title: Symptoms, Quality of Life, and Daily Activities in People With Newly Diagnosed Solid Tumors Presenting to a Medical Oncologist.
abstract: BACKGROUND
  Symptom and Quality of Life (QOL) data are important patient reported outcomes. Early identification of these is critical for appropriate interventions. Data collection may be helped by modern information technology.
  
  
  OBJECTIVE
  This study examined symptoms and QOL in people with solid tumors at their first visit to a medical oncologist. We also evaluated the clinical utility of tablet computers (TC) to collect this data.
  
  
  METHODS
  This was a prospective study of 105 consecutive patients in the cancer outpatient clinic of a tertiary level academic medical center. Symptom and QOL data was collected by TC with wireless database upload.
  
  
  RESULTS
  One-third participants had moderate to severe pain; almost half clinically significant pain that interfered with daily activities. Tiredness, anxiety, and drowsiness were common (prevalence - 79%, 63% and 50% respectively). One-third of those who had items identified from the Edmonton System Assessment System also volunteered other symptoms, mostly gastrointestinal problems. Many of those affected also reported impaired Global Wellbeing and low Overall QOL. There was a 98% completion rate, which took on average ten minutes. Direct observation and informal feedback from patients and physicians regarding the acceptability of TC in this setting was uniformly positive.
  
  
  CONCLUSIONS
  Amongst people with newly diagnosed solid tumors clinically important psychological and physical symptoms, QOL problems and difficulties with daily activities were commonly present in the 24-hour period and in the week before a first Medical Oncology visit. Symptom and QOL data collection by TC in busy outpatient clinics showed good clinical utility.
authors.affiliation: 1 The Harry R. Horvitz Center for Palliative Medicine, Cleveland Clinic, Cleveland, OH, USA.|2 Section of Palliative Medicine and Supportive Oncology, Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA.
authors.forename: Shirley
authors.initials: S
authors.lastname: Thomas
authors.affiliation: 1 The Harry R. Horvitz Center for Palliative Medicine, Cleveland Clinic, Cleveland, OH, USA.|2 Section of Palliative Medicine and Supportive Oncology, Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA.|3 The Harry R Horvitz Chair in Palliative Medicine.|4 Faculty of Health Sciences, Trinity College, Dublin 2, Ireland.
authors.forename: Declan
authors.initials: D
authors.lastname: Walsh
authors.affiliation: 1 The Harry R. Horvitz Center for Palliative Medicine, Cleveland Clinic, Cleveland, OH, USA.|2 Section of Palliative Medicine and Supportive Oncology, Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA.
authors.forename: Shiva
authors.initials: S
authors.lastname: Shrotriya
authors.affiliation: 1 The Harry R. Horvitz Center for Palliative Medicine, Cleveland Clinic, Cleveland, OH, USA.|2 Section of Palliative Medicine and Supportive Oncology, Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA.
authors.forename: Aynur
authors.initials: A
authors.lastname: Aktas
authors.affiliation: 1 The Harry R. Horvitz Center for Palliative Medicine, Cleveland Clinic, Cleveland, OH, USA.|2 Section of Palliative Medicine and Supportive Oncology, Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Hullihen
authors.affiliation: 2 Section of Palliative Medicine and Supportive Oncology, Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA.
authors.forename: Bassam
authors.initials: B
authors.lastname: Estfan
authors.affiliation: 2 Section of Palliative Medicine and Supportive Oncology, Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA.
authors.forename: G Thomas
authors.initials: GT
authors.lastname: Budd
authors.affiliation: 5 Department of Cancer Research and Molecular Medicine, Norway and European Palliative Care Research Centre, Oslo Universitetssykehus, Oslo, Norway.|6 Department of Oncology, Regional Centre for Excellence in Palliative Care, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Marianne Jensen
authors.initials: MJ
authors.lastname: Hjermstad
authors.affiliation: 7 Palliative Medicine, University College, Dublin, Ireland.
authors.forename: Brenda
authors.initials: B
authors.lastname: O'Connor
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D001007:Anxiety / Q000453:epidemiology / Q000209:etiology; D005221:Fatigue / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000706:statistics & numerical data; D009369:Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000523:psychology*; D010146:Pain / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology
keywords: cancer; connected health; e-health; patient-reported outcomes; quality of life; symptoms