Cited by 2,593Cancer survivorship and careMobile Health and mHealth ApplicationsPain Management and Opioid Use

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Symptom Monitoring With Patient-Reported Outcomes During Routine Cancer Treatment: A Randomized Controlled Trial

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Basch, Ethan, Deal, Allison M., Kris, Mark G., Scher, Howard I., Hudis, Clifford A., Sabbatini, Paul, Rogak, Lauren, Bennett, Antonia V., Dueck, Amylou C., Atkinson, Thomas M., Chou, Joanne F., Dulko, Dorothy, Sit, Laura, Barz, Allison, Novotny, Paul, Fruscione, Michael, Sloan, Jeff A., Schrag, Deborah·2016·Journal of Clinical Oncology

DOI 10.1200/jco.2015.63.0830PMC PMC4872028

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Abstract

Purpose: There is growing interest to enhance symptom monitoring during routine cancer care using patient-reported outcomes, but evidence of impact on clinical outcomes is limited. Methods: We randomly assigned patients receiving routine outpatient chemotherapy for advanced solid tumors at Memorial Sloan Kettering Cancer Center to report 12 common symptoms via tablet computers or to receive usual care consisting of symptom monitoring at the discretion of clinicians. Those with home computers received weekly e-mail prompts to report between visits. Treating physicians received symptom printouts at visits, and nurses received e-mail alerts when participants reported severe or worsening symptoms. The primary outcome was change in health-related quality of life (HRQL) at 6 months compared with baseline, measured by the EuroQol EQ-5D Index. Secondary endpoints included emergency room (ER) visits, hospitalizations, and survival. Results: Among 766 patients allocated, HRQL improved among more participants in the intervention group than usual care (34% v 18%) and worsened among fewer (38% v 53%; P < .001). Overall, mean HRQL declined by less in the intervention group than usual care (1.4- v 7.1-point drop; P < .001). Patients receiving intervention were less frequently admitted to the ER (34% v 41%; P = .02) or hospitalized (45% v 49%; P = .08) and remained on chemotherapy longer (mean, 8.2 v 6.3 months; P = .002). Although 75% of the intervention group was alive at 1 year, 69% with usual care survived the year (P = .05), with differences also seen in quality-adjusted survival (mean of 8.7 v. 8.0 months; P = .004). Benefits were greater for participants lacking prior computer experience. Most patients receiving intervention (63%) reported severe symptoms during the study. Nurses frequently initiated clinical actions in response to e-mail alerts. Conclusion: Clinical benefits were associated with symptom self-reporting during cancer care.

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EuroQol: a new facility for the measurement of health-related quality of life
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Background
What Do Patients With Non–Small-Cell Lung Cancer Experience? Content Domain for the MD Anderson Symptom Inventory for Lung Cancer
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Self-citation
Impact of patient-reported outcomes on symptom monitoring during treatment with checkpoint inhibitors: health-related quality of life among melanoma patients in a randomized controlled trial
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BackgroundResult
Fear of Cancer Progression and Death Anxiety in Survivors of Advanced Colorectal Cancer: A Qualitative Study Exploring Coping Strategies and Quality of Life
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“Stepped care, which has been shown to be acceptable and feasible in cancer care (Basch et al., 2016; Butow et al., 2015, 2021), may be helpful, whereby more vulnerable CRC-A survivors with high distress/low QoL receive more intensive support.”
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“Additionally, clinical research regarding cancer patients’ self-report symptoms has also indicated that routine cancer treatment resulted in symptoms that precipitated emergency room visits and hospital admissions [33].”
BackgroundResult
Racial differences in user experiences and perceived value of electronic symptom monitoring in a cohort of black and white bladder and prostate cancer patients
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Self-citation
Longitudinal evaluation of Supportive care Prioritization, Assessment and Recommendations for Kids (SPARK), a symptom screening and management application
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Net Pain Relief After Palliative Radiation Therapy for Painful Bone Metastases: A Useful Measure to Reflect Response Duration? A Further Analysis of the Dutch Bone Metastasis Study
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Your data is gold – Data donation for better healthcare?
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“[43, 44]) can initiate discussions between patients and doctors, but can also improve medical surveillance and treatment [45].”
Background
Improving quality of life through the routine use of the patient concerns inventory for head and neck cancer patients: baseline results in a cluster preference randomised controlled trial
Rogers, S. N., Allmark, C., Bekiroglu, F., Edwards, R. T., Fabbroni, G., Flavel, R., Highet, V., Ho, M. W. S., Humphris, G. M., Jones, T. M., et al. (2020) · European Archives of Oto-Rhino-Laryngology · doi:10.1007/s00405-020-06077-6 · Cited by 27
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Assessing the Feasibility of a Novel mHealth App in Hematopoietic Stem Cell Transplant Patients
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Digital Medicine in Men with Advanced Prostate Cancer – A Feasibility Study of Electronic Patient-reported Outcomes in Patients on Systemic Treatment
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“These systems demonstrate however that PRO use in routine care is both possible and acceptable with evidence of improved symptom management, treatment completion and even overall survival (12,15 – 18).”
