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基于电子患者报告结局(ePRO)平台的晚期癌症门诊患者症状负担的纵向研究:一项单中心、前瞻性研究方案。

Longitudinal study of symptom burden in outpatients with advanced cancers based on electronic Patient-Reported Outcome (ePRO) platform: a single institution, prospective study protocol.

机构信息

Department of Psycho-Oncology, Peking University Cancer Hospital & Institute, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Beijing, China

Department of Psycho-Oncology, Peking University Cancer Hospital & Institute, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Beijing, China.

出版信息

BMJ Open. 2020 Nov 20;10(11):e038223. doi: 10.1136/bmjopen-2020-038223.

Abstract

INTRODUCTION

An electronic Patient-Reported Outcome (ePRO) platform is needed for implementing evidence-based symptom management in outpatients with advanced cancer. We describe the overall protocol and the methodology for measuring symptom burden, to provide critical parameters needed to implement symptom management on the ePRO platform.

METHODS AND ANALYSIS

The study focusses on patients with advanced lung cancer, stomach cancer, oesophagus cancer, liver cancer, colorectal cancer or breast cancer. The primary outcome is the change of symptom burden. MD Anderson Symptom Inventory, and other PRO instruments (Insomnia Severity Index, Hospital Anxiety and Depression Scale, 9-item Patient Health Questionnaire and EuroQol-5 dimensions-5 levels version) were used. The secondary outcomes include feasibility of using ePRO, symptom-related quality of life, reasons for no improvement of symptoms, defining frequency of PRO assessments and cut-points, items for screening and management of comorbidity and satisfaction with ePRO platform in patients and health providers. After initial outpatient visit for baseline assessment, ePRO system will automatically send follow-up notification seven times over 4 weeks to patients. The characteristics and changing trajectory of symptoms of patients will be described. Parameters for using PROs, such as optimal time points for follow-up and cut-off point for alert will be determined. The feasibility of ePRO platform to track the changes of target symptoms in outpatients will be evaluated.

ETHICS AND DISSEMINATION

The study protocol and related documents were approved by the Institutional Research Board (IRB) of Peking University Cancer Hospital on 13 February 2019 (2019YJZ07). The results of this study will be disseminated through academic workshops, peer-reviewed publications and conferences.

TRIAL REGISTRATION NUMBER

ChiCTR1900023560.

摘要

简介

为了在晚期癌症门诊患者中实施基于证据的症状管理,需要一个电子患者报告结局(ePRO)平台。我们描述了衡量症状负担的总体方案和方法,提供了在 ePRO 平台上实施症状管理所需的关键参数。

方法和分析

该研究集中于晚期肺癌、胃癌、食管癌、肝癌、结直肠癌或乳腺癌患者。主要结局是症状负担的变化。使用 MD 安德森症状清单和其他 PRO 工具(失眠严重程度指数、医院焦虑和抑郁量表、9 项患者健康问卷和欧洲五维健康量表 5 级版本)。次要结局包括使用 ePRO 的可行性、与症状相关的生活质量、症状无改善的原因、确定 PRO 评估的频率和临界点、筛查和管理合并症的项目以及患者和卫生保健提供者对 ePRO 平台的满意度。在基线评估的初始门诊就诊后,ePRO 系统将在 4 周内自动向患者发送 7 次随访通知。将描述患者症状的特征和变化轨迹。将确定使用 PRO 的参数,例如后续最佳时间点和警报的截止值。将评估 ePRO 平台在跟踪门诊患者目标症状变化方面的可行性。

伦理和传播

该研究方案和相关文件于 2019 年 2 月 13 日获得北京大学肿瘤医院机构审查委员会(IRB)的批准(2019YJZ07)。本研究的结果将通过学术研讨会、同行评议出版物和会议进行传播。

临床试验注册编号

ChiCTR1900023560。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eef1/7682447/f54e09f643f7/bmjopen-2020-038223f01.jpg

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