Academic Department of Radiation Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States; Department of Radiation Medicine, Northwell Health Cancer Institute, Lake Success, New York, United States.
Department of Radiation Medicine, Northwell Health Cancer Institute, Lake Success, New York, United States.
Oral Oncol. 2021 Nov;122:105551. doi: 10.1016/j.oraloncology.2021.105551. Epub 2021 Oct 23.
To report the early experience using an automated chatbot (Chats)for patient-reported outcomes (PRO) and symptom self-managementinhead and neck cancer (HNC) patients undergoing radiation treatment (RT).
Patients aged ≥ 18 yearsdiagnosed with HNC who were scheduled to begin RT were given the option to use Chats from June 2018 to June 2019. Enrolled patients received chat notifications two days before weekly on-treatment visitsand every 1-4 weeks after RT for an additional 4 months. After the first in-person follow-up visit, participants completed an electronic usability and satisfaction questionnaire.
Of 95 patients who agreed to participate, 84 were eligible for analysis.Participantswere significantly younger than patients who declined participation (mean age 61.3 vs 68.3 years;p-value < 0.001). Patient engagement with Chats was highest at 67% during the first month and declined over time (p-value = 0.004). Concordance between PRO and clinician-reported outcomes (CRO) was fair, ranging from 0.10 to 0.43 (Cohen κ statistics). The most commonly under-reported symptoms were salivary duct inflammation (53%), xerostomia (41%), and mucositis (37%). 89% (39 of 44) of patients who completed surveys found Chats easy to use, and 61% reported that Chats helped with symptom self-management and reduced the need to call the care team.
These early results suggest that an interactive chatbot is feasible and provides support for HNC patients during and after RT. Chats identified discordance between PRO and CRO. Further study is required to measure benefits of Chats in a larger population.
报告使用自动化聊天机器人（Chats）进行患者报告结局（PRO）和头颈部癌症（HNC）患者放疗期间症状自我管理的早期经验。
2018 年 6 月至 2019 年 6 月，年龄≥18 岁、拟接受放疗的 HNC 患者可选择使用 Chats。入组患者在每周治疗期间就诊前两天和放疗后 1-4 周接受聊天通知，共 4 个月。首次面对面随访后，参与者完成电子可用性和满意度问卷。
在 95 名同意参与的患者中，84 名符合分析条件。与拒绝参与的患者相比，参与者年龄明显更小（平均年龄 61.3 岁 vs 68.3 岁；p 值<0.001）。Chats 的患者参与度在第一个月最高，为 67%，随后逐渐下降（p 值=0.004）。PRO 和临床医生报告结局（CRO）之间的一致性为中度，范围为 0.10 至 0.43（Cohen κ 统计量）。报告比例最低的症状是唾液腺炎（53%）、口干（41%）和黏膜炎（37%）。完成调查的患者中，89%（39/44）认为 Chats 易于使用，61%的患者表示 Chats 有助于症状自我管理并减少致电医护团队的需求。
这些早期结果表明，交互式聊天机器人是可行的，可为放疗期间和放疗后的 HNC 患者提供支持。Chats 确定了 PRO 和 CRO 之间的差异。需要进一步研究来衡量更大人群中 Chats 的益处。