Background
Development and Pilot Implementation of a Remote Monitoring System for Acute Toxicity Using Electronic Patient-Reported Outcomes for Patients Undergoing Radiation Therapy for Breast Cancer
Lapen, K., Sabol, C., Tin, A. L., Lynch, K. A., Kassa, A., Mabli, X., Ford, J., Cha, E., Bernstein, M. B., Braunstein, L. Z., et al. (2021) · International Journal of Radiation Oncology*Biology*Physics · doi:10.1016/j.ijrobp.2021.07.1692 · Cited by 28
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Perspectives of Patients, Nurses, and Nephrologists About Electronic Symptom Monitoring With Feedback in Hemodialysis Care
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Deep Learning for Cancer Symptoms Monitoring on the Basis of Electronic Health Record Unstructured Clinical Notes
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“Symptoms have a major effect on patients’ quality of life,(1,2) treatment tolerance, and prognosis.(3,4) Symptoms are therefore critical outcomes to monitor in therapeutic clinical trials, observational research, and population-level surveillance.”
Background
A modified Edmonton Symptom Assessment Scale for symptom clusters in radiation oncology patients
Johnstone, P. A. S., Lee, J., Zhou, J., Ma, Z., Portman, D. G., Jim, H., & Tsai, Y.-Y. (2017) · Cancer Medicine · doi:10.1002/cam4.1125 · Cited by 27
“Moreover, patients and providers report high satisfaction with symptom monitoring [1, 2], indicating that it results in improved communication about symptoms with little to no additional burden.”
Background
Telehealth in older adults with cancer in the United States: The emerging use of wearable sensors
Shen, J., & Naeim, A. (2017) · Journal of Geriatric Oncology · doi:10.1016/j.jgo.2017.08.008 · Cited by 28
Use of patient-reported outcomes in regional cancer centres over time: a retrospective study
Barbera, L. C., Lee, F., & Sutradhar, R. (2019) · CMAJ Open · doi:10.9778/cmajo.20180074 · Cited by 27
Thirty-Day Unplanned Hospital Readmissions in Patients With Cancer and the Impact of Social Determinants of Health: A Machine Learning Approach
Stabellini, N., Nazha, A., Agrawal, N., Huhn, M., Shanahan, J., Hamerschlak, N., Waite, K. A., Barnholtz‐Sloan, J. S., & Montero, A. J. (2023) · JCO Clinical Cancer Informatics · doi:10.1200/cci.22.00143 · Cited by 29
An Integrated Care Approach to Improve Well-Being in Breast Cancer Patients
Fabi, A., Rossi, A., Mocini, E., Cardinali, L., Bonavolontá, V., Cenci, C., Magno, S., Barberi, V., Moretti, A., Besharat, Z. M., et al. (2024) · Current Oncology Reports · doi:10.1007/s11912-024-01500-1 · Cited by 30
“An important change is represented using the Patient Reported Outcome Measures (PROMs-e-PROMs), related to health status reported directly by the patient, without the mediation of the clinical interview that often leads to underestimating effects [113].”
Method
Engagement Among Diverse Patient Backgrounds in a Remote Symptom Monitoring Program
Rocque, G. B., Caston, N. E., Hildreth, K., Deng, L., Henderson, N. L., Williams, C., Azuero, A., Jackson, B. E., Franks, J. A., McGowan, C., et al. (2024) · JCO Oncology Practice · doi:10.1200/op.24.00066 · Cited by 25
Self-citation
Provincial development of a patient-reported outcome initiative to guide patient care, quality improvement, and research
Olson, R. A., Howard, A. F., Lapointe, V., Schellenberg, D. D., Nichol, A., Bowering, G., Curtis, S., Walter, A., Brown, S., Thompson, C., et al. (2017) · Healthcare Management Forum · doi:10.1177/0840470417715478 · Cited by 27
Pain management index (PMI)—does it reflect cancer patients’ wish for focus on pain?
