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多中心、以患者为中心的转移性乳腺癌患者癌症登记系统的开发与概念验证——“转移性疾病患者的乳腺癌护理”(BRE-4-MED)登记系统。

Development and proof-of-concept of a multicenter, patient-centered cancer registry for breast cancer patients with metastatic disease-the "Breast cancer care for patients with metastatic disease" (BRE-4-MED) registry.

作者信息

Stangl Stephanie, Haas Kirsten, Eichner Felizitas A, Grau Anna, Selig Udo, Ludwig Timo, Fehm Tanja, Stüber Tanja, Rashid Asarnusch, Kerscher Alexander, Bargou Ralf, Hermann Silke, Arndt Volker, Meyer Martin, Wildner Manfred, Faller Hermann, Schrauder Michael G, Weigel Michael, Schlembach Ulrich, Heuschmann Peter U, Wöckel Achim

机构信息

1Institute of Clinical Epidemiology and Biometry (ICE-B), University of Würzburg, Würzburg, Germany.

2Department of Gynecology and Obstetrics, University Hospital Würzburg, Würzburg, Germany.

出版信息

Pilot Feasibility Stud. 2020 Feb 4;6:11. doi: 10.1186/s40814-019-0541-3. eCollection 2020.

Abstract

BACKGROUND

Patients with metastatic breast cancer (MBC) are treated with a palliative approach with focus on controlling for disease symptoms and maintaining high quality of life. Information on individual needs of patients and their relatives as well as on treatment patterns in clinical routine care for this specific patient group are lacking or are not routinely documented in established Cancer Registries. Thus, we developed a registry concept specifically adapted for these incurable patients comprising primary and secondary data as well as mobile-health (m-health) data.

METHODS

The concept for patient-centered "Breast cancer care for patients with metastatic disease" (BRE-4-MED) registry was developed and piloted exemplarily in the region of Main-Franconia, a mainly rural region in Germany comprising about 1.3 M inhabitants. The registry concept includes data on diagnosis, therapy, progression, patient-reported outcome measures (PROMs), and needs of family members from several sources of information including routine data from established Cancer Registries in different federal states, treating physicians in hospital as well as in outpatient settings, patients with metastatic breast cancer and their family members. Linkage with routine cancer registry data was performed to collect secondary data on diagnosis, therapy, and progression. Paper and online-based questionnaires were used to assess PROMs. A dedicated mobile application software (APP) was developed to monitor needs, progression, and therapy change of individual patients. Patient's acceptance and feasibility of data collection in clinical routine was assessed within a proof-of-concept study.

RESULTS

The concept for the BRE-4-MED registry was developed and piloted between September 2017 and May 2018. In total = 31 patients were included in the pilot study, = 22 patients were followed up after 1 month. Record linkage with the Cancer Registries of Bavaria and Baden-Württemberg demonstrated to be feasible. The voluntary APP/online questionnaire was used by = 7 participants. The feasibility of the registry concept in clinical routine was positively evaluated by the participating hospitals.

CONCLUSION

The concept of the BRE-4-MED registry provides evidence that combinatorial evaluation of PROMs, needs of family members, and raising clinical parameters from primary and secondary data sources as well as m-health applications are feasible and accepted in an incurable cancer collective.

摘要

背景

转移性乳腺癌(MBC)患者采用姑息治疗方法,重点是控制疾病症状并维持高质量生活。关于患者及其亲属的个体需求以及该特定患者群体在临床常规护理中的治疗模式的信息缺乏,或未在既定的癌症登记处进行常规记录。因此,我们开发了一种专门适用于这些无法治愈患者的登记概念,包括初级和二级数据以及移动健康(m-health)数据。

方法

以患者为中心的“转移性疾病患者的乳腺癌护理”(BRE-4-MED)登记处的概念在德国主要为农村地区的美因-弗兰肯行政区开发并进行了示例性试点,该地区约有130万居民。登记概念包括来自多个信息源的数据,如诊断、治疗、病情进展、患者报告的结局指标(PROMs)以及家庭成员的需求,这些信息源包括不同联邦州既定癌症登记处的常规数据、医院及门诊环境中的治疗医生、转移性乳腺癌患者及其家庭成员。与常规癌症登记数据进行关联以收集关于诊断、治疗和病情进展的二级数据。使用纸质和基于网络的问卷来评估PROMs。开发了一个专用的移动应用软件(APP)来监测个体患者的需求、病情进展和治疗变化。在一项概念验证研究中评估了患者对临床常规数据收集的接受度和可行性。

结果

BRE-4-MED登记处的概念于2017年9月至2018年5月期间开发并进行了试点。试点研究共纳入31例患者,1个月后对22例患者进行了随访。与巴伐利亚州和巴登-符腾堡州癌症登记处的记录关联证明是可行的。7名参与者使用了自愿性的APP/在线问卷。参与医院对登记概念在临床常规中的可行性给予了积极评价。

结论

BRE-4-MED登记处的概念提供了证据,表明对PROMs、家庭成员需求以及从初级和二级数据源以及移动健康应用中收集临床参数进行综合评估在无法治愈的癌症群体中是可行且被接受的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3829/7001276/9b0c9b472fe7/40814_2019_541_Fig1_HTML.jpg

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