How Should Oncologists Choose an Electronic Patient-Reported Outcome System for Remote Monitoring of Patients With Cancer?

Denis, Fabrice; Krakowski, I.

doi:10.2196/30549

Cited by 13 publications

(10 citation statements)

References 22 publications

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“…The most represented medical fields were oncology (22%) and cross-cutting solutions covering several specialties (23%). This is confirmed by the literature; the specialty areas that have the most clinically validated eHealth solutions in terms of quality of life or survival are oncology and cardiology [ 17 , 18 ].…”

Section: Discussionmentioning

confidence: 64%

Assessing a New Prescreening Score for the Simplified Evaluation of the Clinical Quality and Relevance of eHealth Apps: Instrument Validation Study

Wagneur¹,

Callier²,

Zeitoun³

et al. 2022

J Med Internet Res

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Background In 2020, more than 250 eHealth solutions were added to app stores each day, or 90,000 in the year; however, the vast majority of these solutions have not undergone clinical validation, their quality is unknown, and the user does not know if they are effective and safe. We sought to develop a simple prescreening scoring method that would assess the quality and clinical relevance of each app. We designed this tool with 3 health care stakeholder groups in mind: eHealth solution designers seeking to evaluate a potential competitor or their own tool, investors considering a fundraising candidate, and a hospital clinician or IT department wishing to evaluate a current or potential eHealth solution. Objective We built and tested a novel prescreening scoring tool (the Medical Digital Solution scoring tool). The tool, which consists of 26 questions that enable the quick assessment and comparison of the clinical relevance and quality of eHealth apps, was tested on 68 eHealth solutions. Methods The Medical Digital Solution scoring tool is based on the 2021 evaluation criteria of the French National Health Authority, the 2022 European Society of Medical Oncology recommendations, and other provided scores. We built the scoring tool with patient association and eHealth experts and submitted it to eHealth app creators, who evaluated their apps via the web-based form in January 2022. After completing the evaluation criteria, their apps obtained an overall score and 4 categories of subscores. These criteria evaluated the type of solution and domain, the solution’s targeted population size, the level of clinical assessment, and information about the provider. Results In total, 68 eHealth solutions were evaluated with the scoring tool. Oncology apps (22%, 20/90) and general health solutions (23%, 21/90) were the most represented. Of the 68 apps, 32 (47%) were involved in remote monitoring by health professionals. Regarding clinical outcomes, 5% (9/169) of the apps assessed overall survival. Randomized studies had been conducted for 21% (23/110) of the apps to assess their benefit. Of the 68 providers, 38 (56%) declared the objective of obtaining reimbursement, and 7 (18%) out of the 38 solutions seeking reimbursement were assessed as having a high probability of reimbursement. The median global score was 11.2 (range 4.7-17.4) out of 20 and the distribution of the scores followed a normal distribution pattern (Shapiro-Wilk test: P =.33). Conclusions This multidomain prescreening scoring tool is simple, fast, and can be deployed on a large scale to initiate an assessment of the clinical relevance and quality of a clinical eHealth app. This simple tool can help a decision-maker determine which aspects of the app require further analysis and improvement.

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Section: Discussionmentioning

confidence: 64%

Assessing a New Prescreening Score for the Simplified Evaluation of the Clinical Quality and Relevance of eHealth Apps: Instrument Validation Study

Wagneur¹,

Callier²,

Zeitoun³

et al. 2022

J Med Internet Res

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“…Since cancer is more prevalent in older adults, the problem of increased toxicity associated with poor eating in sarcopenic, frail, older patients with co-morbidities and polypharmacy can be challenging [74,77,118,[128][129][130][131][132]. Use of the Geriatric Nutrition Risk Index (GNRI) or Mini-Nutritional Assessment (MNA) tools [133][134][135] and patient reported outcomes (PRO) such as the PG-SGA [69][70][71][72][73][136][137][138][139][140] could help to predict risk and trigger more timely interventions to address eating behaviors, malnutrition, cachexia, and sarcopenia in this particularly vulnerable, high-risk population. A recent study showed a proactive team approach which included an oncologist, NP, social worker, PT/OT, pharmacist, and nutritionist resulted in the significant reduction of grade 3 or higher toxicities in older adults [141].…”

