Feasibility and acceptance of electronic monitoring of symptoms and syndromes using a handheld computer in patients with advanced cancer in daily oncology practice.
OBJECTIVE
We investigated the feasibility and acceptance of electronic monitoring of symptoms and syndromes in oncological outpatient clinics using a PALM (handheld computer).


METHODS
The assessment of a combination of symptoms and clinical benefit parameters grouped in four pairs was tested in a pilot phase in advanced cancer patients. Based on these experiences, the software E-MOSAIC was developed, consisting of patient-reported symptoms and nutritional intake and objective assessments (weight, weight loss, performance status and medication for pain, fatigue, and cachexia). E-MOSAIC was then tested in four Swiss oncology centers. In order to compare the methods, patients completed the E-MOSAIC as a paper and a PALM version. Preferences of version and completion times were collected. Assessments were compared using Wilcoxon signed-rank tests , and the test-retest reliability was evaluated.


RESULTS
The pilot phase was completed by 22 patients. Most patients and physicians perceived the assessment as useful. Sixty-two patients participated in the feasibility study. Twelve patients reported problems (understanding, optical, tactile), and five patients could not complete the assessment. The median time to complete the PALM-based assessment was 3 min. Forty-nine percent of patients preferred the PALM, 23 % preferred a paper version, and 28 % of patients had no preference. Paper vs. PALM revealed no significant differences in symptoms, but in nutritional intake (p = 0.013). Test-retest (1 h, n = 20) reliability was satisfactory (r = 073-98).


CONCLUSIONS
Electronic symptom and clinical benefit monitoring is feasible in oncology outpatient clinics and perceived as useful by patients, oncology nurses, and oncologists. E-MOSAIC is tested in a prospective randomized trial.
Oncological Palliative Medicine, Oncology, Dept. Internal Medicine & Palliative Center, Cantonal Hospital, St. Gallen, Switzerland, david.blum@ntnu.no.
D
D
Blum
D
D
Koeberle
A
A
Omlin
J
J
Walker
R
R
Von Moos
W
W
Mingrone
S
S
deWolf-Linder
S
S
Hayoz
S
S
Kaasa
F
F
Strasser
K
K
Ribi
D000328:Adult; D000368:Aged; D034201:Computers, Handheld; D059026:Diagnostic Self Evaluation; D018450:Disease Progression; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000295:instrumentation* / Q000523:psychology; D009369:Neoplasms / Q000150:complications / Q000473:pathology / Q000628:therapy*; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D010147:Pain Measurement; D015203:Reproducibility of Results; D057566:Self Report; D012984:Software; D013577:Syndrome