Department of Gastroenterological Surgery, Peking University People's Hospital, Beijing, China.
Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Beijing, China.
JMIR Mhealth Uhealth. 2021 Mar 19;9(3):e22647. doi: 10.2196/22647.
Low anterior resection syndrome (LARS) is a common functional disorder that develops after patients with rectal cancer undergo anal preservation surgery. Common approaches to assess the symptoms of patients with LARS are often complex and time-consuming. Instant messaging/social media has great application potential in LARS follow-up, but has been underdeveloped.
The aim of this study was to compare data between a novel instant messaging/social media follow-up system and a telephone interview in patients with LARS and to analyze the consistency of the instant messaging/social media platform.
Patients with R0 resectable rectal cancer who accepted several defecation function visits via the instant messaging/social media platform and agreed to a telephone interview after the operation using the same questionnaire including subjective questions and LARS scores were included. Differences between the 2 methods were analyzed in pairs and the diagnostic consistency of instant messaging/social media was calculated based on telephone interview results.
In total, 21 questionnaires from 15 patients were included. The positive rates of defecation dissatisfaction, life restriction, and medication use were 10/21 (48%), 11/21 (52%), and 8/21 (38%) for telephone interview and 10/21 (48%), 13/21 (62%), and 5/21 (24%) for instant messaging/social media, respectively. No statistically significant difference was observed between instant messaging/social media and telephone interview in terms of total LARS score (mean 22.4 [SD 11.9] vs mean 24.7 [SD 10.7], P<.21) and LARS categories (Z=-0.264, P=.79); however, instant messaging/social media showed a more negative tendency. The kappa values of 3 subjective questions were 0.618, 0.430, and 0.674, respectively. The total LARS scores were consistent between both groups (Pearson coefficient 0.760, P<.001; category correlation coefficient 0.570, P=.005). Patients with major LARS had highly consistent results, with sensitivity, specificity, kappa value, and P value of 77.8%, 91.7%, 0.704, and .001, respectively.
Instant messaging/social media can be a major LARS screening method. However, further research on information accuracy and user acceptance is needed before implementing a mature system.
ClinicalTrials.gov NCT03009747; https://clinicaltrials.gov/ct2/show/NCT03009747.
低位前切除术综合征（LARS）是一种常见的功能性障碍，发生在接受保肛直肠癌手术的患者中。评估 LARS 患者症状的常见方法往往比较复杂且耗时。即时通讯/社交媒体在 LARS 随访中有很大的应用潜力，但尚未得到充分发展。
本研究旨在比较新型即时通讯/社交媒体随访系统与电话访谈在 LARS 患者中的数据，并分析即时通讯/社交媒体平台的一致性。
纳入接受即时通讯/社交媒体平台多次排便功能检查并在手术后同意使用相同问卷（包括主观问题和 LARS 评分）进行电话访谈的 R0 可切除直肠癌症患者。对两种方法进行配对分析，并根据电话访谈结果计算即时通讯/社交媒体的诊断一致性。
共纳入 15 例患者的 21 份问卷。电话访谈的排便满意度、生活受限和用药阳性率分别为 10/21（48%）、11/21（52%）和 8/21（38%），即时通讯/社交媒体为 10/21（48%）、13/21（62%）和 5/21（24%）。即时通讯/社交媒体与电话访谈在总 LARS 评分（均值 22.4[SD 11.9] vs 均值 24.7[SD 10.7]，P<.21）和 LARS 类别（Z=-0.264，P=.79）方面无统计学差异，但即时通讯/社交媒体显示出更消极的趋势。3 个主观问题的 Kappa 值分别为 0.618、0.430 和 0.674。两组间总 LARS 评分一致（Pearson 系数 0.760，P<.001；类别相关系数 0.570，P=.005）。具有主要 LARS 的患者结果具有高度一致性，其敏感性、特异性、Kappa 值和 P 值分别为 77.8%、91.7%、0.704 和.001。
即时通讯/社交媒体可以作为主要的 LARS 筛查方法。然而，在实施成熟系统之前，需要进一步研究信息准确性和用户接受度。
ClinicalTrials.gov NCT03009747；https://clinicaltrials.gov/ct2/show/NCT03009747。
