherapy.

Keywords: cancer; febrile neutropenia; real-time temperature monitoring; wearable device.

Figure 1

A schematic framework of the study timeline comparing reference and MT100D temperature measurements.

Figure 2

An illustration of the MT100D device and thynC^TM for real-time body temperature (RBT) monitoring. The left-hand image shows the MT100D device suitable for daily use; the center panel demonstrates RBT monitoring in a clinical environment, and the right panel displays the thynC^TM user interface.

Figure 3

A patient inclusion and exclusion flow diagram for the prospective study.

Figure 4

A Bland–Altman plot of all data pairs.

Figure 5

Early fever detection analysis. (a) Early fever detection rates for all febrile events (left) and multiple febrile episodes (right). (b) Representative clinical case illustrating early fever detection by the MT100D compared to the reference device.