Implementation of an interactive, risk adaptive cardio oncological survivorship platform using continuous cardiovascular monitoring

Background Long-term cancer survivors are at increased risk for cardiovascular complications related to cardiotoxic therapies, thoracic surgery, and metabolic sequelae. In current clinical practice, cardio-oncological follow-up relies largely on fixed-interval visits and imaging, providing only episodic assessments of cardiovascular health. Subclinical changes in functional status, heart rate variability, or physical activity may therefore remain undetected between visits, despite their potential relevance for early cardiovascular risk stratification and individualized survivorship care. Purpose KI-COMPASS is a project funded by the German Federal Ministry of Research, Technology and Space (BMFTR) under the directive "Interactive Technology for cardio-oncological Aftercare". The project aims to develop and clinically evaluate an interactive, risk-adaptive follow-up platform integrating continuous cardiovascular monitoring with routine cardiological assessments in survivors of gastro-oesophageal adenocarcinoma. A central objective is the development of transparent, model-based digital patient representations to support personalized risk assessment and longitudinal simulation of cardiovascular trajectories. Methods In a prospective exploratory setting, 100 patients in oncological survivorship care will be enrolled. Continuous physiological and functional parameters, including heart rate, heart rate variability, activity, and sleep patterns, will be collected via wearable devices and smartphones and combined with standard cardiological data such as echocardiography, biomarkers, and documented cardiovascular events. The multimodal data streams will be integrated into patient-specific digital models, enabling longitudinal risk profiling and scenario-based simulation. Results will be presented in a clinician-facing dashboard designed as decision support, preserving cardiologist-led interpretation and clinical responsibility. Risk-adaptive follow-up strategies will be evaluated in simulated clinical scenarios. Expected Results The project is expected to demonstrate the feasibility and clinical acceptability of integrating continuous cardiovascular data into routine cardio-oncological follow-up. Anticipated benefits include improved detection of early functional deterioration, enhanced longitudinal risk awareness between scheduled visits, and support for individualized surveillance strategies. Model-based simulations may enable intensified monitoring for high-risk patients while avoiding unnecessary testing in low-risk survivors. Conclusion KI-COMPASS represents a clinically oriented, publicly funded approach toward interactive and personalized cardio-oncological survivorship care. By complementing guideline-based follow-up with continuous cardiovascular monitoring, transparent AI-based modelling, and expert-guided interpretation, the project aims to inform future models of risk-adaptive, patient-centered cardio-oncology care in routine clinical practice.