Computerized Assessment for Patients with Cancer

描述（由申请人提供）：癌症症状和生活质量评估的传统程序是由患者或研究参与者完成的纸质问卷。 标准化的患者报告工具作为癌症临床护理的常规评估工具已得到推广，但报告不多，使用率低。 临床使用的障碍包括数据收集的人员成本、书面问卷的管理以及临床医生不熟悉查询和数字量表评分的性质。 已经开发了基于网络的技术，并使用触摸屏、笔记本电脑和计算机化筛查评估程序进行了可行性测试，为癌症临床医生提供了可用且易于解释的图形输出。 本研究的目的是加强和评估基于网络的计算机化评估，ESRA-C，在一个主要的，多学科的医疗中心和癌症中心。 这是一项随机对照试验，ESRA-C输出作为实验干预，对照条件为无输出。 将邀请所有进行患者咨询和治疗访视的临床医生参加。 在华盛顿大学医学中心和西雅图癌症护理联盟这两个研究中心接受癌症治疗评价的850名门诊患者，能够用英语交流（或通过机构提供的许多口译员之一），并且能够理解研究信息并提供知情同意书，也将被邀请参加研究。 我们将比较在常规实践和程序中进行的评估与计算机化ESRA-C程序的临床提供对以下结果的评估：症状和生活质量问题的沟通和记录，症状管理转诊的适当性，效率和可用性。 我们预计ESRA-C系统将减少评估时间，加强临床医生与患者之间关于症状和生活质量问题的沟通，增加症状预防和管理的具体干预措施的数量，并增加适当的转诊支持服务。 患者将在首次门诊访视和4周治疗访视时完成计算机化评估。 图形输出将立即提供给临床医生。 将使用比较统计学来评价向临床医生提供计算机化评估输出的影响。 我们将使用受试者内健康转变方法分析生活质量评分的临床意义，以确定生活质量评分随时间变化对患者的主观意义。

DESCRIPTION (provided by applicant): The traditional procedure for cancer symptom and quality of life assessment is a paper questionnaire completed by the patient or research participant. The use of standardized, patient report instruments as routine assessment in clinical cancer care has been promoted, but infrequently reported and the utilization rate is low. Barriers to clinical use include the personnel cost of data collection, management of written questionnaires and the clinicians' unfamiliarity with the nature of the queries and numerical scale scores. Web-based technology has been developed and tested for feasibility using touch screen, notebook computers and a computerized screening assessment program providing usable and easily interpreted graphic output to cancer clinicians. The purpose of this study is to enhance and evaluate the web-based computerized assessment, ESRA-C, in a major, multi-disciplinary medical center and cancer center. This is a randomized controlled trial with ESRA-C output as the experimental intervention and a control condition of no output. All clinicians who are conducting patient consults and on-treatment visits will be invited to participate. Eight hundred and fifty outpatients who are evaluated for cancer therapy in each of the two sites, the University of Washington Medical Center and the Seattle Cancer Care Alliance, are able to communicate in English (or through one of the many interpreters available at the institutions), and are competent to understand the study information and give informed consent also will be invited to participate. We will compare conducting assessment in the usual practices and procedures to the clinical provision of the computerized ESRA-C program on the following outcomes: communication about, and documentation of, symptoms and quality of life concerns, appropriateness of symptom management referrals, efficiency and usability. We expect that the ESRA-C system will decrease assessment time, enhance clinician-patient communication about symptoms and quality of life concerns, increase the number of specific interventions for symptom prevention and management and increase appropriate referrals to support services. The patient will complete the computerized assessment at the first clinic visit and again at the four-week on-treatment visit. Graphical output will be immediately available to clinicians. Comparative statistics will be used to evaluate the impact of the providing the computerized assessments output to the clinician. We will analyze the clinical significance of the quality of life scores using a within-subject health transition method to determine the subjective significance to patients of change in quality of life score over time.