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为癌症患者带来最大的积极健康结果： 在支持性环境中为个人创造机会，让他们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，在广泛的诊断和阶段， 这些症状的发生率很高，可能会极大地影响生活质量。然而，临床医生也面临着 往往伴随着资源的缩减， 患者患者报告的结局和状态，特别是症状和生活质量（QOL）问题， 以可靠和系统的方式报告的信息，是信息的基本组成部分， 是临床评估、诊断和治疗计划的基础。在我们目前的临床试验中， 通过将筛查结果提供给医疗服务提供者，我们证明了患者症状评估的可行性和可接受性。 和QOL结果筛查在一个大型综合癌症中心。我们准备分析当前 数据，这将有助于我们回答对供应商沟通的影响的问题，但某些关键 问题仍然与患者和家庭护理人员描述和呈现的能力有关， 毫不犹豫地，症状和生活质量的问题，是关注。我们有证据表明 症状（例如，认知功能障碍）在面对面的临床访问中报告不足。这些发现 与患者报告的卵巢癌症状、癌症相关 疲劳和性活动的变化。能够将这些担忧传达给临床提供者， 要求患者和/或护理人员理解问题的重要性， 和方法进行沟通，临床提供者将确认并解决问题。的 本研究的目的是进一步评估临床，并重新评估远程，使用我们的增强 基于网络的癌症电子自我报告评估程序。癌症患者将使用 系统，以自我评估他们的症状和QOL之前，期间和之后的治疗。除了ESRA-C 总结给临床医生，突出关注的领域，我们的系统将提供一个定制的总结， 患者可以使用的格式，并通过三个信息指导每位患者：a）为什么以及多久一次 症状或QOL问题（SQI）通常发生在像您这样的患者中，B）可以处理，以及c）如何与 关于SQI的临床提供者。这些信息将有助于患者在面对面的诊所会议， 提供者，促进患者表达和沟通的问题，患者是 专家，癌症相关症状和QOL问题。这种双管齐下的方法， 沟通，提供给供应商和患者，被假设为是一个强大的辅助优秀的 临床监测和护理。癌症患者的诊断和分期范围很广，症状发生率很高 这可能会极大地影响生活质量。患者报告的结局和状态，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 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.