Computerized Assessment for Patients with Cancer: ESRA-C II

这项研究计划的最终目标是通过以下方式最大化癌症患者的积极健康结果 在支持性环境中创造机会，让个人充分表达自己对癌症的看法 症状和生活质量问题。癌症患者，跨越广泛的诊断和阶段， 有可能极大影响生活质量的症状的发生率很高。然而，临床医生也面临着 通常资源缩水，无法与客户进行全面的人际互动 病人。患者报告的结果和状态，特别是症状和生活质量(QOL)问题， 以可靠和系统的方式报告，是关于完整的信息的基本组成部分 临床评估、诊断和治疗计划是有依据的。在我们目前的临床试验中，通过干预 将筛查结果提供给提供者，我们证明了患者症状的可行性和可接受性 在一家大型综合性癌症中心进行生活质量结果筛查。我们准备分析目前的情况 将帮助我们回答对提供商通信的影响问题的数据，但某些关键 问题仍然与患者和家庭照顾者描述和陈述的能力有关， 毫不犹豫地，关注的症状和生活质量问题。我们有证据表明 在面对面的诊所就诊中，症状(例如，认知功能障碍)被低估。这些发现是 与其他与患者报告的卵巢癌症状、癌症相关的结果一致的研究 疲劳和性行为的变化。能够将这样的担忧传达给临床提供者， 要求患者和/或护理者了解关心的重要性，有一个方便的时间和地点 和沟通的方法，临床提供者将认识到并解决这一关切。这个 这项研究的目的是进一步评估我们的临床，并重新评估远程使用我们的增强型 基于网络的癌症自我报告评估计划，ESRA-C。癌症患者将使用 系统在治疗前、治疗中和治疗后对他们的症状和生活质量进行自我评估。除了ESRA-C 提供给临床医生的摘要，突出关注的领域，我们的系统将在 可供患者使用的格式，并指导每个患者三条信息：a)为什么这样做以及多久一次这样做 症状或生活质量问题(SQI)通常发生在像您这样的患者中，b)可以处理，以及c)如何交谈 你的临床提供者对SQI的看法。这些信息将帮助患者进行面对面的临床会议 提供者，促进患者就患者所关注的问题进行表达和沟通 专家，癌症相关症状和生活质量问题。这一双管齐下的方法增强了 提供给提供者和患者的沟通被认为是卓越的有力补充 临床监测和护理。癌症患者，在各种诊断和分期中，其症状的发生率都很高。 这可能会极大地影响生活质量。患者报告的结果和状态，特别是症状和 以有效、可靠和系统的方式报告的生活质量问题是以下方面的重要组成部分 完整的临床评估、诊断和治疗计划所依据的信息。

The ultimate goal of this program of research is to maximize positive health outcomes for those with cancer by creating opportunities in a supportive environment for individuals to fully express themselves regarding cancer symptoms and quality of life concerns. Patients with cancer, across a wide range of diagnoses and stages, have a high incidence of symptoms that may greatly impact quality of life. However, clinicians are faced too often with shrinking resources, removing opportunities for comprehensive, interpersonal interactions with patients. Patient-reported outcomes and status, particularly symptoms and quality of life (QOL) concerns, reported in a reliable and systematic way, are essential components of the information on which a complete clinical assessment, diagnosis and treatment plan is based. In our current clinical trial, having intervened by giving screening results to providers, we demonstrated the feasibility and acceptability of patient symptom and QOL outcome screening at a large comprehensive cancer center. We are poised to analyze current data that will help us answer the question of the impact on provider communication, yet certain key questions remain relevant to the ability of the patient and family caregivers to describe and present, without hesitation, the symptom and quality of life issues that are of concern. We have evidence that certain symptoms (e.g., cognitive dysfunction) are underreported in face-to-face clinic visits. These findings are consistent with other studies with patient-reported outcomes in ovarian cancer symptoms, cancer-related fatigue and changes in sexual activities. Being able to communicate such concerns to a clinical provider, requires that the patient and/or caregiver understand the concern is important, have a convenient time, place and method to communicate and that the clinical providers will acknowledge and address the concern. The purpose of this study is to further evaluate the clinical, and newly evaluate the remote, use of our enhanced web-based, electronic self-report assessment program for cancer, ESRA-C. Cancer patients will use the system to self-assess their symptoms and QOL before, during and after treatment. In addition to the ESRA-C summary given to clinicians, highlighting areas of concern, our system will provide a customized summary in a format that is useable by patients and coach each patient with three messages: a) why and how often this symptom or QOL issue (SQI) typically occurs in patients like you, b) it can be dealt with, and c) how to talk to your clinical providers about the SQI. These messages will assist patients in face-to-face clinic meetings with the providers, facilitating patient expression and communication regarding issues for which the patient is the expert, cancer related symptoms and QOL concerns. This two-pronged approach to enhancing communication, delivered to both providers and patients, is hypothesized to be a powerful adjunct to excellent clinical monitoring and care. Patients with cancer, across a wide range of diagnoses and stages, have a high incidence of symptoms that may greatly impact quality of life. Patient-reported outcomes and status, particularly symptoms and quality of life concerns, reported in an efficient, reliable and systematic way, are essential components of the information on which a complete clinical assessment, diagnosis and treatment plan is based.