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Cancel M, Sauger C, Biogeau J, Dardaine-Giraud V, Lecomte T, Solub D, Combe P, Wilmet R, Aubard E, Deloigne A, Hébrard P, Dorval É. FASTOCH: Feasibility of Electronic Patient-Reported Outcomes in Older Patients With Cancer-A Multicenter Prospective Study. J Clin Oncol 2024:JCO2302150. [PMID: 38709983 DOI: 10.1200/jco.23.02150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/09/2024] [Accepted: 02/21/2024] [Indexed: 05/08/2024] Open
Abstract
PURPOSE Multiple studies have demonstrated that electronic patient-reported outcomes (ePROs) improve overall survival and quality of life in cancer care. However, there are no specific prospective data on remote ePRO monitoring in the older population, although they represent a significant proportion of patients with cancer. PATIENTS AND METHODS From February 2021 to April 2022, patients age 75 years and older under active anticancer treatment were consecutively recruited in six institutions. Remote ePRO feasibility was determined in intention-to-test (ITT) on the basis of the number of active users in the overall population. Primary failure applied to patients who had no Internet access or declined to test ePROs, while the other patients were assigned to the ITT population. Feasibility was also determined per-protocol on the basis of the number of active patients in the ITT population. RESULTS Of the 473 patients included, primary failure applied to 288 patients (233 of whom had no Internet access). Among the 185 patients in ITT, 122 used ePROs, leading to a 26% feasibility in ITT and a 66% feasibility per protocol. In a multivariate analysis, the intent to test population was from a higher socioprofessional category (P = .009) and felt in better general condition in the Geriatric 8-score evaluation (P = .002). Active patients significantly differed from the inactive on their self-assessment of a better general condition (P < .001) only. CONCLUSION Our multicenter study showed a limited feasibility rate (26%) of remote ePROs monitoring for older patients with cancer, mainly because of technology barriers. Yet, among the patients who did have Internet access, most of them indeed used ePROs (66%). Given the expected benefit of ePROs, the technology barriers therefore need to be lifted to improve cancer care in older patients.
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Affiliation(s)
- Mathilde Cancel
- Department of Medical Oncology, Regional University Hospital Center, Tours, France
| | - Carine Sauger
- Antenne d'OncoGériatrie, Regional Cancer Network, Regional University Hospital Center, Tours, France
| | - Julie Biogeau
- Department of Geriatrics, Regional University Hospital Center, Tours, France
| | | | - Thierry Lecomte
- Department of Gastroenterology and Digestive Oncology, Regional University Hospital Center, Tours, France
| | | | - Pierre Combe
- Recherche Oncologique Clinique 37 (ROC37), Centre d'Oncologie et Radiothérapie 37 (CORT37), Chambray-lès-Tours, France
| | - Rémy Wilmet
- Centre Saint Jean de Saint Doulchard, Saint-Doulchard, France
| | - Eugénie Aubard
- CH de Châteauroux, Infirmière en Pratiques Avancées mention Oncologie, Châteauroux, France
| | | | | | - Étienne Dorval
- Antenne d'OncoGériatrie, Regional Cancer Network, Regional University Hospital Center, Tours, France
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Singer S, Sykiotis G, Al-Ibraheem A, Pinto M, Iakovou I, Østhus AA, Hammerlid E, Locati LD, Gamper EM, Arraras JI, Jordan S, Buettner M, Engesser D, Taylor K, Canotilho R, Ioannidis G, Husson O, Gama RR, Fanetti G, Moss L, Inhestern J, Andry G, Rimmele H, Kiyota N. The impact of electronic versus paper-based data capture on data collection logistics and on missing scores in thyroid cancer patients. Endocrine 2024; 84:635-645. [PMID: 38103143 PMCID: PMC11076317 DOI: 10.1007/s12020-023-03628-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 11/23/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE The purpose of this study was to investigate the impact of the type of data capture on the time and help needed for collecting patient-reported outcomes as well as on the proportion of missing scores. METHODS In a multinational prospective study, thyroid cancer patients from 17 countries completed a validated questionnaire measuring quality of life. Electronic data capture was compared to the paper-based approach using multivariate logistic regression. RESULTS A total of 437 patients were included, of whom 13% used electronic data capture. The relation between data capture and time needed was modified by the emotional functioning of the patients. Those with clinical impairments in that respect needed more time to complete the questionnaire when they used electronic data capture compared to paper and pencil (ORadj 24.0; p = 0.006). This was not the case when patients had sub-threshold emotional problems (ORadj 1.9; p = 0.48). The odds of having the researcher reading the questions out (instead of the patient doing this themselves) (ORadj 0.1; p = 0.01) and of needing any help (ORadj 0.1; p = 0.01) were lower when electronic data capture was used. The proportion of missing scores was equivalent in both groups (ORadj 0.4, p = 0.42). CONCLUSIONS The advantages of electronic data capture, such as real-time assessment and fewer data entry errors, may come at the price of more time required for data collection when the patients have mental health problems. As this is not uncommon in thyroid cancer, researchers need to choose the type of data capture wisely for their particular research question.
