Mobile App Delivery of the EORTC QLQ-C30 Questionnaire to Assess Health-Related Quality of Life in Oncological Patients: Usability Study

Abstract

BackgroundMobile apps are evolving in the medical field. However, ongoing discussions have questioned whether such apps are really valuable and whether patients will accept their use in day-to-day clinical life. Therefore, we initiated a usability study in our department.ObjectiveWe present our results of the first app prototype and patient testing of health-related quality of life (HRQoL) assessment in oncological patients.MethodsWe developed an app prototype for the iOS operating system within eight months in three phases: conception, initial development, and pilot testing. For the HRQoL assessment, we chose to implement only the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30; German version 3). Usability testing was conducted for three months. Participation was voluntary and pseudonymized. After completion of the QLQ-C30 questionnaire using iPads provided by our department, we performed a short survey with 10 questions. This survey inquired about patients’ opinions regarding general aspects, including technical advances in medicine, mobile and app assistance during cancer treatment, and the app-specific functions (eg, interface and navigation).ResultsAfter logging into the app, the user can choose between starting a questionnaire, reviewing answers (administrators only), and logging out. The questionnaire is displayed with the same information, questions, and answers as on the original QLQ-C30 sheet. No alterations in wording were made. Usability was tested with 81 patients; median age was 55 years. The median time for completing the HRQoL questionnaire on the iPad was 4.0 minutes. Of all participants, 84% (68/81) owned a mobile device. Similarly, 84% (68/81) of participants would prefer a mobile version of the HRQoL questionnaire instead of a paper-based version. Using the app in daily life during and after cancer treatment would be supported by 83% (67/81) of participants. In the prototype version of the app, data were stored on the device; in the future, 79% (64/81) of the patients would agree to transfer data via the Internet.ConclusionsOur usability test showed good results regarding attractiveness, operability, and understandability. Moreover, our results demonstrate a high overall acceptance of mobile apps and telemedicine in oncology. The HRQoL assessment via the app was accepted thoroughly by patients, and individuals are keen to use it in clinical routines, while data privacy and security must be ensured.

Patient-Reported Outcome (PRO) as an Addition to Long-Term Results after High-Precision Stereotactic Radiotherapy in Patients with Secreting and Non-Secreting Pituitary Adenomas: A Retrospective Cohort Study up to 17-Years Follow-Up

“…However, the need for permanent close PRO monitoring is obvious, and in the future, the assessment will be done electronically. In our previous works, we could show that both patients and physicians are willing to participate via app-/web-based tools [29][30][31].…”

“…To date, all clinical results reported include toxicity but not patient-reported outcomes (PRO), which are becoming more and more relevant since modern documentation methods and advanced communication with patients via online tools such as app-based and web-based become available [27][28][29][30][31].…”

Viability of mobile applications for remote support of radiotherapy patients

“…Regarding applications targeted at the patient, recently, Kessel et al 3 tested the usability by patients of an application for applying the QLQ-C30 questionnaire of the EORTC to assess health-related quality of life in oncological patients. The study involved 81 patients with a mean age of 55 years and found an average time of 4 minutes to complete the questionnaire on an iPad.…”

“…Another article also published in 2018 in the form of trial by the same institution of Kessel et al 3 intends to prospectively evaluate the feasibility of using a mobile application to provide systematic support to oncology and radiology patients throughout the future course of their radiotherapy, with the specific objectives to monitor the patients' symptoms and facilitate the exchange of relevant information between patients and physicians. Finally, El Shafie et al 8 intend to research the general performance, quality of life, and need to see a doctor in person of patients undergoing curative Oncologic therapy support via means of a dedicated mobile app (Optimise-1): protocol for a prospective pilot trial…”

Oncology Informatics: Status Quo and Outlook

“…With the spread of mobile technology, structured high-quality data (electronic patient-reported outcomes) can be submitted from the patients themselves and become directly integrated into their records [18]. It has been demonstrated that this is feasible in a general population [19][20][21], and the acceptance rates of such solutions both on the patient side and the side of healthcare providers appear high. Electronic patient-reported outcome measures (ePROMS) enable structured first-hand data and open up the possibility to analyse the psychophysiological background of a reported incident as patient-centred IT may soon be able to connect such reports with measurements from miniature, wearable sensors and devices [22].…”