Section: Discussionmentioning

confidence: 99%

“…Since patient eating behaviors are generally superior as an outpatient compared to inpatient, electronic patient-reported outcomes (ePRO) [69][70][71][72][73]130,[137][138][139][140][166][167][168] may help to generate new data and metrics concerning differences between predominantly outpatient versus inpatient chemotherapy delivery and admissions for chemotherapy and amelioration of serious adverse events (SAEs). For example, this approach could ask for (number of hospital days/year) to generate a new ePRO metric of quality and cost of cancer care.…”

Section: Discussionmentioning

confidence: 99%

Strategies to Mitigate Chemotherapy and Radiation Toxicities That Affect Eating

et al. 2021

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Background: Cancer and its therapy is commonly associated with a variety of side effects that impact eating behaviors that reduce nutritional intake. This review will outline potential causes of chemotherapy and radiation damage as well as approaches for the amelioration of the side effects of cancer during therapy. Methods: Information for clinicians, patients, and their caregivers about toxicity mitigation including nausea reduction, damage to epithelial structures such as skin and mucosa, organ toxicity, and education is reviewed. Results: How to anticipate, reduce, and prevent some toxicities encountered during chemotherapy and radiation is detailed with the goal to improve eating behaviors. Strategies for health care professionals, caregivers, and patients to consider include (a) the reduction in nausea and vomiting, (b) decreasing damage to the mucosa, (c) avoiding a catabolic state and muscle wasting (sarcopenia), and (d) developing therapeutic alliances with patients, caregivers, and oncologists. Conclusions: Although the reduction of side effects involves anticipatory guidance and proactive team effort (e.g., forward observation, electronic interactions, patient reported outcomes), toxicity reduction can be satisfying for not only the patient, but everyone involved in cancer care.

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“…For example, administrative personnel in clinics creating custom PRO-CTCAE assessments using paper forms require additional time to enter the patient responses into digital systems. If the PRO-CTCAE is administered on a clinic-provided digital platform (eg, tablets), administrative support is required to answer questions from patients who do not routinely use technology (eg, for changing passwords) [ 26 , 27 ]. Although these complications are manageable, they may be reduced or eliminated through the development of mobile apps that do not require clinics to provide digital assessment platforms.…”

Section: Introductionmentioning

confidence: 99%

Developing a Mobile Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events Administration System to Capture Postradiation Toxicity in Oncology: Usability and Feasibility Study

UNDERWOOD¹,

McKloskey²,

Raldow³

et al. 2022

JMIR Form Res

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Background Accurate self-reported symptomatic toxicity documentation via the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) is essential throughout cancer treatment to ensure safety and understand therapeutic efficacy. However, the capture of accurate toxicities from patients undergoing radiation therapy is challenging because this is generally provided only at the time of scheduled visits. Objective This study seeks to establish the usability and feasibility of a mobile PRO-CTCAE Administration System (mPROS) to capture toxicities related to radiation therapy. Methods English-speaking adult patients who were undergoing radiation therapy for cancer were enrolled and given a brief demonstration of the Say All Your Symptoms (SAYS) and Symptom Tracking Entry Program (STEP) interfaces of the mPROS app, followed by a patient-use phase where patient actions were observed as they navigated mPROS to enter toxicities. Patient feedback was captured via a semistructured interview and brief questionnaire. Results We enrolled 25 patients (age: mean 60.7 years; females: n=13, 52%; White patients: n=13; 52%; non-Hispanic patients: n=19, 76%; college graduates: n=17, 68%). Patients almost equally preferred the SAYS (n=14, 56%) or STEP (n=11, 44%) interfaces, with 21 patients (84%) agreeing that they would use mPROS to report their symptoms to their health care team and 19 patients (76%) agreeing that they would recommend mPROS to others. Conclusions The mPROS app is usable and feasible for facilitating the patient reporting of radiation therapy–related symptomatic toxicities. A revised version of mPROS that incorporates patient input and includes electronic health record integration is being developed and validated as part of a multicenter trial.

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How Should Oncologists Choose an Electronic Patient-Reported Outcome System for Remote Monitoring of Patients With Cancer?

Cited by 13 publications

References 22 publications

Assessing a New Prescreening Score for the Simplified Evaluation of the Clinical Quality and Relevance of eHealth Apps: Instrument Validation Study

Assessing a New Prescreening Score for the Simplified Evaluation of the Clinical Quality and Relevance of eHealth Apps: Instrument Validation Study

Strategies to Mitigate Chemotherapy and Radiation Toxicities That Affect Eating

Developing a Mobile Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events Administration System to Capture Postradiation Toxicity in Oncology: Usability and Feasibility Study

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