Cited by 233Cancer survivorship and careElectronic Health Records SystemsMobile Health and mHealth Applications

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Bringing PROMIS to practice: Brief and precise symptom screening in ambulatory cancer care

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Wagner, Lynne I., Schink, Julian, Bass, Michael, Patel, Shalini, Diaz, Maria Varela, Rothrock, Nan, Pearman, Timothy, Gershon, Richard, Penedo, Frank J., Rosen, Steven, Cella, David·2015·Cancer

DOI 10.1002/cncr.29104PMC PMC4352124

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Abstract

BACKGROUND: Supportive oncology practice can be enhanced by the integration of a brief and validated electronic patient‐reported outcome assessment into the electronic health record (EHR) and clinical workflow. METHODS: Six hundred thirty‐six women receiving gynecologic oncology outpatient care received instructions to complete clinical assessments through Epic MyChart, an EHR patient communication portal. Patient Reported Outcomes Measurement Information System (PROMIS) computer adaptive tests (CATs) were administered to assess fatigue, pain interference, physical function, depression, and anxiety. Checklists identified psychosocial concerns, informational and nutritional needs, and risk factors for inadequate nutrition. Assessment results, including PROMIS T scores with documented severity thresholds, were immediately populated in the EHR. Clinicians were notified of clinically elevated symptoms through EHR messages. EHR integration was designed to provide automated triage to social work providers for psychosocial concerns, to health educators for information, and to dietitians for nutrition‐related concerns. RESULTS: Four thousand forty‐two MyChart messages sent, and 3203 (79%) were reviewed by patients. The assessment was started by 1493 patients (37%), and once they started, 93% (1386 patients) completed the assessment. According to first assessments only, 49.8% of the patients who reviewed the MyChart message completed the assessment. Mean PROMIS CAT T scores indicated a lower level of physical function and elevated anxiety in comparison with the general population. Fatigue, pain, and depression scores were comparable to those of the general population. Impaired physical functioning was the most common basis for clinical alerts and occurred in 4% of the patients. CONCLUSIONS: PROMIS CATs were used to measure common cancer symptoms in routine oncology outpatient care. Immediate EHR integration facilitated the use of symptom reporting as the basis for referral to psychosocial and supportive care. Cancer 2015;121:927–934. © 2014 American Cancer Society.

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Authors: Wagner, L. I., Schink, J., Bass, M., Patel, S., Diaz, M. V., Rothrock, N., Pearman, T., Gershon, R., Penedo, F. J., Rosen, S., & Cella, D.
Affiliations: Northwestern University (US)
Spectrum Health (US)
City Of Hope National Medical Center (US)
Corresponding author: Wagner, Lynne I.
ORCID: Wagner, Lynne I.
Schink, Julian
Bass, Michael
Patel, Shalini
Diaz, Maria Varela
Rothrock, Nan
Pearman, Timothy
Gershon, Richard
Penedo, Frank J.
Rosen, Steven
Cella, David
Venue: Cancer
Publisher: Wiley
Published: 2014-11-06
Volume: 121
Issue: 6
Pages: 927-934
ISSN: 0008-543X (ISSN-L)
1097-0142
DOI: 10.1002/cncr.29104
PMC: PMC4352124
OpenAlex: W1597614727
Cited by: 233
References: 30
Citations by year: 2026: 11 · 2025: 12 · 2024: 20 · 2023: 18 · 2022: 23 · 2021: 27 · 2020: 25 · 2019: 23 · 2018: 24 · 2017: 21 · 2016: 19 · 2015: 10
FWCI: 8.05
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Cancer (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Cancer Institute (R01 CA60068)
Coleman Foundation
National Institutes of Health (U5 AR057951)
William W. Wirtz Cancer Innovation Fund
Topics: Health Sciences › Medicine › Oncology › Cancer survivorship and care
Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Keywords: PROMIS, computerized adaptive testing, patient-reported outcomes, electronic health record integration, symptom screening, gynecologic oncology, fatigue, pain interference, physical function, depression, anxiety, nutritional risk, cancer supportive care
MeSH terms: Adult, Aged, Aged, 80 and over, Ambulatory Care, Female, Genital Neoplasms, Female, Humans, Middle Aged, Palliative Care, Surveys and Questionnaires, Treatment Outcome, Young Adult, Electronic Health Records, Self Report

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Bringing PROMIS to practice: Brief and precise symptom screening in ambulatory cancer care

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