Basch Ethan, Artz David, Dulko Dorothy, Scher Kevin, Sabbatini Paul, Hensley Martee, Mitra Nandita, Speakman John, McCabe Mary, Schrag Deborah
Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, 307 E 63rd St, New York, NY 10021, USA.
J Clin Oncol. 2005 May 20;23(15):3552-61. doi: 10.1200/JCO.2005.04.275.
Tracking symptoms related to treatment toxicity is standard practice in routine care and during clinical trials. Currently, clinicians collect symptom information via complex and often inefficient mechanisms, but there is growing interest in collecting outcome information directly from patients.
The National Cancer Institute Common Terminology Criteria for Adverse Events schema for seven common symptoms was adapted into a Web-based patient-reporting system, accessible from desktop computers in outpatient clinics and from home computers. Eighty patients with gynecologic malignancies beginning standard chemotherapy regimens were enrolled between April and September 2004. During an 8-week observation period, participants were encouraged to log in and report symptoms at each follow-up visit, or alternatively, to access the system from home.
All patients completed an initial log in. At each subsequent appointment, most enrollees (80% to 85%) reported symptoms using the online system, with a mean of three follow-up visits per patient during the observation period (range, one to six). Sixty of 80 patients (75%) logged in at least once from home. Use was significantly associated with prior Internet experience. Forty-two severe toxicities (grade 3 to 4) entered from home prompted seven clinician interventions. Most patients (96%) found the system useful and would recommend it to others.
Patients are capable of reporting symptoms experienced during chemotherapy using a Web-based interface. Assessment in the clinical trial setting and comparison of direct patient- versus clinician-based approaches for reporting symptoms and their severity are warranted.
在常规护理和临床试验中，追踪与治疗毒性相关的症状是标准做法。目前，临床医生通过复杂且往往效率低下的机制收集症状信息，但直接从患者那里收集结果信息的兴趣日益浓厚。
美国国立癌症研究所不良事件通用术语标准中关于七种常见症状的模式被改编成一个基于网络的患者报告系统，可从门诊诊所的台式电脑以及家用电脑访问。2004年4月至9月期间，招募了80名开始接受标准化化疗方案的妇科恶性肿瘤患者。在为期8周的观察期内，鼓励参与者在每次随访就诊时登录并报告症状，或者也可以在家中访问该系统。
所有患者都完成了首次登录。在随后的每次预约就诊时，大多数登记者（80%至85%）使用在线系统报告症状，观察期内每位患者平均随访就诊三次（范围为一至六次）。80名患者中有60名（75%）至少在家中登录过一次。使用情况与先前的互联网使用经验显著相关。从家中输入的42例严重毒性反应（3至4级）促使临床医生进行了7次干预。大多数患者（96%）认为该系统有用，并会向他人推荐。
患者能够使用基于网络的界面报告化疗期间经历的症状。有必要在临床试验环境中进行评估，并比较直接基于患者和基于临床医生的报告症状及其严重程度的方法。
