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Cited by 414Cancer survivorship and careMobile Health and mHealth ApplicationsTelemedicine and Telehealth Implementation

The DOI matches its Crossref record; 31 of the 32 references it cites were found in a registry or an index.

Effect of Electronic Symptom Monitoring on Patient-Reported Outcomes Among Patients With Metastatic Cancer: A Randomized Clinical Trial

Open access
Basch, Ethan, Schrag, Deborah, Henson, Sydney, Jansen, Jennifer, Ginos, Brenda, Stover, Angela M., Carr, Philip, Spears, Patricia A., Jonsson, Mattias, Deal, Allison M., Bennett, Antonia V., Thanarajasingam, Gita, Rogak, Lauren J., Reeve, Bryce B., Snyder, Claire, Bruner, Deborah, Cella, David, Kottschade, Lisa A., Perlmutter, Jane, Geoghegan, Cindy, Samuel-Ryals, Cleo A., Given, Barbara, Mazza, Gina L., Miller, Robert, Strasser, Jon F., Zylla, Dylan M., Weiss, Anna, Blinder, Victoria S., Dueck, Amylou C.·2022·JAMA
DOI 10.1001/jama.2022.9265PMC PMC9168923
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Abstract

Importance: Electronic systems that facilitate patient-reported outcome (PRO) surveys for patients with cancer may detect symptoms early and prompt clinicians to intervene. Objective: To evaluate whether electronic symptom monitoring during cancer treatment confers benefits on quality-of-life outcomes. Design, Setting, and Participants: Report of secondary outcomes from the PRO-TECT (Alliance AFT-39) cluster randomized trial in 52 US community oncology practices randomized to electronic symptom monitoring with PRO surveys or usual care. Between October 2017 and March 2020, 1191 adults being treated for metastatic cancer were enrolled, with last follow-up on May 17, 2021. Interventions: In the PRO group, participants (n = 593) were asked to complete weekly surveys via an internet-based or automated telephone system for up to 1 year. Severe or worsening symptoms triggered care team alerts. The control group (n = 598) received usual care. Main Outcomes and Measures: The 3 prespecified secondary outcomes were physical function, symptom control, and health-related quality of life (HRQOL) at 3 months, measured by the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ-C30; range, 0-100 points; minimum clinically important difference [MCID], 2-7 for physical function; no MCID defined for symptom control or HRQOL). Results on the primary outcome, overall survival, are not yet available. Results: Among 52 practices, 1191 patients were included (mean age, 62.2 years; 694 [58.3%] women); 1066 (89.5%) completed 3-month follow-up. Compared with usual care, mean changes on the QLQ-C30 from baseline to 3 months were significantly improved in the PRO group for physical function (PRO, from 74.27 to 75.81 points; control, from 73.54 to 72.61 points; mean difference, 2.47 [95% CI, 0.41-4.53]; P = .02), symptom control (PRO, from 77.67 to 80.03 points; control, from 76.75 to 76.55 points; mean difference, 2.56 [95% CI, 0.95-4.17]; P = .002), and HRQOL (PRO, from 78.11 to 80.03 points; control, from 77.00 to 76.50 points; mean difference, 2.43 [95% CI, 0.90-3.96]; P = .002). Patients in the PRO group had significantly greater odds of experiencing clinically meaningful benefits vs usual care for physical function (7.7% more with improvements of ≥5 points and 6.1% fewer with worsening of ≥5 points; odds ratio [OR], 1.35 [95% CI, 1.08-1.70]; P = .009), symptom control (8.6% and 7.5%, respectively; OR, 1.50 [95% CI, 1.15-1.95]; P = .003), and HRQOL (8.5% and 4.9%, respectively; OR, 1.41 [95% CI, 1.10-1.81]; P = .006). Conclusions and Relevance: In this report of secondary outcomes from a randomized clinical trial of adults receiving cancer treatment, use of weekly electronic PRO surveys to monitor symptoms, compared with usual care, resulted in statistically significant improvements in physical function, symptom control, and HRQOL at 3 months, with mean improvements of approximately 2.5 points on a 0- to 100-point scale. These findings should be interpreted provisionally pending results of the primary outcome of overall survival. Trial Registration: ClinicalTrials.gov Identifier: NCT03249090.

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Research works printed but not linked: 2

  1. Stover, 2019, Demographic and symptom differences in PRO-TECT trial (AFT-39) cancer patients electing to complete weekly home patient-reported outcome measures (PROMs) via an automated phone call vs. email: implications for implementing PROs into routine care., Qual Life Res, 28, S1
  2. Fayers, 2001, The EORTC QLQ-C30 Scoring Manual (3rd Edition)

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Metadata

Authors
Basch, E., Schrag, D., Henson, S., Jansen, J., Ginos, B., Stover, A. M., Carr, P., Spears, P. A., Jonsson, M., Deal, A. M., Bennett, A. V., Thanarajasingam, G., Rogak, L. J., Reeve, B. B., Snyder, C., Bruner, D., Cella, D., Kottschade, L. A., Perlmutter, J., Geoghegan, C., Samuel-Ryals, C. A., Given, B., Mazza, G. L., Miller, R., Strasser, J. F., Zylla, D. M., Weiss, A., Blinder, V. S., & Dueck, A. C.
Affiliations
  • University of North Carolina at Chapel Hill (US)
  • Memorial Sloan Kettering Cancer Center (US)
  • Mayo Clinic in Arizona (US)
  • Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill
  • Mayo Clinic (US)
  • Duke University (US)
  • Johns Hopkins University (US)
  • Emory University (US)
  • Northwestern University (US)
  • Gemini Group, Ann Arbor, Michigan
  • Patient and Partners, Madison, Connecticut
  • Michigan State University (US)
  • American Society of Clinical Oncology (US)
  • Christiana Care Health System (US)
  • Park Nicollet Health Services (US)
  • Brigham and Women's Hospital (US)
Corresponding author
Basch, Ethan
ORCID
Venue
JAMA
Publisher
American Medical Association (AMA)
Published
2022-06-28
Volume
327
Issue
24
Pages
2413
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.2022.9265
PMC
PMC9168923
OpenAlex
W4281790169
Cited by
413
References
32
Citations by year
2026: 117 · 2025: 112 · 2024: 102 · 2023: 71 · 2022: 11
FWCI
30.97
Type
journal article
Language
en
Open access
Locations
  • JAMA (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
  • UNC Libraries
Funders
  • Patient-Centered Outcomes Research Institute
  • National Cancer Institute (P30CA008748, P30CA016086, P30CA014236)
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 › Telemedicine and Telehealth Implementation
Keywords
electronic symptom monitoring, patient-reported outcomes, metastatic cancer, health-related quality of life, physical function, symptom management, EORTC QLQ-C30, internet-based survey, community oncology practice, early symptom detection, cancer treatment side effects
MeSH terms
Patient Reported Outcome Measures, Adult, Electronics, Female, Health Status Indicators, Humans, Male, Middle Aged, Neoplasm Metastasis, Neoplasms, Quality of Life, Surveys and Questionnaires, Neoplasms, Second Primary, Telemedicine, Monitoring, Ambulatory, Internet

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