title: A prospective study of the feasibility and acceptability of a Web-based, electronic patient-reported outcome system in assessing patient recovery after major gynecologic cancer surgery.
abstract: OBJECTIVE
  The purposes of this study are to evaluate the feasibility of capturing patient-reported outcomes (PROs) electronically and to identify the most common distressing symptoms in women recovering from major gynecologic cancer surgery.
  
  
  METHODS
  This was a prospective, single-arm pilot study. Eligible participants included those scheduled for a laparotomy for presumed or known gynecologic malignancy. Patients completed a Web-based "STAR" (Symptom Tracking and Reporting for Patients) questionnaire once preoperatively and weekly during the 6-week postoperative period. The questionnaire consisted of the patient adaptation of the NCI CTCAE 3.0 and EORTC QLQ-C30 3.0. When a patient submitted a response that was concerning, an automated email alert was sent to the clinician. The patient's assessment of STAR's usefulness was measured via an exit survey.
  
  
  RESULTS
  Forty-nine patients completed the study. The procedures included the following: hysterectomy±staging (67%), resection of tumor (22%), salpingo-oophorectomy (6%), and other (4%). Most patients (82%) completed at least 4 sessions in STAR. The CTC generated 43 alerts. These alerts resulted in 25 telephone contacts with patients, 2 ER referrals, one new appointment, and one pharmaceutical prescription. The 3 most common patient-reported symptoms generating an alert were as follows: poor performance status (19%), nausea (18%), and fatigue (17%). Most patients found STAR useful (80%) and would recommend it to others (85%).
  
  
  CONCLUSIONS
  Application of a Web-based, electronic STAR system is feasible in the postoperative period, highly accepted by patients, and warrants further study. Poor performance status, nausea, and fatigue were the most common distressing patient-reported symptoms.
authors.affiliation: Gynecology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.
authors.forename: Vaagn
authors.initials: V
authors.lastname: Andikyan
authors.forename: Youssef
authors.initials: Y
authors.lastname: Rezk
authors.forename: M Heather
authors.initials: MH
authors.lastname: Einstein
authors.forename: Gina
authors.initials: G
authors.lastname: Gualtiere
authors.forename: Mario M
authors.initials: MM
authors.lastname: Leitao
authors.forename: Yukio
authors.initials: Y
authors.lastname: Sonoda
authors.forename: Nadeem R
authors.initials: NR
authors.lastname: Abu-Rustum
authors.forename: Richard R
authors.initials: RR
authors.lastname: Barakat
authors.forename: Ethan M
authors.initials: EM
authors.lastname: Basch
authors.forename: Dennis S
authors.initials: DS
authors.lastname: Chi
mesh_terms: D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D005833:Genital Neoplasms, Female / Q000601:surgery*; D013509:Gynecologic Surgical Procedures; D006801:Humans; D020407:Internet; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010865:Pilot Projects; D011183:Postoperative Complications / Q000453:epidemiology; D011184:Postoperative Period; D011446:Prospective Studies; D011788:Quality of Life; D057566:Self Report; D011795:Surveys and Questionnaires; D016896:Treatment Outcome