title: Enhancing patient-provider communication with the electronic self-report assessment for cancer: a randomized trial.
abstract: OBJECTIVE
  Although patient-reported cancer symptoms and quality-of-life issues (SQLIs) have been promoted as essential to a comprehensive assessment, efficient and efficacious methods have not been widely tested in clinical settings. The purpose of this trial was to determine the effect of the Electronic Self-Report Assessment-Cancer (ESRA-C) on the likelihood of SQLIs discussed between clinicians and patients with cancer in ambulatory clinic visits. Secondary objectives included comparison of visit duration between groups and usefulness of the ESRA-C as reported by clinicians.
  
  
  METHODS
  This randomized controlled trial was conducted in 660 patients with various cancer diagnoses and stages at two institutions of a comprehensive cancer center. Patient-reported SQLIs were automatically displayed on a graphical summary and provided to the clinical team before an on-treatment visit (n = 327); in the control group, no summary was provided (n = 333). SQLIs were scored for level of severity or distress. One on-treatment clinic visit was audio recorded for each participant and then scored for discussion of each SQLI. We hypothesized that problematic SQLIs would be discussed more often when the intervention was delivered to the clinicians.
  
  
  RESULTS
  The likelihood of SQLIs being discussed differed by randomized group and depended on whether an SQLI was first reported as problematic (P = .032). Clinic visits were similar with regard to duration between groups, and clinicians reported the summary as useful.
  
  
  CONCLUSIONS
  The ESRA-C is the first electronic self-report application to increase discussion of SQLIs in a US randomized clinical trial.
authors.affiliation: Harvard Medical School, Boston, MA, USA. donna_berry@dfci.harvard.edu
authors.forename: Donna L
authors.initials: DL
authors.lastname: Berry
authors.forename: Brent A
authors.initials: BA
authors.lastname: Blumenstein
authors.forename: Barbara
authors.initials: B
authors.lastname: Halpenny
authors.forename: Seth
authors.initials: S
authors.lastname: Wolpin
authors.forename: Jesse R
authors.initials: JR
authors.lastname: Fann
authors.forename: Mary
authors.initials: M
authors.lastname: Austin-Seymour
authors.forename: Nigel
authors.initials: N
authors.lastname: Bush
authors.forename: Bryant T
authors.initials: BT
authors.lastname: Karras
authors.forename: William B
authors.initials: WB
authors.lastname: Lober
authors.forename: Ruth
authors.initials: R
authors.lastname: McCorkle
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D003196:Computer Graphics; D020000:Decision Support Systems, Clinical; D034742:Electronic Mail; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D016017:Odds Ratio; D010817:Physician-Patient Relations; D011446:Prospective Studies; D011788:Quality of Life; D057566:Self Report; D014481:United States; D055815:Young Adult