Department of Medicine, Division of Medical Oncology, Duke University Medical Center, Durham, North Carolina 27710, USA.
Curr Opin Support Palliat Care. 2010 Mar;4(1):36-45. doi: 10.1097/SPC.0b013e32833575fd.
Gastrointestinal symptoms are prevalent, often persistent, and detrimental to patients' quality of life. This review discusses evaluation of gastrointestinal symptoms as patient-reported outcomes (PROs) and presents an information technology-based system for symptom monitoring and management. The electronic PRO (ePRO) system is then placed within the larger context of rapid learning healthcare, a concept currently under development in which data obtained through both research and clinical care continuously build large datasets for analysis, seed future research, fuel expansion of the evidence base, and support clinical decision-making.
PROs are increasingly recognized as valid measures of symptoms, functional status, and quality of life. They have demonstrated prognostic significance and are being developed as a component of toxicity reporting in clinical trials. Recent studies have validated an information technology-based approach for collecting ePROs in routine clinical care. The system is feasible and acceptable; electronic and paper-based data, collected on validated assessment instruments, are equivalent; ePRO collection supports real-time symptom monitoring and management. The ePRO system represents a first step toward implementing rapid learning healthcare at the clinic level.
ePROs provide a rich source of information to support monitoring and clinical management of troubling symptoms such as gastrointestinal complaints.
胃肠道症状普遍存在，常持续存在，并对患者的生活质量造成损害。本文讨论了将胃肠道症状评估作为患者报告结局（PROs），并介绍了一种基于信息技术的症状监测和管理系统。然后，将电子 PRO（ePRO）系统置于快速学习医疗保健的大背景下，这是一个正在开发的概念，通过研究和临床护理获得的数据不断构建大型数据集进行分析，为未来的研究提供种子，扩展证据基础，并支持临床决策。
PROs 越来越被认为是症状、功能状态和生活质量的有效衡量标准。它们已经证明具有预后意义，并被开发为临床试验中毒性报告的一个组成部分。最近的研究已经验证了一种基于信息技术的方法，用于在常规临床护理中收集 ePROs。该系统是可行且可接受的；电子和纸质数据，使用经过验证的评估工具进行收集，是等效的；ePRO 收集支持实时症状监测和管理。ePRO 系统代表着在临床层面实施快速学习医疗保健的第一步。
ePROs 提供了丰富的信息来源，可支持监测和临床管理胃肠道等不适症状。
