Currently submitted to: JMIR Cancer
Date Submitted: Apr 12, 2026
Open Peer Review Period: Apr 14, 2026 - Jun 9, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited.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.
Real-world impact of electronic patient-reported outcomes on early intervention in elderly patients with lung cancer: a prospective cohort study
ABSTRACT
Background:
Electronic patient-reported outcomes (ePRO) have demonstrated higher sensitivity in detecting adverse events than clinician-reported outcomes. However, conventional care faces challenges with recall bias, and evidence in real-world elderly populations is limited. This study evaluates the feasibility of an ePRO system integrated with Ecological Momentary Assessment (EMA) and Intervention (EMI) to facilitate a concordance model within the framework of Digital Transformation (DX) in healthcare.
Objective:
This study aims to evaluate the satisfaction, usability, and clinical impact of an ePRO system integrated with Ecological Momentary Assessment (EMA) and Intervention (EMI) in a real-world cohort of elderly lung cancer patients, investigating its ability to facilitate a patient-centered concordance model within the framework of Digital Transformation (DX) in healthcare.
Methods:
In this single-center prospective cohort study, 35 lung cancer patients used the "Welby My Carte ONC" application to record daily symptoms and visual data. Satisfaction and usability were evaluated using 1–10 scales at the end of the first and third treatment cycles. The study focused on the clinical impact of EMI triggered by ePRO data, such as early detection of toxicities.
Results:
The cohort included a high proportion of elderly patients (n=20 in their 70s and 80s). Satisfaction and usability scores significantly improved over time (Satisfaction: 6.0 to 8.0; Usability: 5.0 to 8.0). ePRO enabled early detection of critical events, including immune-related uveitis (Case 1), Stevens–Johnson syndrome (Case 2), rare drug-induced purpura (Case 3), and facilitated monitoring of infusion-related reactions (Case 4).
Conclusions:
ePRO is feasible for elderly lung cancer patients and enhances safety through timely EMI. It serves as a core component of a comprehensive Patient Support Program (PSP) and supports the transition to an active concordance model, ultimately improving patient well-being.
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