A Novel Remote Follow-Up Tool Based on an Instant Messaging/Social Media App for the Management of Patients With Low Anterior Resection Syndrome: Pilot Prospective Self-Control Study (Preprint)

Abstract

BACKGROUND 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 (IMSM) has great application potential in low anterior resection syndrome (LARS) follow-up, but has been underdeveloped. OBJECTIVE To compare data from a novel instant messaging social media (IMSM) follow-up system and a telephone interview (TI) in patients with low anterior resection syndrome (LARS) and to analyse the consistency of the IMSM platform. METHODS R0-resectable rectal cancer patients who accepted several defecation function visits via the IMSM platform and a telephone interview (TI) after the operation using the same questionnaire, including subjective questions and LARS scores, were included. Differences between the two methods were analysed in pairs and the diagnostic consistency of IMSM was calculated based on TI results. RESULTS In total, 21 questionnaires from 15 patients were included. The positive rates of defecation satisfaction, life restriction and medication use were 52.4%, 52.4%, 38.1% for TI and 52.4%, 61.9%, 23.8% for IMSM, respectively. No statistically significant difference was observed between IMSM and TI in terms of total LARS score (22.4 ± 11.9 vs 24.7 ± 10.7,P < 0.213) and LARS categories (Z = −0.264, P = 0.792); however, IMSM showed a more negative tendency. The Kappa values of three 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 < 0.001; category correlation coefficient 0.570, P = 0.005). Patients with major LARS had highly consistent results, with sensitivity, specificity, kappa value and p of 77.8%, 91.7%, 0.704 and 0.001, respectively. CONCLUSIONS IMSM can be a significant LARS screening method. However, further research on information accuracy and user acceptance is needed before implementing a mature application. CLINICALTRIAL This study is a subproject of the registered study Bas-1611, which was registered on ClinicalTrail.org website and numbered NCT03009747 in January 2017.