{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T19:13:27Z","timestamp":1788981207993,"version":"build-2803163510"},"reference-count":29,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Postoperative outcome assessment is often based on discrete follow-up visits, limiting characterization of individual recovery trajectories, and the timely identification of adverse events (AEs). Longitudinal smartphone-based monitoring may overcome these limitations by enabling frequent, resource-efficient collection of patient-reported outcomes and complications throughout recovery. Such data may provide a more patient-centered understanding of the postoperative course and complement conventional clinical surveillance.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to evaluate the feasibility of smartphone-based longitudinal monitoring of quality of life, subjective well-being, and AEs after elective neurosurgery and compare postoperative recovery trajectories and agreement between patient- and clinician-reported AEs.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This interim analysis of a prospective cohort study included adult patients undergoing elective lumbar decompression, lumbar fusion, supratentorial craniotomy, or infratentorial craniotomy at a Swiss tertiary referral center between June 2023 and January 2025. Participants used a smartphone app to longitudinally report subjective well-being (Subjective Well-Being Index; 0\u201010), quality of life (EQ-5D-5L), and AEs for up to 1 year postoperatively. Complications were self-reported using the Therapy-Disability-Neurology (TDN) classification and retrospectively adjudicated by physicians. Descriptive analyses assessed data density, engagement, and concordance between patient- and clinician-reported events. Mixed-effects models were used to evaluate factors associated with postoperative well-being.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of the 100 enrolled patients (median age 64.0, IQR 52.95\u201071.6 years; n=45, 45% women), 86 (86%) provided postoperative data. During a median follow-up of 3.2 (IQR 0.2\u201011.3) months, participants submitted 4354 longitudinal well-being entries. Patients reported 22 unique AEs, whereas physicians identified 44 AEs, with overlap for 9 (20.5%) events. Most physician-reported AEs were mild (30\/44, 68.2%; TDN grade 1\u20102), and no grade 4 or 5 events occurred. Patient-reported AEs primarily reflected symptomatic and functional impairments, whereas physician-reported events more often included clinically detected or subclinical findings. In mixed-effects models, time since surgery was associated with improved well-being, and no other factors were statistically significant.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Smartphone-based postoperative monitoring was feasible in this elective neurosurgical cohort and generated dense longitudinal patient-reported data beyond routine follow-up. Patient and clinician AE reporting captured partly distinct aspects of postoperative recovery, suggesting that smartphone-based self-reporting may complement rather than replace clinical surveillance.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/100934","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T18:52:42Z","timestamp":1788979962000},"page":"e100934-e100934","source":"Crossref","is-referenced-by-count":0,"title":["Smartphone-Based Monitoring of Quality of Life and Adverse Events After Neurosurgery: Prospective Cohort Study"],"prefix":"10.2196","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3721-7484","authenticated-orcid":false,"given":"Alexis Paul Romain","family":"Terrapon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0186-656X","authenticated-orcid":false,"given":"Erik","family":"Schulz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0783-7459","authenticated-orcid":false,"given":"Athina","family":"Firtinidou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0316-9824","authenticated-orcid":false,"given":"Silvio","family":"Heinig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4620-408X","authenticated-orcid":false,"given":"Lorenzo","family":"Bertulli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5365-7511","authenticated-orcid":false,"given":"Felix","family":"Corr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8652-0554","authenticated-orcid":false,"given":"Meltem","family":"G\u00f6nel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7369-5973","authenticated-orcid":false,"given":"Maria","family":"Nikolaeva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1819-3210","authenticated-orcid":false,"given":"Thomas","family":"Petutschnigg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8339-234X","authenticated-orcid":false,"given":"Sivani","family":"Sivanrupan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3499-8801","authenticated-orcid":false,"given":"Jakob","family":"Heimer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2185-4526","authenticated-orcid":false,"given":"Menno