Examining the effectiveness of electronic patient-reported outcomes in people with cancer: systematic review and meta-analysis

Abstract

Background: Electronic patient-reported outcomes (ePROs) are commonly used in oncology clinical practice and have shownbenefits for patients and health resource use.Objective: The aim of this study was to compare the isolated effect of administering ePROs to patients with cancer versus acontrol condition.Methods: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed.Randomized controlled trials evaluating ePRO interventions that aimed to improve health-related outcomes among patients withcancer were included. The primary outcome was health-related quality of life (HRQOL), and the secondary outcomes weresymptoms, hospital admissions, unplanned visits, chemotherapy completion, survival, and satisfaction with care. The effect sizesof ePROs on health-related outcomes were analyzed as standardized mean differences (SMDs) with 95% CIs using a randomeffects model.Results: The search identified 10,965 papers, of which 19 (0.17%) from 15 studies were included. The meta-analysis showedan improvement in HRQOL at 3 months, measured by the Functional Assessment of Cancer Therapy-General (SMD 0.28, 95%CI -1.22 to 1.78), and at 6 months, assessed using various HRQOL measures (SMD 0.07, 95% CI -1.24 to 1.39). The resultsshould be interpreted with caution, given the wide 95% CIs. Of the 15 studies, 9 (60%) reported a positive signal on HRQOL,with two-thirds of the studies (n=6, 67%) including tailored patient advice and two-thirds (n=6, 67%) using clinician alert systems.Conclusions: The meta-analysis showed a potential improvement in HRQOL at 6 months and in Functional Assessment ofCancer Therapy-General scores at 3 months for studies that included tailored advice and clinician alerts, suggesting that theseelements may improve ePRO effectiveness. The findings will provide guidance for future use and help health care professionalschoose the most suitable ePRO features for their patients