Overall survival results of a trial assessing patient-reported outcomes for symptom monitoring during routine cancer treatment
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for advanced cancers, 1 yet are undetected by clinicians up to half the time. 2 There is growing interest in integrating electronic patient-reported outcomes (PROs) into routine oncology practice for symptom monitoring, but evidence demonstrating clinical benefit has been limited.3 We assessed overall survival associated with electronic patient-reported symptom monitoring vs usual care based on follow-up from a randomized clinical trial.
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Prior trials of ePRO monitoring have demonstrated improved symptom control, quality of life, and survival when structured symptom reporting is coupled with clinician response.
“which have demonstrated improved symptom control, quality of life, and survival when structured symptom reporting is coupled with clinician response [3,4,7]”
From Implementing UK Oncology Nursing Society–Informed Digital Symptom Triage With Episode-Based Review in Routine NHS Acute Oncology: Service Evaluation (2026) · cites this paper as [4]
The Methods report structured symptom reporting with nurse alerts, and the Discussion reports clinical responses to those alerts. The paper reports improved quality of life and longer survival versus usual care, but our copy does not report improved symptom control as an outcome. Page numbers are unavailable in the indexed copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredePRO systems have demonstrated that symptom monitoring with clinician response improves symptom control and survival.
“Electronic patient-reported outcome (ePRO) systems have demonstrated that symptom monitoring with clinician response improves symptom control and survival [3,4].”
From Implementing UK Oncology Nursing Society–Informed Digital Symptom Triage With Episode-Based Review in Routine NHS Acute Oncology: Service Evaluation (2026) · cites this paper as [4]
The Methods and Results passages describe electronic symptom reporting with nurse alerts and show longer median survival in the PRO group than with usual care. The Discussion reports nurse responses to alerts, but presents early responsiveness as a potential mechanism; this paper does not establish that clinician response improved symptom control. (LLM, conf=0.86)
Experimental — accuracy not yet measuredRemote patient monitoring (RPM) of symptoms using electronic patient reported outcomes (ePROs) reduces hospitalizations during systemic cancer therapy.
“Remote patient monitoring (RPM) of symptoms using electronic patient reported outcomes (ePROs) has been shown to reduce symptom burden and hospitalizations, increase dose intensity and improve quality of life of patients during systemic therapy being recommended by international guidelines in routine oncology practice.”
From Implementation of a remote symptom monitoring pathway in oncology care: analysis of real-world experience across 33 cancer centres in France and Belgium (2024) · cites this paper as [10]
The Methods (page not provided) describe web-based symptom reporting during chemotherapy, with nurse alerts for severe or worsening symptoms. The paper reports a benefit in emergency department use, but does not report reduced hospitalizations; an emergency visit is not necessarily a hospitalization. (LLM, conf=0.82)
Experimental — accuracy not yet measuredRemote patient monitoring (RPM) of symptoms using electronic patient reported outcomes (ePROs) increases dose intensity during systemic cancer therapy.
“Remote patient monitoring (RPM) of symptoms using electronic patient reported outcomes (ePROs) has been shown to reduce symptom burden and hospitalizations, increase dose intensity and improve quality of life of patients during systemic therapy being recommended by international guidelines in routine oncology practice.”
From Implementation of a remote symptom monitoring pathway in oncology care: analysis of real-world experience across 33 cancer centres in France and Belgium (2024) · cites this paper as [10]
The Discussion (page not specified in our copy) reports that patients in the electronic symptom-monitoring group continued chemotherapy longer than those receiving usual care: 8.2 versus 6.3 months. It also mentions chemotherapy dose modifications, but does not report increased dose intensity. Treatment duration does not establish dose intensity. (LLM, conf=0.84)
Experimental — accuracy not yet measuredRemote patient monitoring (RPM) of symptoms using electronic patient reported outcomes (ePROs) reduces symptom burden during systemic cancer therapy.
