Tenets for Implementing Electronic Patient-Reported Outcomes for Remote Symptom Monitoring During Cancer Treatment

Symptom monitoring with electronic patient-reported outcomes (ePROs) detects problems early, enabling care teams to intervene and prevent downstream complications and thereby improve outcomes. Tenets were developed from prior experiences and research to assist practices with implementing ePRO programs. These tenets include using a quality improvement approach to change management with attention to software functionality, measured outcomes, personnel deployment, leadership and culture, workflow, equity and patient engagement. Practices can optimize program participation and effectiveness by using these tenets and implementing continuous program monitoring to identify and address barriers

The Potential Role of Symptom Questionnaires in Palliative and Supportive Cancer Care Delivery

The American Society of Clinical Oncology (ASCO) palliative care recommendations have been updated into a full guideline. Symptom questionnaires—completed and reviewed with patients during care delivery—are poised to play a large role in this guideline because they provide a more comprehensive understanding of symptoms. This article provides an overview of the guideline and describes how symptom questionnaires can be used to satisfy the guideline

Readability of Colorectal Cancer Online Information: A Brief Report

Purpose: Colorectal cancer (CRC) is the third leading cause of cancer-related death in the United States. A decline in deaths caused by CRC has been largely attributable to screening and prompt treatment. Motivation, shown to influence cancer-related screening and treatment decisions, can be shaped by information from the Internet. The extent to which this information is easily readable on cancer-related websites is not known. The purpose of this study was to assess the readability levels of CRC information on 100 websites. Methods: Using methods from a prior study, the keyword, “colorectal cancer,” was searched on a cleared Internet browser. Scores for each website (n = 100) were generated using five commonly recommended readability tests. Results: All five tests demonstrated difficult readability for the majority of the websites. Conclusions: Online information related to CRC is difficult to read and highlights the need for developing cancer-related online material that is understandable to a wider audience

Financial Relationships With Industry Among National Comprehensive Cancer Network Guideline Authors

Financial conflicts of interest (FCOIs) among authors of clinical practice guidelines have the potential to influence treatment recommendations. To quantify FCOIs with industry among authors of the National Comprehensive Cancer Network (NCCN) guidelines. We assessed FCOIs occurring during 2014 among NCCN guideline authors in the United States. All were physician members of the NCCN guideline committees for lung, breast, prostate, and colorectal cancer as of the end of 2014. The data source for FCOIs was Open Payments, which is publically reported by the Centers for Medicare and Medicaid Services. This study was cross-sectional. The proportion of NCCN authors having FCOIs with industry; the average amount received from industry sources per author. Of 125 guideline authors, 108 (86%) had at least 1 reported FCOI. Authors received an average of $10 011 (range,$0-$106 859) in general payments (GPs), which include consulting, meals, lodging, and similar transfers of value, and$236 066 (range $0-$2 756 713) in industry research payments (RPs), including funding associated with clinical trials. Approximately 84% of authors received GPs, while 47% received RPs. Eight (6%) had FCOIs in excess of the $50 000 net and/or$20 000 single-company maximums stipulated by NCCN. Among NCCN guideline authors, FCOIs involving RPs were of greater value, while those involving GPs were more prevalent. Although FCOIs may result from engaging in important scholarship, FCOIs may still influence guideline authors in counterproductive ways. Research is needed to understand how best to manage author FCOIs during guideline creation

Patient-Reported Outcomes in Clinical Trials of Rare Diseases

The science of measuring patient-reported outcomes (PROs) has advanced substantially in recent decades, allowing evaluation of how patients feel and function in clinical research. Assessment of the patient experience in populations with rare diseases can be successfully achieved using PRO measures when careful planning and rigorous methods are employed. A number of challenges exist when designing and implementing PRO analyses in rare disease contexts, including heterogeneity of outcomes, availability of suitable measures, recruitment, and selection of appropriate data collection methods. Strategies to address these exist and have been employed in past clinical research, particularly in pediatric populations. PRO assessments in rare disease clinical trials have been particularly successful through partnerships between investigators, PRO methodologists, and patient organizations. The overall goal of PRO measurement is to understand the patient experience and it provides an essential part of evaluating the impact of disease and treatment