Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 686 Bay Street, Toronto, Ontario, M5G 0A4, Canada.
Department of Medicine, Toronto General Hospital, 200 Elizabeth Street, Toronto, Ontario, M5G 2C4, Canada.
Support Care Cancer. 2020 Jun;28(6):2729-2734. doi: 10.1007/s00520-019-05115-2. Epub 2019 Nov 9.
Supportive care Prioritization, Assessment and Recommendations for Kids (SPARK) is a web-based application that enables symptom screening and access to clinical practice guidelines for symptom management. Objective was to determine the feasibility of a randomized trial of daily symptom screening for 5 days among children receiving cancer treatments.
We included English-speaking pediatric cancer and hematopoietic stem cell transplantation (HSCT) patients who were 8-18 years of age at enrollment and who were expected to be in the hospital or in clinic daily for five consecutive days. We randomized children to either undergo daily symptom screening with symptom reports provided to the healthcare team using the SPARK vs. standard of care. The primary endpoint was feasibility, defined as being able to enroll at least 30 participants within 1 year, and among those randomized to intervention, at least 75% completing symptom screening on at least 60% of on-study days.
From July 2018 to November 2018, we enrolled and randomized 30 participants. The median age at enrollment was 12.5 (range 8-18) years. Among the intervention group, the median number of days Symptom Screening in Pediatrics Tool (SSPedi) was completed at least once was 5 (range 4 to 5), with one participant missing 1 day of symptom screening. Among all participants, baseline and day 5 SSPedi scores were obtained in 29/30 participants.
A randomized trial of the SPARK with daily symptom screening for 5 days was feasible. It is now appropriate to proceed toward a definitive multi-center trial to test the efficacy of SPARK to improve symptom control.
支持性关怀优先评估和推荐系统（SPARK）是一个基于网络的应用程序，可用于进行症状筛查，并获取症状管理的临床实践指南。本研究旨在确定对接受癌症治疗的儿童进行为期 5 天的每日症状筛查的随机试验的可行性。
我们纳入了讲英语的儿科癌症和造血干细胞移植（HSCT）患者，他们在入组时年龄为 8-18 岁，预计每天在医院或诊所连续 5 天。我们将儿童随机分为两组，一组使用 SPARK 进行每日症状筛查，并将症状报告提供给医疗团队，另一组则采用标准护理。主要终点是可行性，定义为在 1 年内至少能够入组 30 名参与者，并且在随机分组到干预组的参与者中，至少有 75%的参与者在至少 60%的研究日完成了至少 60%的症状筛查。
从 2018 年 7 月至 2018 年 11 月，我们共入组并随机分配了 30 名参与者。入组时的中位年龄为 12.5 岁（范围 8-18 岁）。在干预组中，至少完成一次儿科症状筛查工具（SSPedi）的天数中位数为 5 天（范围 4-5 天），有 1 名参与者漏报了 1 天的症状筛查。在所有参与者中，有 29/30 名参与者获得了基线和第 5 天的 SSPedi 评分。
使用 SPARK 进行为期 5 天的每日症状筛查的随机试验是可行的。现在可以进行多中心的试验，以测试 SPARK 改善症状控制的疗效。
