Grašič Kuhar Cvetka, Privšek Nina, Sraka Marjetka, Grašič Ema, Kovač Timotej, Kukar Matjaž
Department of Medical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
Faculty of Medicine Ljubljana, University of Ljubljana, Ljubljana, Slovenia.
Front Oncol. 2025 Jul 8;15:1595322. doi: 10.3389/fonc.2025.1595322. eCollection 2025.
Electronic patient-reported outcomes (ePROs) are gaining importance. The aim of this study was to investigate the difference in the reporting of symptoms between patients via mobile application (m-app) and doctor assessments. Additionally, usability and satisfaction with the use of the m-app were assessed.
In this single-center prospective cohort study, we analyzed ePROs in 46 patients receiving (neo)adjuvant chemotherapy for early breast cancer. Patients recorded the occurrence and intensity of symptoms via the Android-based m-app daily. Three-monthly, patients completed validated quality of life questionnaires (EORTC C30 and BR23). For the 10 most common symptoms reported by patients, we compared the frequencies and grades between patients and doctors. Additionally, we compared daily symptom reports with questionnaire results. Finally, the usefulness of and level of satisfaction with the m-app by patients and doctors were evaluated.
During the study, patients recorded almost twice as many different symptoms through the m-app as doctors did in the electronic health records (75 49). Symptoms were described by patients as mild (67%), moderate (30%), or severe (3%). The frequency and intensity of symptoms reported by patients were significantly higher than those reported by doctors (p<0.001). Fatigue, insomnia and dry mouth were the three main symptoms reported in more than 75% of patients, but insomnia and dry mouth were also the symptoms most often underreported by doctors. After three months of chemotherapy, QoL assessments revealed worsening of physical, social, cognitive and role functioning, increased fatigue, systemic therapy side effects, and dyspnea but a reduction in arm and shoulder problems. Patients and doctors rated the m-app with an overall score of 4.5 out of 5 (IQR 1.0). Patients expressed high levels of satisfaction with and usability of the m-app. In contrast, doctors were somewhat reluctant to perceive ePROs as an additional burden with patient management.
This study revealed a significant discrepancy between patients' daily symptom reports via the m-app and doctors' assessments, indicating that healthcare professionals may not fully capture patients' experiences. This underscores the importance of integrating PROs to accurately evaluate patients' conditions. Our m-app serves as a promising tool for reporting and managing side effects during systemic treatment of breast cancer.
电子患者报告结局（ePROs）正变得越来越重要。本研究的目的是调查患者通过移动应用程序（m-app）报告的症状与医生评估之间的差异。此外，还评估了m-app的可用性和使用满意度。
在这项单中心前瞻性队列研究中，我们分析了46例接受早期乳腺癌（新）辅助化疗患者的ePROs。患者每天通过基于安卓系统的m-app记录症状的发生情况和严重程度。每三个月，患者完成经过验证的生活质量问卷（EORTC C30和BR23）。对于患者报告的10种最常见症状，我们比较了患者和医生之间的频率和分级。此外，我们还将每日症状报告与问卷结果进行了比较。最后，评估了患者和医生对m-app的有用性和满意度。
在研究期间，患者通过m-app记录的不同症状数量几乎是医生在电子健康记录中记录数量的两倍（75对49）。患者将症状描述为轻度（67%）、中度（30%）或重度（3%）。患者报告的症状频率和严重程度显著高于医生报告的（p<0.001）。疲劳、失眠和口干是超过75%的患者报告的三种主要症状，但失眠和口干也是医生最常漏报的症状。化疗三个月后，生活质量评估显示身体、社会、认知和角色功能恶化，疲劳、全身治疗副作用和呼吸困难增加，但手臂和肩部问题减少。患者和医生对m-app的总体评分均为4.5分（满分5分，四分位间距为1.0）。患者对m-app的满意度和可用性评价很高。相比之下，医生有点不愿意将ePROs视为患者管理的额外负担。
本研究揭示了患者通过m-app每日报告的症状与医生评估之间存在显著差异，表明医疗保健专业人员可能无法完全了解患者的经历。这凸显了整合患者报告结局以准确评估患者病情的重要性。我们的m-app是乳腺癌全身治疗期间报告和管理副作用的一个有前景的工具。
