title: Computerized patient-reported symptom assessment in radiotherapy: a pilot randomized, controlled trial.
abstract: OBJECTIVE
  Computer-based, patient-reported symptom survey tools have been described for patients undergoing chemotherapy. We hypothesized that patients undergoing radiotherapy might also benefit, so we developed a computer application to acquire symptom ratings from patients and generate summaries for use at point of care office visits and conducted a randomized, controlled pilot trial to test its feasibility.
  
  
  METHODS
  Subjects were randomized prior to beginning radiotherapy. Both control and intervention group subjects completed the computerized symptom assessment, but only for the intervention group were printed symptom summaries made available before each weekly office visit. Metrics compared included the Global Distress Index (GDI), concordance of patient-reported symptoms and symptoms discussed by the physician and numbers of new and/or adjusted symptom management medications prescribed.
  
  
  RESULTS
  One hundred twelve patients completed the study: 54 in the control and 58 in the intervention arms. There were no differences in GDI over time between the control and intervention groups. In the intervention group, more patient-reported symptoms were actually discussed in radiotherapy office visits: 46/202 vs. 19/230. A sensitivity analysis to account for within-subjects correlation yielded 23.2 vs. 10.3 % (p = 0.03). Medications were started or adjusted at 15.4 % (43/280) of control visits compared to 20.4 % (65/319) of intervention visits (p = 0.07).
  
  
  CONCLUSIONS
  This computer application is easy to use and makes extensive patient-reported outcome data available at the point of care. Although no differences were seen in symptom trajectory, patients who had printed symptom summaries had improved communication during office visits and a trend towards a more active symptom management during radiotherapy.
authors.affiliation: Division of Hematology & Medical Oncology, OHSU Knight Cancer Institute, Oregon Health & Science University, Mail Code: L586, Portland, OR, 97239, USA. frommee@ohsu.edu.
authors.forename: Erik K
authors.initials: EK
authors.lastname: Fromme
authors.affiliation: Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd Unit 97, Houston, TX, 78240, USA. emmaholliday@gmail.com.
authors.forename: Emma B
authors.initials: EB
authors.lastname: Holliday
authors.affiliation: School of Nursing, Oregon Health & Science University, Portland, OR, USA.
authors.forename: Lillian M
authors.initials: LM
authors.lastname: Nail
authors.affiliation: School of Nursing, Oregon Health & Science University, Portland, OR, USA.
authors.forename: Karen S
authors.initials: KS
authors.lastname: Lyons
authors.affiliation: Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA.
authors.forename: Michelle R
authors.initials: MR
authors.lastname: Hribar
authors.affiliation: Department of Radiation Medicine, OHSU Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA.
authors.forename: Charles R
authors.initials: CR
authors.lastname: Thomas
mesh_terms: D000368:Aged; D003201:Computers / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D010865:Pilot Projects; D011795:Surveys and Questionnaires; D063189:Symptom Assessment / Q000379:methods*
keywords: Communication; Patient-reported outcomes; Radiation therapy; Supportive care