Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: May 17, 2023
Date Accepted: Apr 10, 2024
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Effectiveness of electronic patient-reported outcomes in people with cancer: a systematic review and meta-analysis
ABSTRACT
Background:
Electronic Patient Reported Outcomes (ePROs) are commonly used in oncology clinical practice and have shown benefits for patients and health resource use. This review and meta-analysis examined effectiveness of ePROs compared to usual care for health-related outcomes in people with cancer.
Objective:
To compare the single effect of administering ePROs to patients with cancer versus a control condition.
Methods:
Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Randomised controlled trials evaluating ePRO interventions, improving health-related outcomes, among cancer patients were included. Primary outcome: health-related quality of life (HRQOL). Secondary outcomes: symptoms, hospital admissions, unplanned visits, chemotherapy completion, survival, and satisfaction with care. Effect size of ePROs on health-related outcomes were analysed as standardised mean differences with 95% confidence intervals using the random effects model.
Results:
The search identified 10965 papers. Nineteen papers from 15 studies were included. Meta-analysis showed an improvement in HRQOL at three months, measured by the Functional Assessment of Cancer Therapy- General (FACT-G) (SMD: 0.28 95% CI: -1.22 to 1.78), and at six months with various HRQOL measures (SMD: 0.07 95% CI: -1.24 to 1.39). Results should be interpreted with caution given the wide confidence intervals. Nine studies reported a positive signal on HRQOL with six including tailored patient advice and six using clinician alert systems.
Conclusions:
Meta-analysis showed a potential improvement in HRQOL at six months and in FACT-G scores at three months for studies that included tailored advice and clinician alerts suggesting these elements may improve ePRO effectiveness. Findings will provide guidance for future use and help healthcare professionals choose the most suitable ePRO features for their patients.
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