Thronæs, M., Balstad, T. R., Brunelli, C., Løhre, E. T., Klepstad, P., Vagnildhaug, O. M., Kaasa, S., Knudsen, A. K., & Solheim, T. S. (2019) · Supportive Care in Cancer · doi:10.1007/s00520-019-04981-0 · Cited by 26
Patient-Reported Outcomes in Integrative Oncology
Lopez, G., Lacey, J., Christie, A. J., Powers-James, C. R., Narayanan, S., Liu, W., & Cohen, L. G. (2019) · The Cancer Journal · doi:10.1097/ppo.0000000000000401 · Cited by 26
Late, Persistent, Substantial, Treatment-Related Symptoms After Radiation Therapy (LAPERS): A New Method for Longitudinal Analysis of Late Morbidity—Applied in the EMBRACE Study
Kirchheiner, K., Pötter, R., Nout, R. A., Vittrup, A. S., Holzner, B., Bentzen, S. M., & Tanderup, K. (2019) · International Journal of Radiation Oncology*Biology*Physics · doi:10.1016/j.ijrobp.2019.10.027 · Cited by 26
Physical problem list accompanying the distress thermometer: Its associations with psychological symptoms and survival in patients with metastatic lung cancer
McFarland, D. C., Jutagir, D. R., Miller, A. H., & Nelson, C. J. (2020) · Psycho-Oncology · doi:10.1002/pon.5367 · Cited by 27
Validation of a Novel, Multidomain Head and Neck Cancer Appearance‐ and Function‐Distress Patient‐Reported Outcome Measure
Graboyes, E. M., Hand, B. N., Ellis, M. A., Huang, A. T., Nilsen, M. L., Pipkorn, P. J., Marsh, C. H., Maurer, S. N., Day, T. A., & Sterba, K. R. (2020) · Otolaryngology · doi:10.1177/0194599820927364 · Cited by 26
“PROMs enhance the delivery of patient-centered HNC care(22) and result in improved symptom control, higher levels of patient satisfaction, and decreased mortality when incorporated into clinical oncology practice.(23,24) The paradigm shift toward measuring BID using PROMs, which harness the patient’s words and experie…”
Background
Views From Patients With Cancer in the Setting of Unplanned Acute Care: Informing Approaches to Reduce Health Care Utilization
Kaufmann, T. L., Rendle, K. A. S., Aakhus, E., Nimgaonkar, V. U., Shah, A., Bilger, A., Gabriel, P. E., Trotta, R. L., Braun, J., Shulman, L. N., et al. (2020) · JCO Oncology Practice · doi:10.1200/op.20.00013 · Cited by 26
Development of an electronic patient-reported outcome measure (ePROM) system to aid the management of patients with advanced chronic kidney disease
Kyte, D. G., Anderson, N. E., Auti, R., Aiyegbusi, O. L., Bishop, J. R. B., Bissell, A., Brettell, E. A., Calvert, M., Chadburn, M., Cockwell, P., et al. (2020) · Journal of Patient-Reported Outcomes · doi:10.1186/s41687-020-00223-8 · Cited by 28
“We intend to explore the experiences of patients using RePROM, compared to those documented using the aforementioned ePROM systems in renal disease [17, 18] and cancer [12, 13].”
Feasibility of health-related quality of life (HRQoL) assessment for cancer patients using electronic patient-reported outcome (ePRO) in daily clinical practice
Mouillet, G., Falcoz, A., Fritzsch, J., Almotlak, H., Jacoulet, P., Pivot, X. B., Villanueva, C., Mansi, L., Kim, S. C. H., Curtit, E., et al. (2021) · Quality of Life Research · doi:10.1007/s11136-020-02721-0 · Cited by 25
Patient-Reported Outcomes and Long-Term Nonadherence to Aromatase Inhibitors
Hershman, D. L., Neugut, A. I., Moseley, A. B., Arnold, K. B., Gralow, J. R., Henry, N. L., Hillyer, G. C., Ramsey, S. D., & Unger, J. M. (2021) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/djab022 · Cited by 26
“AI nonadherence was greater at 36 months among those with more baseline endocrine symptoms, higher pain, and worse HRQOL.”
MethodInfluential
Symptom Diaries of Patients with Midgut Neuroendocrine Tumors Treated with 177Lu-DOTATATE
Strosberg, J., Srirajaskanthan, R., El-Haddad, G. E., Wolin, E. M., Chasen, B. A., Kulke, M. H., Bushnell, D. L., Caplin, M. E., Baum, R. P., Hendifar, A. E., et al. (2021) · Journal of Nuclear Medicine · doi:10.2967/jnumed.120.258897 · Cited by 26
“a positive PROmeasures outcome in cancer trials (17).”
Background
Clinicians’ knowledge and attitudes towards patient reported outcomes in colorectal cancer care – insights from qualitative interviews
Sibert, N. T., Kowalski, C., Pfaff, H., Wesselmann, S., & Breidenbach, C. (2021) · BMC Health Services Research · doi:10.1186/s12913-021-06361-z · Cited by 27
“These instruments are called patientreported outcomes (PROs), and many clinical trials have already shown that they have benefits for monitoring purposes [3].”
Background
Development of an integrated model of care for allogeneic stem cell transplantation facilitated by eHealth—the SMILe study
Leppla, L., Schmid, A., Valenta, S., Mielke, J., Beckmann, S., Ribaut, J., Teynor, A., Dobbels, F., Duerinckx, N., Zeiser, R., et al. (2021) · Supportive Care in Cancer · doi:10.1007/s00520-021-06328-0 · Cited by 29
“In cancer patients, eHealth-facilitated care models integrating two or more eCCM dimensions led to, e.g., reduced symptom burden [18], re-hospitalizations, improved survival, quality of life [19, 20], and physical activity [21].”
Background
User-centered design and agile development of a novel mobile health application and clinician dashboard to support the collection and reporting of patient-reported outcomes for breast cancer care
Tsangaris, E., Edelen, M. O., Means, J., Gregorowitsch, M. L., O’Gorman, J., Pattanaik, R., Dominici, L. S., Hassett, M. J., Witkowski, M. L., Schrieber, K., et al. (2022) · BMJ Surgery Interventions & Health Technologies · doi:10.1136/bmjsit-2021-000119 · Cited by 32
Engaging TEAM Medicine in Patient Care: Redefining Cancer Survivorship From Diagnosis
Alfano, C. M., Oeffinger, K. C., Sanft, T. B., & Tortorella, B. (2022) · American Society of Clinical Oncology Educational Book · doi:10.1200/edbk_349391 · Cited by 26
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Dyer, N. L., Surdam, J., Srinivasan, R., Agarwal, A., & Dusek, J. A. (2022) · Journal of Integrative and Complementary Medicine · doi:10.1089/jicm.2021.0413 · Cited by 26
“9 In the case of chronic and/or terminal illness where no effective cure is available, or may only modestly prolong life, treatment emphasis is often placed on improving health-related quality of life.”
