Pasquale F Innominato1,2,3, Sandra Komarzynski4, Robert Dallmann5, Nicholas I Wreglesworth6,7, Mohamed Bouchahda8,9,10,11, Abdoulaye Karaboué8,12, Ayhan Ulusakarya8,11, Christian P Subbe7,13, David Spiegel14,15, Francis A Lévi5,8,11,16. 1. Oncology Department, Ysbyty Gwynedd, Betsi Cadwaladr University Health Board, Bangor, UK. pasquale.innominato@wales.nhs.uk. 2. Warwick Medical School & Cancer Research Centre, University of Warwick, Coventry, UK. pasquale.innominato@wales.nhs.uk. 3. UPR "Chronotherapy, Cancers and Transplantation", Faculty of Medicine, Paris-Saclay University, Villejuif, France. pasquale.innominato@wales.nhs.uk. 4. Aparito, Ltd, Wrexham, UK. 5. Warwick Medical School & Cancer Research Centre, University of Warwick, Coventry, UK. 6. Oncology Department, Ysbyty Gwynedd, Betsi Cadwaladr University Health Board, Bangor, UK. 7. School of Medical Sciences, Bangor University, Bangor, UK. 8. UPR "Chronotherapy, Cancers and Transplantation", Faculty of Medicine, Paris-Saclay University, Villejuif, France. 9. Medical Oncology Unit, Clinique du Mousseau, Evry, France. 10. Medical Oncology Unit, Clinique Saint Jean L'Ermitage, Melun, France. 11. Chronotherapy Unit, Department of Medical Oncology, Paul Brousse Hospital, Public Hospitals of Paris (AP-HP), Villejuif, France. 12. Medical Oncology Unit, GHI Le Raincy-Montfermeil, Montfermeil, France. 13. Acute and Critical Care Medicine, Ysbyty Gwynedd, Betsi Cadwaladr University Health Board, Bangor, UK. 14. Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA. 15. Stanford Cancer Institute, Stanford School of Medicine, Stanford, CA, USA. 16. Hepatobiliary Centre, Paul Brousse Hospital, Public Hospitals of Paris (AP-HP), Villejuif, France.
Abstract
BACKGROUND AND AIM: The evaluation of patient-reported outcomes (PRO) in cancer has proven relevant positive clinical impact on patients' communication with healthcare professionals, decision-making for management, well-being, and overall survival. However, the optimal frequency of PRO assessment has yet to be defined. Based on the assumption that more frequent sampling would enhance accuracy, we aimed at identifying the optimal sampling frequency that does not miss clinically relevant insight. METHODS: We used pilot data from 31 advanced cancer patients who completed once daily the 19-item MD Anderson Symptom Inventory at home. The resulting dataset allowed us to compare different PRO assessment frequencies to daily sampling, i.e., alternate days (q2d), every third day (q3d), or once a week (q1w). We evaluated the sampling frequencies for two main outcomes: average symptom intensity and identification of severe symptoms. RESULTS: The majority of the differences between corresponding averages of daily data and those for q2d, q3d, and q1w datasets were close to 0, yet the extremes exceeded 5. Clinically meaningful differences, i.e., > 1, were observed in 0.76% of patient items for q2d, in 2.72% for q3d, and in 11.93% for q1w. Moreover, median values of missed instances of a severe symptom (i.e., > 6) were 14.6% for q2d, 27.8% for q3d, and 55.6% for q1w. CONCLUSIONS: Our analysis suggests that in patients receiving chemotherapy for advanced cancer, increasing the density of PRO collection enhances the accuracy of PRO assessment to a clinically meaningful extent. This is valid for both computations of averages symptom burden and for the recognition of episodes of severe symptom intensity.
BACKGROUND AND AIM: The evaluation of patient-reported outcomes (PRO) in cancer has proven relevant positive clinical impact on patients' communication with healthcare professionals, decision-making for management, well-being, and overall survival. However, the optimal frequency of PRO assessment has yet to be defined. Based on the assumption that more frequent sampling would enhance accuracy, we aimed at identifying the optimal sampling frequency that does not miss clinically relevant insight. METHODS: We used pilot data from 31 advanced cancerpatients who completed once daily the 19-item MD Anderson Symptom Inventory at home. The resulting dataset allowed us to compare different PRO assessment frequencies to daily sampling, i.e., alternate days (q2d), every third day (q3d), or once a week (q1w). We evaluated the sampling frequencies for two main outcomes: average symptom intensity and identification of severe symptoms. RESULTS: The majority of the differences between corresponding averages of daily data and those for q2d, q3d, and q1w datasets were close to 0, yet the extremes exceeded 5. Clinically meaningful differences, i.e., > 1, were observed in 0.76% of patient items for q2d, in 2.72% for q3d, and in 11.93% for q1w. Moreover, median values of missed instances of a severe symptom (i.e., > 6) were 14.6% for q2d, 27.8% for q3d, and 55.6% for q1w. CONCLUSIONS: Our analysis suggests that in patients receiving chemotherapy for advanced cancer, increasing the density of PRO collection enhances the accuracy of PRO assessment to a clinically meaningful extent. This is valid for both computations of averages symptom burden and for the recognition of episodes of severe symptom intensity.
Entities:
Keywords:
Cancer; Digital oncology; Domomedicine; MDASI; MHealth; Patient-reported outcomes; Symptoms
Authors: Joseph A Greer; Jamie M Jacobs; Nicole Pensak; Lauren E Nisotel; Joel N Fishbein; James J MacDonald; Molly E Ream; Emily A Walsh; Joanne Buzaglo; Alona Muzikansky; Inga T Lennes; Steven A Safren; William F Pirl; Jennifer S Temel Journal: J Natl Compr Canc Netw Date: 2020-02 Impact factor: 11.908
Authors: Max Gibb; Hannah Winter; Sandra Komarzynski; Nicholas I Wreglesworth; Pasquale F Innominato Journal: Integr Cancer Ther Date: 2022 Jan-Dec Impact factor: 3.077