Feasibility of health-related quality of life (HRQoL) assessment for cancer patients using electronic patient-reported outcome (ePRO) in daily clinical practice

Mouillet, Guillaume; Falcoz, Alexandre; Fritzsch, J.; Almotlak, Hamadi; Jacoulet, P.; Pivot, Xavier; Villanueva, Cristian; Mansi, Laura; Kim, Stéfano; Curtit, Elsa; Meneveau, Nathalie; Adotévi, Olivier; Jary, Marine; Eberst, Guillaume; Vienot, Angélique; Calcagno, Fabien; Pozet, Astrid; Djoumakh, O.; Borg, Christophe; Westeel, Virginie; Anota, Amélie; Paget‐Bailly, Sophie

doi:10.1007/s11136-020-02721-0

Cited by 13 publications

(21 citation statements)

References 40 publications

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“…In a recent study, patients were invited to complete the European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life questionnaire (QLQ-C30) and cancer site-specific modules before each visit on tablets or computers in the hospital or at home. An adequate compliance (at least 66% of health-related quality of life assessments were [21], which we consider comparable to the results of our study.…”

Section: Discussionsupporting

confidence: 90%

The Effect of Collaborative Reviews of Electronic Patient-Reported Outcomes on the Congruence of Patient- and Clinician-Reported Toxicity in Cancer Patients Receiving Systemic Therapy: Prospective, Multicenter, Observational Clinical Trial

Trojan¹,

Leuthold²,

Thomssen³

et al. 2021

J Med Internet Res

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Background Electronic patient-reported outcomes (ePRO) are a relatively novel form of data and have the potential to improve clinical practice for cancer patients. In this prospective, multicenter, observational clinical trial, efforts were made to demonstrate the reliability of patient-reported symptoms. Objective The primary objective of this study was to assess the level of agreement κ between symptom ratings by physicians and patients via a shared review process in order to determine the future reliability and utility of self-reported electronic symptom monitoring. Methods Patients receiving systemic therapy in a (neo-)adjuvant or noncurative intention setting captured ePRO for 52 symptoms over an observational period of 90 days. At 3-week intervals, randomly selected symptoms were reviewed between the patient and physician for congruency on severity of the grading of adverse events according to the Common Terminology Criteria of Adverse Events (CTCAE). The patient-physician agreement for the symptom review was assessed via Cohen kappa (κ), through which the interrater reliability was calculated. Chi-square tests were used to determine whether the patient-reported outcome was different among symptoms, types of cancer, demographics, and physicians’ experience. Results Among the 181 patients (158 women and 23 men; median age 54.4 years), there was a fair scoring agreement (κ=0.24; 95% CI 0.16-0.33) for symptoms that were entered 2 to 4 weeks before the intended review (first rating) and a moderate agreement (κ=0.41; 95% CI 0.34-0.48) for symptoms that were entered within 1 week of the intended review (second rating). However, the level of agreement increased from moderate (first rating, κ=0.43) to substantial (second rating, κ=0.68) for common symptoms of pain, fever, diarrhea, obstipation, nausea, vomiting, and stomatitis. Similar congruency levels of ratings were found for the most frequently entered symptoms (first rating: κ=0.42; second rating: κ=0.65). The symptom with the lowest agreement was hair loss (κ=–0.05). With regard to the latency of symptom entry into the review, hardly any difference was demonstrated between symptoms that were entered from days 1 to 3 and from days 4 to 7 before the intended review (κ=0.40 vs κ=0.39, respectively). In contrast, for symptoms that were entered 15 to 21 days before the intended review, no congruency was demonstrated (κ=–0.15). Congruency levels seemed to be unrelated to the type of cancer, demographics, and physicians’ review experience. Conclusions The shared monitoring and review of symptoms between patients and clinicians has the potential to improve the understanding of patient self-reporting. Our data indicate that the integration of ePRO into oncological clinical research and continuous clinical practice provides reliable information for self-empowerment and the timely intervention of symptoms. Trial Registration ClinicalTrials.gov NCT03578731; https://clinicaltrials.gov/ct2/show/NCT03578731