Implementation and evaluation of an expanded electronic health record-integrated bilingual electronic symptom management program across a multi-site Comprehensive Cancer Center: The NU IMPACT protocol
Cella, D. F., Garcia, S. F., Cahue, S., Smith, J. D., Yanez, B. R., Scholtens, D. M., Lancki, N., Bass, M., Kircher, S. M., Flores, A. M., et al. (2023) · Contemporary Clinical Trials · doi:10.1016/j.cct.2023.107171 · Cited by 28
Dosimetric Predictors of Patient-Reported Xerostomia and Dysphagia With Deintensified Chemoradiation Therapy for HPV-Associated Oropharyngeal Squamous Cell Carcinoma
Chera, B. S., Fried, D., Price, A. T., Amdur, R. J., Mendenhall, W. M., Lu, C., Das, S. K., Sheets, N. C., Marks, L. B., & Mavroidis, P. (2017) · International Journal of Radiation Oncology*Biology*Physics · doi:10.1016/j.ijrobp.2017.03.034 · Cited by 26
Relationship between patient-reported outcomes and clinical outcomes in metastatic castration-resistant prostate cancer: post hoc analysis of COU-AA-301 and COU-AA-302
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Toxicity of Cancer Therapies in Older Patients
Saux, O. L., & Falandry, C. (2018) · Current Oncology Reports · doi:10.1007/s11912-018-0705-y · Cited by 26
Evaluation of a survivorship needs assessment planning tool for head and neck cancer survivor-caregiver dyads
Sterba, K. R., Armeson, K. E., Zapka, J., Scallion, M. L., Garris, T. K., Graboyes, E. M., Ruggiero, K. J., & Day, T. A. (2019) · Journal of Cancer Survivorship · doi:10.1007/s11764-019-0732-1 · Cited by 26
Comparing the patients’ subjective experiences of acute side effects during radiotherapy for head and neck cancer with four different patient-reported outcomes questionnaires
Holländer-Mieritz, C., Johansen, J., Johansen, C., Vogelius, I. R., Kristensen, C. A., & Pappot, H. (2019) · Acta Oncologica · doi:10.1080/0284186x.2018.1563713 · Cited by 26
“This approach has recently been performed with success during chemotherapy of metastatic cancer disease [2] and follow-up of lung cancer [3], both studies using schedules including 12 questions and showing significant improvement on survival using PRO [1,3].”
Background
InSight Care Pilot Program: Redefining Seeing a Patient
Daly, B., Kuperman, G. J., Zervoudakis, A., Medsker, A. B., Roy, A., Ro, A. S., Arenas, J. M., Yanamandala, H. V., Kottamasu, R., Salvaggio, R., et al. (2020) · JCO Oncology Practice · doi:10.1200/op.20.00214 · Cited by 26
“Eligible patients (1) were 18 years of age or older; (2) had a diagnosis of a solid tumor or lymphoma; (3) were starting intravenous antineoplastic therapy, including a cytotoxic, immunologic, or biologic agent, that was initial therapy or had been at least 6 months since their last treatment; (4) had access to a smar…”
Background
Using Technology to Improve Cancer Care: Social Media, Wearables, and Electronic Health Records
Fisch, M. J., Chung, A. E., & Accordino, M. K. (2016) · American Society of Clinical Oncology Educational Book · doi:10.1200/edbk_156682 · Cited by 27
Data Mining in Oncology: The ukCAT Project and the Practicalities of Working with Routine Patient Data
Price, G., van Herk, M., & Faivre-Finn, C. (2017) · Clinical Oncology · doi:10.1016/j.clon.2017.07.011 · Cited by 25
Why focus on patient-reported outcome measures in older colorectal cancer patients?
Doolin, J. W., Halpin, M., Berry, J. L., Hshieh, T. T., & Zerillo, J. A. (2019) · European Journal of Surgical Oncology · doi:10.1016/j.ejso.2019.07.028 · Cited by 25
Characteristics of Participation in Patient-Reported Outcomes and Electronic Data Capture Components of NRG Oncology Clinical Trials
Pugh, S. L., Rodgers, J. P., Yeager, K. A., Chen, R. C., Movsas, B., Bonanni, R., Dignam, J. J., & Bruner, D. W. (2020) · International Journal of Radiation Oncology*Biology*Physics · doi:10.1016/j.ijrobp.2020.06.030 · Cited by 25
Exploring the use of Mobile applications by cancer patients undergoing chemotherapy: A scoping review
Magalhães, B. M. B. D. S., Fernandes, C. S., Martínez‐Galiano, J. M., & Santos, C. (2020) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2020.104293 · Cited by 32
Severe reflux, sleep disturbances, and health-related quality of life after esophageal cancer surgery
Lagergren, P., Johar, A. M., Rosenlund, H., Arnberg, L., Haglund, L., Ness‐Jensen, E., & Schandl, A. R. (2021) · Journal of Cancer Survivorship · doi:10.1007/s11764-020-00974-9 · Cited by 26
Completion of Patient-Reported Outcome Questionnaires Among Older Adults with Advanced Cancer
Flannery, M. A., Mohile, S. G., Culakova, E., Norton, S. A., Kamen, C. S., Dionne-Odom, J. N., DiGiovanni, G., Griggs, L., Bradley, T. P., Hopkins, J. O., et al. (2021) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2021.07.032 · Cited by 25
A predictive algorithm using clinical and laboratory parameters may assist in ruling out and in diagnosing MDS
Oster, H. S., Crouch, S., Smith, A. G., Yu, G., Shrkihe, B. A., Baruch, S., Kolomansky, A., Ben‐Ezra, J. M., Naor, S., Fenaux, P., et al. (2021) · Blood Advances · doi:10.1182/bloodadvances.2020004055 · Cited by 25
Emerging digital technologies in cancer treatment, prevention, and control
Hesse, B. W., Kwaśnicka, D., & Ahern, D. K. (2021) · Translational Behavioral Medicine · doi:10.1093/tbm/ibab033 · Cited by 29
“…use the powerful analytic capabilities made possible through just-in-time data analytic systems to intervene early when adverse events are detected [34] and to help hospital administrators allocate scarce resources proactively to those at highest risk for worse outcomes and in greatest need [93].”