R","family":"Germans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1866-1682","authenticated-orcid":false,"given":"Christian","family":"Zweifel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3886-466X","authenticated-orcid":false,"given":"Andreas","family":"Raabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8025-3694","authenticated-orcid":false,"given":"Philippe","family":"Schucht","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4639-4474","authenticated-orcid":false,"given":"Luca","family":"Regli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2828-4706","authenticated-orcid":false,"given":"Marian Christoph","family":"Neidert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4620-3992","authenticated-orcid":false,"given":"Oliver","family":"Bozinov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3146-4646","authenticated-orcid":false,"given":"Linda","family":"B\u00e4ttig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6417-1787","authenticated-orcid":false,"given":"Martin Nikolaus","family":"Stienen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"issue":"2","key":"R1","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1097\/01.sla.0000133083.54934.ae","article-title":"Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey","volume":"240","author":"Dindo","journal-title":"Ann Surg"},{"issue":"2","key":"R2","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1097\/SLA.0b013e3181b13ca2","article-title":"The Clavien-Dindo classification of surgical complications: five-year experience","volume":"250","author":"Clavien","journal-title":"Ann Surg"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m2917","article-title":"Prospective validation of classification of intraoperative adverse events (ClassIntra): international, multicentre cohort study","volume":"370","author":"Dell-Kuster","journal-title":"BMJ"},{"issue":"5-6","key":"R4","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1016\/j.wneu.2010.11.010","article-title":"A new classification of complications in neurosurgery","volume":"75","author":"Landriel Iba\u00f1ez","journal-title":"World Neurosurg"},{"issue":"3","key":"R5","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1227\/01.NEU.0000350860.59902.68","article-title":"Quantitative analysis of adverse events in neurosurgery","volume":"65","author":"Houkin","journal-title":"Neurosurgery"},{"issue":"2","key":"R6","doi-asserted-by":"publisher","first-page":"256","DOI":"10.3171\/2016.1.SPINE14808","article-title":"Spinal Adverse Events Severity System, version 2 (SAVES-V2): inter- and intraobserver reliability assessment","volume":"25","author":"Rampersaud","journal-title":"J Neurosurg Spine"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2018.05.121","article-title":"Interobserver reliability of Spinal Adverse Events Severity System - Neuro (SAVES-N): a prospective adverse event reporting system for neurosurgical cases","volume":"116","author":"Castle-Kirszbaum","journal-title":"World Neurosurg"},{"issue":"1","key":"R8","doi-asserted-by":"publisher","first-page":"272","DOI":"10.3171\/2018.9.JNS181004","article-title":"Defining a new neurosurgical complication classification: lessons learned from a monthly Morbidity and Mortality conference","volume":"132","author":"Gozal","journal-title":"J Neurosurg"},{"key":"R9","doi-asserted-by":"publisher","DOI":"10.1016\/j.inat.2020.101002","article-title":"Prospective study of complications in neurosurgery and their impact on the health related quality of life (HRQOL) \u2013 proposal of a new complication grading in neurosurgery based on HRQOL","volume":"23","author":"Chandra Venkata Vemula","journal-title":"Interdiscip Neurosurg"},{"issue":"2","key":"R10","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1093\/neuros\/nyab121","article-title":"Adverse events in neurosurgery: the novel Therapy-Disability-Neurology grade","volume":"89","author":"Terrapon","journal-title":"Neurosurgery"},{"issue":"1","key":"R11","doi-asserted-by":"publisher","DOI":"10.1007\/s10143-023-02103-3","article-title":"Decision-making tree for surgical treatment in meningioma: a geriatric cohort study","volume":"46","author":"Li","journal-title":"Neurosurg Rev"},{"issue":"1","key":"R12","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-21065-8","article-title":"International survey-based assessment of the reliability, validity, and interpretability of the TDN grade for neurosurgical adverse events","volume":"15","author":"Terrapon","journal-title":"Sci Rep"},{"issue":"2","key":"R13","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-025-05312-6","article-title":"Adverse events in meningioma surgery classified using the Therapy-Disability-Neurology (TDN) grading