“Remote patient monitoring (RPM) of symptoms using electronic patient reported outcomes (ePROs) has been shown to reduce symptom burden and hospitalizations, increase dose intensity and improve quality of life of patients during systemic therapy being recommended by international guidelines in routine oncology practice.”
From Implementation of a remote symptom monitoring pathway in oncology care: analysis of real-world experience across 33 cancer centres in France and Belgium (2024) · cites this paper as [10]
The Methods describe web-based symptom reporting during chemotherapy, with alerts to nurses for severe or worsening symptoms. The Discussion describes symptom-management interventions, but neither section reports that symptom burden was reduced compared with usual care; the paper reports benefits in other outcomes instead. Page numbers are unavailable in our copy. (LLM, conf=0.83)
Experimental — accuracy not yet measured
The findings of this evaluation are consistent with prior trials of ePRO monitoring.
“The findings of this evaluation are consistent with prior trials of ePRO monitoring”
From Implementing UK Oncology Nursing Society–Informed Digital Symptom Triage With Episode-Based Review in Routine NHS Acute Oncology: Service Evaluation (2026) · cites this paper as [4]
Remote patient monitoring (RPM) of symptoms using electronic patient reported outcomes (ePROs) improves quality of life during systemic cancer therapy.
“Remote patient monitoring (RPM) of symptoms using electronic patient reported outcomes (ePROs) has been shown to reduce symptom burden and hospitalizations, increase dose intensity and improve quality of life of patients during systemic therapy being recommended by international guidelines in routine oncology practice.”
From Implementation of a remote symptom monitoring pathway in oncology care: analysis of real-world experience across 33 cancer centres in France and Belgium (2024) · cites this paper as [10]
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- Role of the Funder/Sponsor: The Conquer Cancer Foundation had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Trial Registration: clinicaltrials.gov: NCT00578006 Disclaimer: Drs Basch and Schrag, both JAMA associate editors, were not involved in the review of or decision to publish this letter. Meeting Presentation: This article was presented at the annual American Society of Clinical Oncology meeting; June 4, 2017; Chicago, Illinois. Additional Contributions: We thank Lauren Rogak, MA, Laura Sit, MA, Thomas Atkinson, PhD, Dorothy Dulko, RN, PhD, and Paul Sabbatini, MD (all from Memorial Sloan Kettering Cancer Center);
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Self-citationEthical Considerations for the Inclusion of Patient-Reported Outcomes in Clinical Research
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Self-citationThe HOPE Pilot Study: Harnessing Patient-Reported Outcomes and Biometric Data to Enhance Cancer Care
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Self-citation
- Authors
- Basch, E., Deal, A. M., Dueck, A. C., Scher, H. I., Kris, M. G., Hudis, C., & Schrag, D.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Mayo Clinic in Arizona (US)
- Memorial Sloan Kettering Cancer Center (US)
- American Society of Clinical Oncology (US)
- Harvard University (US)
- Corresponding author
- Basch, Ethan
- ORCID
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2017-07-11
- Volume
- 318
- Issue
- 2
- Pages
- 197
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- PMC
- PMC5817466
- OpenAlex
- W2620925856
- Cited by
- 2,302
- References
- 4
- Citations by year
- 2026: 223 · 2025: 214 · 2024: 280 · 2023: 268 · 2022: 294 · 2021: 284 · 2020: 270 · 2019: 244 · 2018: 169 · 2017: 52 · 2014: 1
- FWCI
- 88.59
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- JAMA (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- UNC Libraries
- Funders
- Conquer Cancer Foundation
- AstraZeneca
- Sanofi
- Janssen Research and Development
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Keywords
- patient-reported outcomes, electronic symptom monitoring, cancer symptoms, advanced cancer, overall survival, symptom detection, usual care
- MeSH terms
- Patient Reported Outcome Measures, Adult, Aged, Aged, 80 and over, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neoplasm Metastasis, Neoplasms, Quality of Life, Survival Analysis, Randomized Controlled Trials as Topic, Symptom Assessment
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