Duke University School of Medicine, Durham, NC, 27710, USA.
Duke Cancer Institute, Durham, NC, 27710, USA.
Support Care Cancer. 2020 Nov;28(11):5099-5107. doi: 10.1007/s00520-020-05338-8. Epub 2020 Feb 10.
Utilization of electronic patient-reported outcomes (ePROs) in the clinic can improve quality of life and prolong survival in cancer care. However, there remain unanswered questions regarding trends in missing data and the potential effect on real-time patient care.
This study utilized a prospectively collected dataset of ePROs from oncology clinics that administered the Patient Care Monitor 2.0 (PCM), a validated symptoms survey assessing 78 items for men, and 86 for women. We tabulated the frequency of missing items, by item and domain (emotional, functional and physical symptom-related), and examined these by age, gender, education, race and marital status.
Within 20,986 encounters, there were responses to at least 1 PCM item from 6933 unique patients. The highest frequency of missing answers occurred for: "attend a paid job" (10.7%), "reduced sexual enjoyment" (3.8%), and "run" (3.7%). By domain, 12.3% of functional, 8.4% of physical symptom-related, and 1.6% of emotional constructs contained at least one missing item. For functional and physical symptom-related items, missingness was most common in patients >60 years old.
The frequency of missingness was highest for functional items, like attending a paid job, suggesting that some respondents (e.g., retirees without a paid job) skipped questions that were less applicable to them. More universal issues for cancer patients, such as emotional well-being, had much lower frequencies of missingness. This suggests differential item completion that warrants further study to understand the inherent drivers. Identifying causes of missingness could improve the clinical utility of ePROs and highlight opportunities to personalize care.
在癌症护理中使用电子患者报告结局（ePRO）可以改善生活质量并延长生存期。然而，对于缺失数据的趋势以及对实时患者护理的潜在影响，仍存在一些未解决的问题。
本研究利用前瞻性收集的癌症诊所电子患者报告结局（ePRO）数据集，该数据集使用了患者护理监测器 2.0（PCM），这是一种经过验证的症状调查工具，评估了男性的 78 项和女性的 86 项症状。我们统计了缺失项的频率，按项和域（情感、功能和与身体症状相关）进行了统计，并按年龄、性别、教育程度、种族和婚姻状况进行了检查。
在 20986 次就诊中，有 6933 位独特的患者对至少一项 PCM 项目作出了回应。缺失回答率最高的项目是：“参加有薪工作”（10.7%）、“性快感降低”（3.8%）和“跑步”（3.7%）。按域划分，12.3%的功能项、8.4%的与身体症状相关的项目和 1.6%的情感构建项目至少包含一个缺失项目。对于功能和与身体症状相关的项目，60 岁以上患者的缺失率最高。
缺失率最高的是参加有薪工作等功能项，这表明一些受访者（例如，没有有薪工作的退休人员）跳过了对他们不太适用的问题。癌症患者更普遍的问题，如情绪健康，缺失率要低得多。这表明不同的项目完成情况，需要进一步研究以了解内在驱动力。确定缺失的原因可以提高电子患者报告结局的临床实用性，并突出个性化护理的机会。