Background
DIGITAL THERAPEUTICS IN ONCOLOGY: FINDINGS, BARRIERS AND PROSPECTS. A NARRATIVE REVIEW
Gussoni, G., Ravot, E., Zecchina, M., Recchia, G., Santoro, E., R., A., & Perrone, F. (2022) · Annals of Research in Oncology · doi:10.48286/aro.2022.39 · Cited by 23
Supportive oncology care at home interventions: protocols for clinical trials to shift the paradigm of care for patients with cancer
Nipp, R. D., Shulman, E., Smith, M. H., Brown, P. M. C., Johnson, P. C., Gaufberg, E., Vyas, C., Qian, C. L., Neckermann, I., Hornstein, S., et al. (2022) · BMC Cancer · doi:10.1186/s12885-022-09461-z · Cited by 25
Real-World Adherence to Patient-Reported Outcome Monitoring as a Cancer Care Quality Metric
Takvorian, S. U., Anderson, R. T., Gabriel, P. E., Poznyak, D., Lee, S., Simon, S., Barrett, K. A., & Shulman, L. N. (2022) · JCO Oncology Practice · doi:10.1200/op.21.00855 · Cited by 25
“We limited our sample to those receiving active treatment given the particularly strong evidence base for PRO symptommonitoring in this population.(1-3,5) The primary outcome was patient-level adherence to PRO monitoring, defined for each participant as the proportion of active treatment visits during which a PRO ques…”
BackgroundMethod
An implementation study of electronic assessment of patient-reported outcomes in inpatient radiation oncology
Nordhausen, T., Lampe, K., Vordermark, D., Holzner, B., Al‐Ali, H. K., Meyer, G., & Schmidt, H. (2022) · Journal of Patient-Reported Outcomes · doi:10.1186/s41687-022-00478-3 · Cited by 25
Effects of eHealth Interventions on Quality of Life and Psychological Outcomes in Cardiac Surgery Patients: Systematic Review and Meta-analysis
Ni, R., Liu, M., Huang, S., & Yang, J. (2022) · Journal of Medical Internet Research · doi:10.2196/40090 · Cited by 25
“With the increasing social demand for electronic technology, the use of mobile devices has the great potential to transform conventional health care and implement patient-centered initiatives [15-17].”
Background
Patient-Reported Outcome Dashboards Within the Electronic Health Record to Support Shared Decision-making: Protocol for Co-design and Clinical Evaluation With Patients With Advanced Cancer and Chronic Kidney Disease
Perry, L. M., Morken, V., Peipert, J. D., Yanez, B. R., Garcia, S. F., Barnard, C., Hirschhorn, L. R., Linder, J. A., Jordan, N., Ackermann, R. T., et al. (2022) · JMIR Research Protocols · doi:10.2196/38461 · Cited by 30
“In particular, our dashboard aims to improve recognition and shared decision-making for the management of patients’ symptoms and treatment needs, which can promote more effective use of the health care system and translate into improved patient outcomes [17,18,29,76].”
Background
A Review of Patient-Reported Outcome Measures in Childhood Cancer
Horan, M. R., Sim, J.-A., Krull, K. R., Baker, J. N., & Huang, I. (2022) · Children · doi:10.3390/children9101497 · Cited by 25
“Collecting patient-reported symptoms is especially meaningful and clinically actionable, which has shown HRQOL improvement for adult cancer patients [50].”
Background
Systematic symptom screening in patients with advanced cancer treated in certified oncology centers: results of the prospective multicenter German KeSBa project
Braulke, F., Para, S., Alt‐Epping, B., Tewes, M., Bäumer, M., Haberland, B., Mayer‐Steinacker, R., Hopprich, A., de Wit, M., Grabe, M., et al. (2023) · Journal of Cancer Research and Clinical Oncology · doi:10.1007/s00432-023-04818-8 · Cited by 25
Quality of life after patient-initiated vs physician-initiated response to symptom monitoring: the SYMPRO-Lung trial
Billingy, N. E., Tromp, V. N. M. F., Aaronson, N. K., Hoek, R. J. A., Bogaard, H. J., Onwuteaka-Philipsen, B. D., van de Poll-Franse, L. V., Hugtenburg, J. G., Belderbos, J. S. A., Becker‐Commissaris, A., et al. (2023) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/djad159 · Cited by 26
“Our findings are consistent with earlier studies on PRO symptom monitoring, which reported similar results with respect to HRQOL in metastatic cancer patients (7,11,26), curatively treated patients (27), and lung cancer patients (9).”
