Tracking Symptoms during Chemotherapy via Online Patient Self-reporting

描述(由申请人提供)：这项提案设想了一项全面的计划，为伊桑·巴施博士在癌症结果研究方面的职业发展制定计划。通过指导研究、课程作业和独立研究，Basch博士将发展合作关系和方法技能，以支持他在临床信息学和患者症状管理方面的研究议程。这项工作的重点是使用新技术来改善癌症护理和试验期间的症状监测，特别是通过评估以患者为中心的治疗模式，其中整合了患者报告的结果(PRO)。目前，使用患者自己报告的症状信息来监控癌症治疗并不是标准的。相反，临床医生被依赖来引出、筛选和报告这些信息--这是NCI和行业赞助的试验要求的一种方法。这与生活质量或症状研究形成鲜明对比，在这些研究中，专业人员是标准。这项研究计划的总体目标是探索患者自我报告在肿瘤治疗中的症状监测中的应用，作为一种可能的新范式。具体目标是：1)评估在癌症护理和试验期间通过网络常规收集症状PRO的可行性；2)使用为此目的的标准美国仪器-NCI的不良事件通用术语标准(CTCAE)来衡量患者和临床医生症状报告之间的关系；以及3)评估患者自我报告对临床和管理结果的影响。这一议程将通过巴施博士在纪念斯隆-凯特琳癌症中心设计并系统地进行的一系列IRB批准的研究来实现，以及嵌套在NCI和行业赞助的多中心临床试验中。相关性：患者自我报告可能会提高临床操作的效率，促进对严重不良事件的早期发现，并提高患者满意度。让患者积极参与研究和自己的护理传达了这样一个信息，即治疗耐受性是一个重要的终点。这项工作将有助于确定如何部署新技术来改进传统的护理模式。

DESCRIPTION (provided by applicant): This proposal envisions a comprehensive plan for the career development of Dr. Ethan Basch in cancer outcomes research. Through mentored research, coursework, and independent study, Dr. Basch will develop collaborative relationships and methodologic skills to support his research agenda in clinical informatics and patient symptom management. This work focuses on the use of novel technologies to improve symptom monitoring during cancer care and trials, specifically through the evaluation of patient- centered treatment models which integrate patient reported outcomes (PROs). Currently, it is not standard to use patients' own self-reported symptom information to monitor cancer care. Rather, clinicians are relied upon to elicit, filter and report this information - an approach which is mandated in NCI and industry-sponsored trials. This stands in contrast to quality of life or symptom research, in which PROs are standard. The overall objective of this research program is to explore the application of patient self-reporting to symptom monitoring in oncology treatment, as a possible new paradigm. The specific aims are: 1) to assess the feasibility of routinely collecting symptom PROs via the web during cancer care and trials; 2) to measure the relationship between patient and clinician symptom reporting using the standard U.S. instrument for this purpose, the NCI's Common Terminology Criteria for Adverse Events (CTCAE); and 3) to evaluate the impact of patient self-reporting on clinical and administrative outcomes. This agenda will be accomplished through a series of IRB-approved studies Dr. Basch has designed and is systematically conducting at Memorial Sloan-Kettering Cancer Center, as well as nested in multicenter NCI and industry-sponsored clinical trials. RELEVANCE: Patient self-reporting may increase the efficiency of clinical operations, foster early detection of serious adverse events, and improve patient satisfaction. Engaging patients as active participants in research and in their own care conveys the message that treatment tolerance is an important endpoint. This work will help determine how new technologies may be deployed to improve traditional models of care.