Trojan Andreas, Bättig Basil, Mannhart Meinrad, Seifert Burkhardt, Brauchbar Mathis N, Egbring Marco
OnkoZentrum Zürich, Zürich, Switzerland.
Onkologie Bellevue, Zürich, Switzerland.
JMIR Cancer. 2021 Mar 17;7(1):e26950. doi: 10.2196/26950.
Digital monitoring of treatment-related symptoms and self-reported patient outcomes is important for the quality of care among cancer patients. As mobile devices are ubiquitous nowadays, the collection of electronic patient-reported outcomes (ePROs) is gaining momentum. So far, data are lacking on the modalities that contribute to the quantity and quality of ePROs.
The objective of our study was to compare the utilization of two versions of a subsequently employed mobile app for electronic monitoring of PROs and to test our hypothesis that a shared review of symptoms in patient-physician collaboration has an impact on the number of data entries.
The Consilium Care app engages cancer patients to standardize reporting of well-being and treatment-related symptoms in outpatient settings. For descriptive comparison of the utilization of two slightly different app versions, data were obtained from an early breast cancer trial (version 1 of the app, n=86) and an ongoing study including patients with advanced disease (version 2 of the app, n=106). In both app versions, patients and doctors were allowed to share the information from data entries during consultations. Version 2 of the app, however, randomly selected symptoms that required a detailed and shared regular patient-doctor review in order to focus on the collection and appropriate interpretation regarding awareness and guidance for severity grading. The numbers and types of symptom entries, satisfaction with both app versions, and patients' perceived effects during consultations were included for analysis.
Symptom severity grading was performed according to the Common Terminology Criteria for Adverse Events (CTCAE) using a horizontal slider and was indicated in descriptive terminology in both apps, while a graphical display facilitated the illustration of symptom history charts. In total, 192 patients electronically reported 11,437 data entries on well-being and 33,380 data entries on individual symptoms. Overall, 628 (of 872 intended) requested patient-doctor symptom reviews were performed in version 2 of the app. Both the amount of data entries per patient and day for well-being (version 1 vs version 2: 0.3 vs 1.0; P<.001) and symptoms (version 1 vs version 2: 1.3 vs 1.9; P=.04) appeared significantly increased in version 2 of the app. Overall satisfaction with both app versions was high, although version 2 of the app was perceived to be more helpful in general.
Version 2 of the app showed much better results than version 1 of the app. A request for collaborative patient-doctor symptom review is likely to affect the number of digital symptom data entries. This app shows high potential to improve the patient-doctor experience.
ClinicalTrials.gov NCT02004496; https://clinicaltrials.gov/ct2/show/NCT02004496 and ClinicalTrials.gov NCT03578731; https://clinicaltrials.gov/ct2/show/NCT03578731.
对与治疗相关的症状进行数字监测以及患者自我报告的治疗结果，对于癌症患者的护理质量至关重要。如今移动设备无处不在，电子患者报告结局（ePROs）的收集正蓬勃发展。到目前为止，关于有助于ePROs数量和质量的方式的数据尚缺。
我们研究的目的是比较随后使用的一款用于电子监测PROs的移动应用程序的两个版本的使用情况，并检验我们的假设，即患者与医生协作进行症状的共同审查会对数据录入数量产生影响。
Consilium Care应用程序让癌症患者在门诊环境中对幸福感和与治疗相关的症状报告进行标准化。为了对两个略有不同的应用程序版本的使用情况进行描述性比较，数据来自一项早期乳腺癌试验（应用程序版本1，n = 86）和一项正在进行的包括晚期疾病患者的研究（应用程序版本2，n = 106）。在两个应用程序版本中，患者和医生在会诊期间都可以共享数据录入中的信息。然而，应用程序版本2会随机选择需要患者与医生进行详细且定期共同审查的症状，以便专注于关于严重程度分级的认识和指导的收集及恰当解读。纳入症状录入的数量和类型、对两个应用程序版本的满意度以及患者在会诊期间的感知效果进行分析。
使用水平滑块根据不良事件通用术语标准（CTCAE）对症状严重程度进行分级，并在两个应用程序中用描述性术语表示，同时图形显示便于绘制症状历史图表。总共，192名患者以电子方式报告了11437条关于幸福感的数据录入和33380条关于个体症状的数据录入。总体而言，应用程序版本2进行了628次（共872次计划的）患者与医生症状审查。应用程序版本2中，每位患者每天关于幸福感的数据录入量（版本1与版本2：0.3对1.0；P <.001）和症状的数据录入量（版本1与版本2：1.3对1.9；P =.04）均显著增加。对两个应用程序版本的总体满意度都很高，不过普遍认为应用程序版本2更有帮助。
应用程序版本2的结果比版本1好得多。患者与医生协作进行症状审查的要求可能会影响数字症状数据录入的数量。这款应用程序在改善患者与医生体验方面显示出很高的潜力。
ClinicalTrials.gov NCT02004496；https://clinicaltrials.gov/ct2/show/NCT02004496 以及 ClinicalTrials.gov NCT03578731；https://clinicaltrials.gov/ct2/show/NCT03578731