BackgroundResult
Remote Symptom Monitoring With Ecological Momentary Computerized Adaptive Testing: Pilot Cohort Study of a Platform for Frequent, Low-Burden, and Personalized Patient-Reported Outcome Measures
Harrison, C. J., Trickett, R. W., Wormald, J. C. R., Dobbs, T. D., Lis, P., Popov, V., Beard, D. J., & Rodrigues, J. N. (2023) · Journal of Medical Internet Research · doi:10.2196/47179 · Cited by 25
“These sampling frequencies exceed those typically reported by studies aiming to monitor patients with traditional PROMs of similar lengths to the PEM [9,17,45,46].”
Evaluation of clinical decision support systems in oncology: An updated systematic review
Nafees, A., Khan, M., Chow, R., Fazelzad, R., Hope, A. J., Liu, G., Létourneau, D., & Raman, S. (2023) · Critical Reviews in Oncology/Hematology · doi:10.1016/j.critrevonc.2023.104143 · Cited by 24
Assessing Patient-Reported Outcomes in Routine Cancer Clinical Care Using Electronic Administration and Telehealth Technologies: Realist Synthesis of Potential Mechanisms for Improving Health Outcomes
Govindaraj, R., Agar, M. R., Currow, D. C., & Luckett, T. (2023) · Journal of Medical Internet Research · doi:10.2196/48483 · Cited by 27
“The risk of bias in the abovementioned RCTs, contributing to the testing of program theory 3, concerns the lack of blinding in all the studies (n=21) and significant attrition and missing outcomes in the studies by Basch et al [4], Greer et al [88], and Absolom et al [78].”
Influential
Telemedicine-Enabled Clinical Trial of Metformin in Patients With Prostate Cancer
Galsky, M. D., Shahin, M., Jia, R., Shaffer, D. R., Gimpel-Tetra, K., Tsao, C., Baker, C., Leiter, A., Holland, J., Sablinski, T., et al. (2017) · JCO Clinical Cancer Informatics · doi:10.1200/cci.17.00044 · Cited by 25
Digital Follow-Up and the Perspective of Patient-Centered Care in Oncology: What’s the PROblem?
Giordano, F. A., Welzel, G., Siefert, V., Jahnke, L., Ganslandt, T., Wenz, F. K., Grosu, A., Heinemann, F. E., & Nicolay, N. H. (2018) · Oncology · doi:10.1159/000495294 · Cited by 26
Advances in Health Technology Use and Implementation in the Era of Healthy Living: Implications for Precision Medicine
Phillips, S. A., Ali, M. M., Modrich, C., Oke, S., Elokda, A. S., Laddu, D., & Bond, S. (2018) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2018.12.007 · Cited by 27
The use of digitally collected patient-reported outcome measures for newly operated patients with total knee and hip replacements to improve post-treatment recovery: study protocol for a randomized controlled trial
Kuklinski, D., Oschmann, L., Pross, C. M., Busse, R., & Geißler, A. (2020) · Trials · doi:10.1186/s13063-020-04252-y · Cited by 25
COVID-19 and Cancer Care: Ensuring Safety While Transforming Care Delivery
Mulvey, T. M., & Jacobson, J. O. (2020) · Journal of Clinical Oncology · doi:10.1200/jco.20.01474 · Cited by 25
Advancing patient-centric care: integrating patient reported outcomes for tolerability assessment in early phase clinical trials – insights from an expert virtual roundtable
Yap, C., Aiyegbusi, O. L., Alger, E., Basch, E., Bell, J. A., Bhatnagar, V., Cella, D. F., Collis, P., Dueck, A. C., Gilbert, A., et al. (2024) · EClinicalMedicine · doi:10.1016/j.eclinm.2024.102838 · Cited by 26
“35,36 Though somewhat different than ad hoc reporting, these results may indicate promise for the ability of ad hoc PRO reports to have clinical value, though this would require testing.”
