Randomized Trial Comparing a Web-Mediated Follow-up With Routine Surveillance in Lung Cancer Patients.
Fabrice Denis,Claire Lethrosne,N. Pourel,Olivier Molinier,Yoann Pointreau,Julien Domont,Hugues Bourgeois,Hélène Senellart,P. Trémolières,T. Lizée,Jaafar Bennouna,Thierry Urban,Claude El Khouri,Alexandre Charron,Anne-Lise Septans,Magali Balavoine,Sébastien Landry,Philippe Solal-Celigny,Christophe Letellier +18 more
TLDR
A web-mediated follow-up algorithm based on self-reported symptoms improved OS due to early relapse detection and better performance status at relapse.Abstract:
Background: The use of web-based monitoring for lung cancer patients is growing in interest because of promising recent results suggesting improvement in cancer and resource utilization outcomes. It remains an open question whether the overall survival (OS) in these patients could be improved by using a web-mediated follow-up rather than classical scheduled follow-up and imaging. Methods: Advanced-stage lung cancer patients without evidence of disease progression after or during initial treatment were randomly assigned in a multicenter phase III trial to compare a web-mediated follow-up algorithm (experimental arm), based on weekly self-scored patient symptoms, with routine follow-up with CT scans scheduled every three to six months according to the disease stage (control arm). In the experimental arm, an alert email was automatically sent to the oncologist when self-scored symptoms matched predefined criteria. The primary outcome was OS. Results: From June 2014 to January 2016, 133 patients were enrolled and 121 were retained in the intent-to-treat analysis; 12 deemed ineligible after random assignment were not subsequently followed. Most of the patients (95.1%) had stage III or IV disease. The median follow-up was nine months. The median OS was 19.0 months (95% confidence interval [CI] = 12.5 to non-calculable) in the experimental and 12.0 months (95% CI = 8.6 to 16.4) in the control arm (one-sided P = .001) (hazard ratio = 0.32, 95% CI = 0.15 to 0.67, one-sided P = .002). The performance status at first detected relapse was 0 to 1 for 75.9% of the patients in the experimental arm and for 32.5% of those in the control arm (two-sided P \textless .001). Optimal treatment was initiated in 72.4% of the patients in the experimental arm and in 32.5% of those in the control arm (two-sided P \textless .001). Conclusions: A web-mediated follow-up algorithm based on self-reported symptoms improved OS due to early relapse detection and better performance status at relapse.read more
Citations
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Two-Year Survival Comparing Web-Based Symptom Monitoring vs Routine Surveillance Following Treatment for Lung Cancer.
Fabrice Denis,Ethan Basch,Anne Lise Septans,Jaafar Bennouna,Thierry Urban,Amylou C. Dueck,Christophe Letellier +6 more
TL;DR: In this article, the authors report 2-year survival outcomes among patients with advanced nonprogressive stage IIA to IV lung cancer randomized to symptom monitoring during chemotherapy via web-based patient-reported outcomes vs standard scheduled imaging after treatment to detect symptomatic recurrence.
Journal ArticleDOI
Real-world Data for Clinical Evidence Generation in Oncology.
TL;DR: Prospective collection of RWD can enable evidence generation based on pragmatic clinical trials (PCTs) that support randomized study designs and expand clinical research to the point of care and may help address the growing demands for access to experimental therapies while increasing patient participation in cancer clinical trials.
Journal ArticleDOI
What is the clinical value of mHealth for patients
TL;DR: Clinical guidance on how mobile apps should be utilized to add value to patient care is discussed and efforts to develop guidelines for the development of safe and effective mHealth apps in the US and elsewhere are discussed.
Journal ArticleDOI
Challenges for the evaluation of digital health solutions-A call for innovative evidence generation approaches.
TL;DR: This article reviews current research approaches and discusses their limitations; discusses challenges faced by different stakeholders in undertaking evaluations; and calls for new approaches to facilitate the safe and responsible growth of the digital health sector.
Journal ArticleDOI
The increasing value of eHealth in the delivery of patient-centred cancer care
Frank J. Penedo,Laura B. Oswald,Joshua P. Kronenfeld,Sofia F. Garcia,David Cella,Betina Yanez +5 more
TL;DR: A brief, narrative appraisal of the peer reviewed literature over the past 10 years related to the uses of patient-centred eHealth to improve cancer care delivery, including the addressal of symptom management, health-related quality of life, and other patient-reported outcomes across cancer care are provided.
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