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Section: Discussionsupporting

confidence: 90%

The Effect of Collaborative Reviews of Electronic Patient-Reported Outcomes on the Congruence of Patient- and Clinician-Reported Toxicity in Cancer Patients Receiving Systemic Therapy: Prospective, Multicenter, Observational Clinical Trial

Trojan¹,

Leuthold²,

Thomssen³

et al. 2021

J Med Internet Res

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“…There is an increasing availability of PRO data not only in clinical trials [29,30] but also in everyday clinical practice where its implementation [31] still faces some hurdles [32]. One of the cited reasons at the level of healthcare providers is the difficulty to correctly interpret the available PRO values in a specific setting [6,7,31,33,34]. While there are several publications regarding PRO values in breast cancer patients, many are lacking PRO values before the start of treatment [35].…”

Section: Aim Of the Studymentioning

confidence: 99%

Real-world reference scores for EORTC QLQ-C30 and EORTC QLQ-BR23 in early breast cancer patients

Karsten

Roehle

Albers

et al. 2022

European Journal of Cancer

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To deliver patient-reported outcome (PRO) reference data for breast cancer and various other breast diseases to facilitate the interpretation of PRO scores during routine breast cancer treatment. Methods: To determine reference baseline values for the PRO measures EORTC QLQ-C30 and EORTC QLQ-BR23, PRO data captured in the breast cancer centre at Charite ´e Universita ¨tsmedizin Berlin from 2016 to 2021 were evaluated. As part of the clinical routine, ambulatory patients were asked to answer a digital survey regarding their medical history, current health status and health-related quality of life using the aforementioned questionnaires prior to their doctor's appointment in the outpatient breast clinic. Adjusted linear and variable dispersion beta regression models were used to compare different diagnosis groups. Results: A total of 3689 patients were included in the digital PRO program, of which 1478 were eligible for this study; 729 had invasive breast cancer or ductal carcinoma in situ, 270 patients were diagnosed with fibroadenoma and 479 patients had other breast diseases such as cysts, mastopathy or abscesses. Overall, patients with breast cancer reported worse scores in almost all domains except for role functioning, sexual functioning and body image.

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“…Nevertheless, patients who were more aware of their symptom levels and less hesitant to engage with their health care providers found the questions too similar to assessments during treatment visits. The QOLIBRY study [38] investigated the feasibility of using an ePRO in clinical settings in France and found differences in the use across physicians included in the study-familiarity with the systems, usefulness of the feedback, and perceived appropriateness for the treatment process are discussed as reasons by the authors. Leaving cancer care, the online evaluation of the KLIK PROM portal through clinicians using this system [39] mirrors a number of these topics in pediatric care; and the sixth paper in this section [40] investigates general practitioners' views about depression screening combined with targeted feedback.…”

Section: The Special Issuementioning

confidence: 99%

Using feedback tools to enhance the quality and experience of care

Boehnke

Rutherford

2021

Qual Life Res

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Feasibility of health-related quality of life (HRQoL) assessment for cancer patients using electronic patient-reported outcome (ePRO) in daily clinical practice

Cited by 13 publications

References 40 publications

The Effect of Collaborative Reviews of Electronic Patient-Reported Outcomes on the Congruence of Patient- and Clinician-Reported Toxicity in Cancer Patients Receiving Systemic Therapy: Prospective, Multicenter, Observational Clinical Trial

The Effect of Collaborative Reviews of Electronic Patient-Reported Outcomes on the Congruence of Patient- and Clinician-Reported Toxicity in Cancer Patients Receiving Systemic Therapy: Prospective, Multicenter, Observational Clinical Trial

Real-world reference scores for EORTC QLQ-C30 and EORTC QLQ-BR23 in early breast cancer patients

Using feedback tools to enhance the quality and experience of care

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