BackgroundSelf-citation
Transforming healthcare delivery with conversational AI platforms
Mahajan, A., & Powell, D. (2025) · npj Digital Medicine · doi:10.1038/s41746-025-01968-6 · Cited by 26
A cross‐cultural convergent parallel mixed methods study of what makes a cancer‐related symptom or functional health problem clinically important
Giesinger, J., Aaronson, N., Arraras, J., Efficace, F., Groenvold, M., Kieffer, J., Loth, F., Petersen, M., Ramage, J., Tomaszewski, K., et al. (2018) · Psycho-Oncology · doi:10.1002/pon.4548 · Cited by 22
“has been shown to be feasible and associated with a number of clinical benefits including fewer hospitalizations and superior quality adjusted survival.(5) However, the interpretation of scores derived from PRO questionnaires is often challenging for patients and HCPs, partly because results are given on metrics (eg,…”
Background
Rationale for routine collection of patient reported outcomes during integrative medicine consultation visits
Dusek, J. A., JaKa, M. M., Wallerius, S., Fairchild, S., Victorson, D. E., Rivard, R. L., & Betzner, A. E. (2018) · Complementary Therapies in Medicine · doi:10.1016/j.ctim.2018.01.012 · Cited by 24
Patient-reported outcome measures used in patients with primary sclerosing cholangitis: a systematic review
Isa, F., Turner, G., Kaur, G., Kyte, D. G., Slade, A. L., Pankhurst, T., Kerecuk, L., Keeley, T., Ferguson, J., & Calvert, M. (2018) · Health and Quality of Life Outcomes · doi:10.1186/s12955-018-0951-6 · Cited by 25
AMTRA: a multicentered experience of a web-based monitoring and tailored toxicity management system for cancer patients
Rasschaert, M. A., Vulsteke, C., Keersmaecker, S. D., Vandenborne, K., Dias, S., Verschaeve, V., Vuylsteke, P., Brussel, I. V., Ravelingien, J., van Dam, P. A., et al. (2020) · Supportive Care in Cancer · doi:10.1007/s00520-020-05550-6 · Cited by 24
“Examples of successful implementation of electronic symptom/toxicity reporting tools based on patient adapted version of the CTCAE include Patient Viewpoint, the symptom tracking and reporting system (STAR) system for patients to report chemotherapy AE and the Tell Us system® for patients in hospices (both in the USA)…”
MethodResultInfluential
Integrating Patient‐Reported Outcomes Within Routine Hepatology Care: A Prompt to Action
Verma, M., & Younossi, Z. M. (2020) · Hepatology · doi:10.1002/hep.31550 · Cited by 24
Measuring Quality of Life in Ovarian Cancer Clinical Trials—Can We Improve Objectivity and Cross Trial Comparisons?
Bhat, G. R., Karakasis, K., & Oza, A. M. (2020) · Cancers · doi:10.3390/cancers12113296 · Cited by 23
“Data show that integration of electronic PRO into routine care of recurrent metastatic cancer is associated with survival improvement and may be considered as part of high-quality cancer care [59].”
Background
Adaptation and Evaluation of a Symptom-Monitoring Digital Health Intervention for Patients With Relapsed and Refractory Multiple Myeloma: Pilot Mixed-Methods Implementation Study
Biran, N., Kouyaté, R. A., Yücel, E., McGovern, G. E., Schoenthaler, A., Durling, O. G., Unawane, R., Schutt, A., & Panjabi, S. S. (2020) · JMIR Formative Research · doi:10.2196/18982 · Cited by 22
“One study, conducted at Memorial Sloan Kettering Cancer Center among patients initiating chemotherapy for certain metastatic solid tumors, found that patients using an ePRO system had greater improvement in health-related quality of life, were less frequently admitted to the emergency department or hospital, remained…”
BackgroundMethodInfluential
Different Approaches for Case-Mix Adjustment of Patient-Reported Outcomes to Compare Healthcare Providers—Methodological Results of a Systematic Review
Sibert, N. T., Pfaff, H., Breidenbach, C., Wesselmann, S., & Kowalski, C. (2021) · Cancers · doi:10.3390/cancers13163964 · Cited by 24
Incidence of and Factors Associated With Nonfatal Self-injury After a Cancer Diagnosis in Ontario, Canada
Noel, C. W., Eskander, A. E., Sutradhar, R., Mahar, A. L., Vigod, S. N., Isenberg‐Grzeda, E., Bolton, J. M., Deleemans, J. M., Chan, W. C., Vasdev, R., et al. (2021) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.26822 · Cited by 24
Digital Health for Patients With Multiple Myeloma: An Unmet Need
Jagannath, S., Mikhael, J. R., Nadeem, O., & Raje, N. S. (2021) · JCO Clinical Cancer Informatics · doi:10.1200/cci.20.00145 · Cited by 24
Reducing the pressures of outpatient care: the potential role of patient-reported outcomes
Aiyegbusi, O. L., Hughes, S., Peipert, J. D., Schougaard, L. M. V., Wilson, R., & Calvert, M. (2023) · Journal of the Royal Society of Medicine · doi:10.1177/01410768231152222 · Cited by 24
Efficacy of the PRO-CTCAE mobile application for improving patient participation in symptom management during cancer treatment: a randomized controlled trial
Lee, M., Kang, D., Kang, E., Kim, S.-Y., Kim, Y., Ahn, J. S., Park, S., Lee, Y.-Y., Oh, D., Noh, J. M., et al. (2023) · Supportive Care in Cancer · doi:10.1007/s00520-023-07779-3 · Cited by 29
“However, previous randomized controlled trials on ePRO have not evaluated the improvement of patient participation, which is an important mediator in regular clinic visits [4, 13, 15, 18, 19, 24].”
Background
Usability of Electronic Patient-Reported Outcome Measures for Older Patients With Cancer: Secondary Analysis of Data from an Observational Single Center Study
Riedl, D., Lehmann, J., Rothmund, M., Dejaco, D., Grote, V., Fischer, M. J., Rumpold, G., Holzner, B., & Licht, T. (2023) · Journal of Medical Internet Research · doi:10.2196/49476 · Cited by 24
“These results are encouraging given the numerous studies that have highlighted the benefits of using ePROs in oncology [44-46].”