system","volume":"176","author":"Leistner","journal-title":"J Neurooncol"},{"issue":"6","key":"R14","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci16060599","article-title":"Assessment of adverse events using the Therapy-Disability-Neurology (TDN) grading system in a cohort of aneurysmal subarachnoid hemorrhage patients: a single-center retrospective cohort study","volume":"16","author":"K\u00e4lin","journal-title":"Brain Sci"},{"key":"R15","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.792878","article-title":"Classification of adverse events following surgery in patients with diffuse lower-grade gliomas","volume":"11","author":"G\u00f3mez Vecchio","journal-title":"Front Oncol"},{"issue":"1","key":"R16","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-021-00525-1","article-title":"Mobile devices and wearable technology for measuring patient outcomes after surgery: a systematic review","volume":"4","author":"Knight","journal-title":"NPJ Digit Med"},{"issue":"10","key":"R17","doi-asserted-by":"publisher","first-page":"1727","DOI":"10.1007\/s11136-011-9903-x","article-title":"Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L)","volume":"20","author":"Herdman","journal-title":"Qual Life Res"},{"issue":"1","key":"R18","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1007\/s00701-021-04967-0","article-title":"Determining the impact of postoperative complications in neurosurgery based on simulated longitudinal smartphone app-based assessment","volume":"164","author":"Comfort","journal-title":"Acta Neurochir (Wien)"},{"issue":"3","key":"R19","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1111\/j.1747-4949.2009.00271.x","article-title":"Functional outcome measures in contemporary stroke trials","volume":"4","author":"Quinn","journal-title":"Int J Stroke"},{"key":"R20","unstructured":"R Core Team. R: a language and environment for statistical computing. R Foundation for Statistical Computing. 2024. URL: https:\/\/www.R-project.org\/ [Accessed 25-08-2026]"},{"issue":"43","key":"R21","doi-asserted-by":"publisher","first-page":"1686","DOI":"10.21105\/joss.01686","article-title":"Welcome to the tidyverse","volume":"4","author":"Wickham","journal-title":"J Open Source Softw"},{"key":"R22","doi-asserted-by":"crossref","unstructured":"Wickham H . ggplot2: Elegant Graphics for Data Analysis. Springer; 2016. [doi: 10.1007\/978-3-319-24277-4]","DOI":"10.1007\/978-3-319-24277-4_9"},{"key":"R23","unstructured":"Iannone R Cheng J Schloerke B et al. gt: easily create presentation-ready display tables. The Comprehensive R Archive Network. 2026. URL: https:\/\/cran.r-project.org\/web\/packages\/gt\/index.html [Accessed 25-08-2026]"},{"key":"R24","unstructured":"Pinheiro J Bates D DebRoy S et al. nlme: linear and nonlinear mixed effects models. The Comprehensive R Archive Network. 2026. URL: https:\/\/cran.r-project.org\/web\/packages\/nlme\/index.html [Accessed 26-08-2026]"},{"key":"R25","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i1174","article-title":"Guidelines for reporting of health interventions using mobile phones: mobile health (mHealth) evidence reporting and assessment (mERA) checklist","volume":"352","author":"Agarwal","journal-title":"BMJ"},{"issue":"7624","key":"R26","doi-asserted-by":"publisher","first-page":"806","DOI":"10.1136\/bmj.39335.541782.AD","article-title":"Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"335","author":"von Elm","journal-title":"BMJ"},{"issue":"Pt B","key":"R27","doi-asserted-by":"publisher","first-page":"110783","DOI":"10.1016\/j.compbiomed.2025.110783","article-title":"AI-driven wearable sensors for postoperative monitoring in surgical patients: a systematic review","volume":"196","author":"Khan","journal-title":"Comput Biol Med"},{"key":"R28","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2022.07.036","article-title":"Utilizing data from wearable technologies in the era of telemedicine to assess patient function and outcomes in neurosurgery: systematic review and time-trend analysis of the literature","volume":"166","author":"Mualem","journal-title":"World Neurosurg"},{"key":"R29","doi-asserted-by":"publisher","DOI":"10.1016\/j.bas.2022.100860","article-title":"Neurosurgery outcomes and complications in a monocentric 7-year patient registry","volume":"2","author":"Sarnthein","journal-title":"Brain Spine"}],"container-title":["Journal of Medical Internet Research"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T18:52:44Z","timestamp":1788979964000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jmir.org\/2026\/1\/e100934"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,9]]},"references-count":29,"URL":"https:\/\/doi.org\/10.2196\/100934","relation":{},"ISSN":["1438-8871"],"issn-type":[{"value":"1438-8871","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,9]]},"article-number":"v28i2e100934"}}