Systematic symptom screening in patients with advanced cancer treated in certified oncology centers: results of the prospective multicenter German KeSBa project

Braulke, Friederike; Para, Servet; Alt-Epping, Bernd; Tewes, Mitra; Bäumer, Markus; Haberland, Birgit; Mayer-Steinacker, Regine; Hopprich, A; Wit, Maike de; Grabe, Michaela; Bender-Säbelkampf, Sophia; Weßling, Caroline; Aulmann, Christoph; Gerlach, Christina; Regincos, Pascale; Fischer, Ferdinand; Haarmann, Soraya; Huys, Tatjana; Drygas, Sabine; Rambau, Anett; Kiani, Alexander; Schnabel, Astrid; Buhl, Christoph; Seipke, Stefanie; Hiemer, Sonja; Polata, Silke; Meßmann, M.; Hansmeier, Anna; Anastasiadou, Louiza; Letsch, Anne; Wecht, Daniel; Hellberg-Naegele, Matthias; Krug, Utz; Wedding, U.; Oorschot, Birgitt van

doi:10.1007/s00432-023-04818-8

Cited by 14 publications

(1 citation statement)

References 43 publications

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“…Die Erfassung der Symptome und Bedarfe sollte nach den Leitlinien [8,9,10] In den Onkologischen Zentren Deutschlands wird derzeit wegen fehlender IT-Ressourcen überwiegend eine papierbasierte Erfassung durchgeführt [32], die jedoch trotz der Gleichwertigkeit mit einer elektronischen PROM als zeit-und personalintensiv empfunden wird [33]. Fehlende IT-Ressourcen stellen bei einer Implementierung einer elektronischen PROM eine große Hürde dar [34].…”

Section: Validierte Fragebögenunclassified

Symptome und Bedarfe von onkologischen Patienten, digitale Erfassung und zielgerichtete multiprofessionelle Interventionsplanung

Tewes¹,

Hosters²,

Teufel³

2023

Zeitschrift für Palliativmedizin

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Section: Validierte Fragebögenunclassified

Symptome und Bedarfe von onkologischen Patienten, digitale Erfassung und zielgerichtete multiprofessionelle Interventionsplanung

Tewes¹,

Hosters²,

Teufel³

2023

Zeitschrift für Palliativmedizin

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Determining the cut-off value for the Minimal Documentation System (MIDOS2) screening tool to initiate specialized palliative care based on patient’s subjective need for palliative support and symptom burden in inpatients with advanced cancer

Heinzelmann,

Tewes,

Müller

et al. 2024

J Cancer Res Clin Oncol

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Purpose The Minimal Documentation System (MIDOS2) is recommended as a systematic screening tool for assessing symptom burden and patient needs in advanced cancer patients. Given the absence of an optimal weighting of individual symptoms and a corresponding cut-off value, this study aims to determine a threshold based on inpatient’s subjective need for palliative support. Additionally, we investigate the correlation between symptom burden and subjective need for palliative support collected through a patient-reported outcome measure (PROM) with survival duration of less or more than one year. Methods Inpatients diagnosed with advanced solid cancer completed an electronic PROM, which included the MIDOS2 questionnaire among other tools. Differences in symptom burden were analysed between patients expressing subjective need for palliative support and those with survival of less or more than one year using ANOVA, Mann–Whitney-U Test, logistic regression, Pearson and Spearman correlation tests. Cut-off analyses were performed using a ROC curve. Youden-Index, sensitivity, and specificity measures were used as well. Results Between April 2020 and March 2021, 265 inpatients were included in the study. Using a ROC curve, the MIDOS2 analysis resulted in an Area under the curve (AUC) of 0.732, a corresponding cut-off value of eight points, a sensitivity of 76.36% and a specificity of 62.98% in assessing the subjective need for palliative support. The MIDOS2, with double weighting of the significant symptoms, showed a cut-off value of 14 points, achieving a sensitivity of 78.18% and a specificity of 72.38%. A total of 55 patients (20.8%) expressed a need for support from the palliative care team. This need was independent of the oncological tumour entity and increased among patients with a survival of less than one year. These patients reported significantly poorer physical (p < 0.001) or mental (p < 0.001) condition. Additionally, they reported higher intensities of pain (p = 0.002), depressive symptoms (p < 0.001), weakness (p < 0.001), anxiety (p < 0.001), and tiredness (p < 0.001). Conclusion Using the established MIDOS2 cut-off value with an adjusted double weighting in our study, a large proportion of inpatients may be accurately referred to SPC based on their subjective need for palliative support. Additionally, subjective reports of poor general, mental, and physical condition, as well as pain, depressive symptoms, weakness, anxiety, and tiredness, increase the subjective need for palliative support, particularly in patients with a survival prognosis of less than one year.

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Systematic development of a patient-reported ONCOlogical-ROUTinE-Screening (ONCO-ROUTES) procedure at the University Cancer Center Regensburg

Maurer,

Saibold,

Gerl

et al. 2024

J Cancer Res Clin Oncol

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Purpose The evaluation of treatment success and progression in oncology patient-reported outcomes (PROs) is playing an increasingly important role. Meanwhile, PROs are a component of the certification requirements of the German Cancer Society for oncology centers. PROs are used to provide supportive therapy. There is currently no instrument that fully covers the requirements. At the University Hospital Regensburg (UKR), a digital ONCOlogical-ROUTinE-Screening (ONCO-ROUTES) procedure was developed in order to assess the need for supportive therapy in a standardized way and to provide patients with supportive interventions tailored to their needs. Methods On the basis of current requirements and guidelines, the development of ONCO-ROUTES was supported by experts in focus groups and interviews, and digitalization was carried out in connection with the IT infrastructure. Results A Needs-based, Quality-of-life (QoL) and Symptoms Screening (NQS2) tool already established in the routine at the UKR was further developed into ONCO-ROUTES, which is made up of the domains therapy phase, nutrition, tobacco use, alcohol use, quality of life, general condition/functional status, physical activity, psychooncology, social services, and further support needs. By linking the digitized questionnaire to the hospital information system, the results are available for immediate use in routine operations and thus for the referral of patients for further supportive therapy. Conclusion The digital PRO application ONCO-ROUTES is designed to involve patients in monitoring additional supportive needs and thus, improves supportive interdisciplinary treatment.

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Systematic symptom screening in patients with advanced cancer treated in certified oncology centers: results of the prospective multicenter German KeSBa project

Cited by 14 publications

References 43 publications

Symptome und Bedarfe von onkologischen Patienten, digitale Erfassung und zielgerichtete multiprofessionelle Interventionsplanung

Symptome und Bedarfe von onkologischen Patienten, digitale Erfassung und zielgerichtete multiprofessionelle Interventionsplanung

Determining the cut-off value for the Minimal Documentation System (MIDOS2) screening tool to initiate specialized palliative care based on patient’s subjective need for palliative support and symptom burden in inpatients with advanced cancer

Systematic development of a patient-reported ONCOlogical-ROUTinE-Screening (ONCO-ROUTES) procedure at the University Cancer Center Regensburg

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