Improving cancer patient emergency room utilization: A New Jersey state assessment
Scholer, A. J., Mahmoud, O., Ghosh, D., Schwartzman, J., Farooq, M., Cabrera, J., Wieder, R., Adam, N. R., & Chokshi, R. J. (2017) · Cancer Epidemiology · doi:10.1016/j.canep.2017.09.006 · Cited by 25
Use of an electronic patient-reported outcome measure in the management of patients with advanced chronic kidney disease: the RePROM pilot trial protocol
Kyte, D. G., Bishop, J. R. B., Brettell, E. A., Calvert, M., Cockwell, P., Dutton, M., Eddington, H., Hadley, G., Ives, N. J., Jackson, L. J., et al. (2018) · BMJ Open · doi:10.1136/bmjopen-2018-026080 · Cited by 24
Association Between Patient Experience With Patient-Reported Outcome Measurements and Overall Satisfaction With Care in Neurology
Lapin, B. R., Honomichl, R. D., Thompson, N. R., Rose, S. L., Sugano, D., Udeh, B. L., & Katzan, I. L. (2019) · Value in Health · doi:10.1016/j.jval.2019.02.007 · Cited by 25
PATIENT VOICES, a project for the integration of the systematic assessment of patient reported outcomes and experiences within a comprehensive cancer center: a protocol for a mixed method feasibility study
Brunelli, C., Borreani, C., Caraceni, A. T., Roli, A., Bellazzi, M., Lombi, L., Zito, E., Pellegrini, C., Spada, P., Kaasa, S., et al. (2020) · Health and Quality of Life Outcomes · doi:10.1186/s12955-020-01501-1 · Cited by 26
mHealth: Mobile Technologies to Virtually Bring the Patient Into an Oncology Practice
Pennell, N. A., Dicker, A. P., Tran, C. N., Jim, H., Schwartz, D. L., & Stepanski, E. J. (2017) · American Society of Clinical Oncology Educational Book · doi:10.1200/edbk_176093 · Cited by 26

Authors: Basch, E., Deal, A. M., Kris, M. G., Scher, H. I., Hudis, C. A., Sabbatini, P., Rogak, L., Bennett, A. V., Dueck, A. C., Atkinson, T. M., Chou, J. F., Dulko, D., Sit, L., Barz, A., Novotny, P., Fruscione, M., Sloan, J. A., & Schrag, D.
Affiliations: University of North Carolina at Chapel Hill (US)
Ethan Basch, Mark G. Kris, Howard I. Scher, Clifford A. Hudis, Paul Sabbatini, Lauren Rogak, Thomas M. Atkinson, Joanne F. Chou, Dorothy Dulko, Laura Sit, Michael Fruscione, and Deborah Schrag, Memorial Sloan Kettering Cancer Center, New York, NY; Ethan Basch, Allison M. Deal, and Antonia V. Bennett, University of North Carolina, Chapel Hill, NC; Amylou C. Dueck, Mayo Clinic, Scottsdale, AZ; Allison Barz, Children’s Hospital of Philadelphia, Philadelphia, PA; Paul Novotny and Jeff A. Sloan, Mayo Clinic,...
ORCID: Basch, Ethan
Deal, Allison M.
Kris, Mark G.
Scher, Howard I.
Hudis, Clifford A.
Sabbatini, Paul
Rogak, Lauren
Bennett, Antonia V.
Dueck, Amylou C.
Atkinson, Thomas M.
Chou, Joanne F.
Dulko, Dorothy
Sit, Laura
Novotny, Paul
Fruscione, Michael
Sloan, Jeff A.
Schrag, Deborah
Venue: Journal of Clinical Oncology
Publisher: American Society of Clinical Oncology (ASCO)
Published: 2016-02-20
Volume: 34
Issue: 6
Pages: 557-565
ISSN: 0732-183X (ISSN-L)
1527-7755
DOI: 10.1200/jco.2015.63.0830
PMC: PMC4872028
OpenAlex: W2195040438
Cited by: 2,593
References: 36
Citations by year: 2026: 252 · 2025: 263 · 2024: 321 · 2023: 288 · 2022: 316 · 2021: 299 · 2020: 292 · 2019: 191 · 2018: 180 · 2017: 143 · 2016: 44
FWCI: 53.87
Type: journal article
Language: en
Update notices: correction (2019-02-07)
correction (2016-06-20)
Open access: green
www.ncbi.nlm.nih.gov
Locations: Journal of Clinical Oncology (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: Memorial Sloan-Kettering Cancer Center
Society of Memorial Sloan Kettering
National Cancer Institute (P30CA008748, P30CA015083, P30CA016086)
Topics: Health Sciences › Medicine › Oncology › Cancer survivorship and care
Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Keywords: patient-reported outcomes, symptom monitoring, cancer chemotherapy, health-related quality of life, advanced solid tumors, e-mail alerts, emergency department visits, hospitalization, survival, quality-adjusted survival, computer literacy, outpatient oncology
MeSH terms: Adult, Aged, Aged, 80 and over, Ambulatory Care, Antineoplastic Agents, Emergency Service, Hospital, Female, Hospitalization, Humans, Male, Middle Aged, Neoplasms, Quality of Life, Survival Rate, Internet, Nurse's Role, Electronic Mail, Self Report, Symptom Assessment

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Symptom Monitoring With Patient-Reported Outcomes During Routine Cancer Treatment: A Randomized Controlled Trial

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