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Affiliation(s)
- Susanne Singer
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre Mainz, Mainz, Germany.
- University Cancer Centre, Mainz, Germany.
| | - Gerasimos Sykiotis
- Service of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Akram Al-Ibraheem
- Department of Nuclear Medicine, King Hussein Cancer Center, Amman, Jordan
| | - Monica Pinto
- Rehabilitation Medicine Unit, Strategic Health Services Department, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Naples, Italy
| | - Ioannis Iakovou
- Department of Nuclear Medicine, Aristotle University, Thessaloniki, Greece
| | - Arild Andre Østhus
- ENT and Head and Neck Department, University Medical Centre Oslo, Oslo, Norway
| | - Eva Hammerlid
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Otorhinolaryngology-Head and Neck Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Laura Deborah Locati
- Head and Neck Medical Oncology Unit, Fondazione IRCCS istituto Nazionale dei Tumori, Milan, Italy
| | - Eva Maria Gamper
- Department of Nuclear Medicine and Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Susan Jordan
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Matthias Buettner
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre Mainz, Mainz, Germany
| | - Deborah Engesser
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre Mainz, Mainz, Germany
| | - Katherine Taylor
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre Mainz, Mainz, Germany
| | - Rita Canotilho
- Instituto Português do Oncologia do Porto Francisco Gentil, Porto, Portugal
| | | | - Olga Husson
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Giuseppe Fanetti
- Division of Radiotherapy, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, PN, Italy
| | - Laura Moss
- Velindre Cancer Centre, Velindre University NHS Trust, Cardiff, UK
| | - Johanna Inhestern
- Department of Otorhinolaryngology, Oberhavelkliniken, Hennigsdorf, Germany
| | - Guy Andry
- Surgery Department, Jules Bordet Institute, Brussels, Belgium
| | - Harald Rimmele
- Bundesverband Schilddrüsenkrebs - Ohne Schilddrüse leben e. V., Berlin, Germany
| | - Naomi Kiyota
- Department of Medical Oncology and Hematology, Cancer Center, Kobe University Hospital, Kobe, Japan
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McLeod LD, Rockwood NJ. Comparability Among Modes of Data Collection for Patient-Reported Outcome Measures: Opening the Gates for Faithful Migration. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2023; 26:620-622. [PMID: 36990208 DOI: 10.1016/j.jval.2023.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/21/2023] [Accepted: 03/22/2023] [Indexed: 05/03/2023]
Affiliation(s)
- Lori D McLeod
- Patient-Centered Outcomes Assessment, RTI Health Solutions, Research Triangle Park, NC, USA.
| | - Nicholas J Rockwood
- Patient-Centered Outcomes Assessment, RTI Health Solutions, Research Triangle Park, NC, USA
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Novotny PJ, Dueck AC, Satele D, Frost MH, Beebe TJ, Yost KJ, Lee MK, Eton DT, Yount S, Cella D, Mendoza TR, Cleeland CS, Blinder V, Basch E, Sloan JA. Effects of patient-reported outcome assessment order. Clin Trials 2022; 19:307-315. [PMID: 35088616 DOI: 10.1177/17407745211073788] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND In clinical trials and clinical practice, patient-reported outcomes are almost always assessed using multiple patient-reported outcome measures at the same time. This raises concerns about whether patient responses are affected by the order in which the patient-reported outcome measures are administered. METHODS This questionnaire-based study of order effects included adult cancer patients from five cancer centers. Patients were randomly assigned to complete questionnaires via paper booklets, interactive voice response system, or tablet web survey. Linear Analogue Self-Assessment, Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events, and Patient-Reported Outcomes Measurement Information System assessment tools were each used to measure general health, physical function, social function, emotional distress/anxiety, emotional distress/depression, fatigue, sleep, and pain. The order in which the three tools, and domains within tools, were presented to patients was randomized. Rates of missing data, scale scores, and Cronbach's alpha coefficients were compared by the order in which they were assessed. Analyses included Cochran-Armitage trend tests and mixed models adjusted for performance score, age, sex, cancer type, and curative intent. RESULTS A total of 1830 patients provided baseline patient-reported outcome assessments. There were no significant trends in rates of missing values by whether a scale was assessed earlier or later. The largest order effect for scale scores was due to a large mean score at one assessment time point. The largest difference in Cronbach's alpha between the versions for the Patient-Reported Outcomes Measurement Information System scales was 0.106. CONCLUSION The well-being of a cancer patient has many different aspects such as pain, fatigue, depression, and anxiety. These are assessed using a variety of surveys often collected at the same time. This study shows that the order in which the different aspects are collected from the patient is not important.
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Affiliation(s)
- Paul J Novotny
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Amylou C Dueck
- Department of Quantitative Health Sciences, Mayo Clinic, Scottsdale, AZ, USA
| | - Daniel Satele
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | | | - Timothy J Beebe
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Kathleen J Yost
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Minji K Lee
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - David T Eton
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Susan Yount
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - David Cella
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Tito R Mendoza
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Charles S Cleeland
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Ethan Basch
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | - Jeff A Sloan
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
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