Electronic patient reporting outcomes are a promising predictive factor of prostate cancer patient survival: The Protecty study.

Abstract

76 Background: The benefits of Electronic Patient Remote Outcomes (e-PRO) for telemonitoring are well established, allowing early detection of illnesses and continuous monitoring of patients. We have previously shown high levels of compliance of use of telemonitoring in daily care. This new PROTECTY study assesses the predictive power of patient health status in the first month of treatment on survival, evaluated with the telemonitoring platform Cureety. Methods: This prospective study was conducted at the Military Hospital Bégin on prostate cancer patients. Patients were allowed to respond to a symptomatology questionnaire based on CTCAE v.5.0, personalized to their pathology and treatment. An algorithm evaluates the health status of the patient based on the reported adverse events, with a classification into 2 different states: Good Health status (A) Poor Health status (B) In case of A, the patient received therapeutic advice to help manage each of the reported adverse events. In case of B, the patient is invited to call the hospital. For the purpose of this analysis, we collected their health status during the first month after initiation of treatment. The primary endpoint was to assess if the first month health status is a predictive factor of progression free-survival (PFS) for prostate cancer patient. The secondary endpoint was to assess if the first month health status is a predictive factor of overall survival (OS) for prostate cancer patient. Results: Sixty-one patients were enrolled between July 1st, 2020 and June 30st, 2021. The median age was 74.0 (range 58.0 – 94.0). 62% presented a metastatic stage, and the most represented cancer was mHSPC with 39,5% among metastatic patients. Overall, 2443 questionnaires were completed by the patients, 4.0% resulted in a health classification in state B. 86,9% of patient were classified in group A the first month. 13,1% of patient were classified in group B the first month. The median follow up was 12.3 months. PFS at 12 months was 89% in A group vs 60% in B group, p=0,17 OS at 12 months was 100% in A group vs 86% in B group, p=0,15. Conclusions: Our study is the first to assess the impact of tolerance treatment on survival. The initial results suggest that e-PRO assessment by the platform could help identify in the early stages the patients that require further health assessment and potential therapeutic changes. While further follow-up of more patients will be required, our study highlights the importance of e-PRO in cancer patient care.

The advantages, disadvantages, threats, and opportunities of electronic patient-reported outcome systems in cancer: A systematic review

“…According to Table 1 , The advantages of ePRO were found to be diverse, with “Improved Quality of Life and Care” being the most prominent, cited in 45 studies (28.48%). 14 – 16 , 18 , 31 – 71 This was followed by “Real-time and Remote Monitoring” with 39 references (24.68%), highlighting its significance in real-time health monitoring, which can significantly impact patient outcomes 1 , 16 – 18 , 31 , 33 , 34 , 36 – 39 , 43 , 44 , 47 , 49 …”

“… 18 , 24 , 25 , 37 , 44 , 47 , 50 , 51 , 57 , 59 , 63 , 66 , 67 , 72 , 79 , 80 , 84 – 89 Conversely, the minimum count within the advantages is represented by “Broader Healthcare Integration with electronic patient record (EPR) systems” and “Beyond Cancer Treatment with Electronic Health Platforms,” each featuring only one study. 34 , 81 …”

“…On the other hand, the review also identified several disadvantages associated with electronic Patient Reported Outcome Measures (ePROMs). The most prevalent disadvantage was “Small sample size,” cited in 19 studies (15.70%), reflecting a common challenge in research methodologies that may limit the generalizability of findings, 1 , 17 , 33 , 34 , 38 , 47 , 54 , 56 , 58 , 63 , 65 , 70 , 72 , 74 , 83 , 85 , 87 , 90 , 91 followed by “Technical issues” with 16 references (13.22%), highlighting the challenges posed by technology in the implementation of electronic health platforms 18 , 19 , 24 , 34 , 39 , 47 , 50 , 60 , 66 – 68 , 74 , 76 , 81 , 92 , 93 and “Potential bias” with 12 references (9.92%), emphasizing the need for researchers to address and mitigate bias in participant selection, data extraction and reporting. 16 , 22 , 40 , 41 , 43 , 57 , 65 , 74 , 84 ,…”

“…In terms of threats, the review identified “Challenges in data security and technical skills” as the most prevalent threat, cited in 21 studies, (42.00%) reflecting the growing concern around data security and the importance of technical expertise in managing electronic health platforms, 18 , 19 , 24 , 34 , 39 , 47 , 50 , 60 , 66 – 68 , 71 , 74 , 76 , 81 , 84 , 92 , 93 , 96 followed by “Integration Challenges” with nine references (18.00%), indicating the complexities associated with seamlessly integrating these platforms into existing healthcare systems. 25 , 39 , 52 , 59 , 83 , 84 , 93 , 97 , 98 and “Potential Resource, Administrative Challenges and Resource Constraints” with six references, (12.00%) indicating the complexities associated with seamlessly integrating these platforms into existing healthcare systems.…”

“…Finally, the review also highlighted various opportunities associated with ePROMs. The most prevalent opportunity was “Addressing data security and technical skills concerns,” cited in 20 studies (18.02%), indicating the recognition of these concerns as potential areas for improvement and advancement, 18 , 19 , 24 , 34 , 39 , 47 , 50 , 60 , 66 – 68 , 71 , 74 , 76 , 81 , 92 , 93 , 96 followed by “Opportunities for symptom management, monitoring and detection” with 19 references (17.12%), emphasizing the potential for technological advancements to enhance symptom management and monitoring, 39 , 44 , 49 , 51 , 70 , 75 – 77 , 80 , 81 , 84 , 86 – 89 , 98 – 101 and “Improved communication” with 11 references (9.91%), reflecting the recognition of enhanced communication as a valuable opportunity for better patient outcomes. 18 , 24 , 25 , 32 , 44 , 51 , 59 , 79 , …”