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| ID | Type | Description | Link |
|---|---|---|---|
| 1UM1CA233080-01 | U.S. NIH Grant/Contract | View source |
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| Name | Class |
|---|---|
| National Cancer Institute (NCI) | NIH |
| RTI International | OTHER |
| Baptist Memorial Health Care Corporation | OTHER |
| Dartmouth-Hitchcock Medical Center |
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Deficits in the management of common symptoms cause substantial morbidity for cancer patients.Because the health care delivery system is structured to be reactive and not proactive, there are missed opportunities to optimize symptom control. Growth in Internet access and proliferation of smartphones has created an opportunity to re-engineer cancer care delivery. Electronic symptom tracking and feedback is a promising strategy to improve symptom control. Electronic patient reported outcome (ePRO) monitoring of cancer symptoms has been shown to decrease symptom burden, improve quality of life, reduce acute care and even extend survival. SIMPRO will use functioning ePRO prototypes to create and refine the electronic symptom management system eSyM
A multi-disciplinary team of investigators from 6 health systems have formed the Symptom Management IMplementation of Patient Reported Outcomes in Oncology (SIMPRO) Research Center. SIMPRO will use functioning ePRO prototypes to create and refine the electronic symptom management system eSyM. eSyM is the name of the platform the team will refine, integrate, implement and evaluate. eSyM addresses each of the 4 evidence gaps by:
This project contains 5 activities:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Stakeholder Feedback (Control Period) | Other | Eligible stakeholders at each SIMPRO site were invited to provide feedback through focus groups, team meetings, and surveys before the trial rollout of eSyM to inform development and implementation. Stakeholders included:
|
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| Stakeholder Feedback (Intervention Period) | Other | Eligible stakeholders at each SIMPRO site were invited to provide feedback through surveys after the trial rollout of eSyM to inform intervention normalization and sustainability. Stakeholders included:
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| SASS Questionnaire Participants (Control Period) | Other | A subset of trial control patients were asked to complete a research questionnaire called the SASS Questionnaire before the roll-out of eSyM to assess patient outcomes including self-efficacy, attainment of informational needs, symptom burden, and satisfaction with care. |
|
| SASS Questionnaire Participants (Intervention Period) | Other | A subset of trial intervention patients were asked to complete a research questionnaire called the SASS Questionnaire after the roll-out of eSyM to assess patient outcomes including self-efficacy, attainment of informational needs, symptom burden, and satisfaction with care. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Stakeholder Survey (Control Period) | Other | Before eSyM go-live, study team members from each site will solicit input via emailed survey, remote meetings and/or in-person meeting on the use of ePROs in oncology from stakeholders to obtain input regarding adaptation, anticipated challenges, and implementation. |
| Measure | Description | Time Frame |
|---|---|---|
| Emergency Department Treat/Release [EDTR] Event Occurrence Status at Day 30 | The primary study outcome of the stepped wedge cluster RCT (randomized controlled trial) is the EDTR rate. This outcome will be defined in relation to the date of discharge from hospital (surgical cohort) or the initiation date of a new intravenous chemo regimen (medical oncology cohort). This is a binary outcome and we will analyze the absolute difference and odds ratio for the medical oncology and surgical cohorts combined and independently. | 30 days |
| Measure | Description | Time Frame |
|---|---|---|
| Emergency Department Treat/Release [EDTR] Event Occurrence Status at Day 90 | This outcome will be defined in relation to the date of discharge from hospital (surgical cohort) or the initiation date of a new intravenous chemo regimen (medical oncology cohort). This is a binary outcome and we will analyze the absolute difference and odds ratio for the medical oncology and surgical cohorts combined and independently. |
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Inclusion Criteria:
Stakeholder Feedback and Stakeholder Qualitative Interviews Population:
Cluster Randomized Trial, Patient QualitativeInterviews, Pilot Testing & SASS Questionnaire Population:
Age ≥ 18 years
Priority population will be patients who meet one of the following:
Total population allowed to use eSyM:
Exclusion Criteria:
- Participants not meeting the inclusion critera above.
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| Name | Affiliation | Role |
|---|---|---|
| Michael Hassett, MD | Dana-Farber Cancer Institute | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Maine Medical Center | Portland | Maine | 04101 | United States | ||
| Dana Farber Cancer Institute |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28055103 | Background | Siegel RL, Miller KD, Jemal A. Cancer Statistics, 2017. CA Cancer J Clin. 2017 Jan;67(1):7-30. doi: 10.3322/caac.21387. Epub 2017 Jan 5. | |
| 17951226 | Background | Cleeland CS. Symptom burden: multiple symptoms and their impact as patient-reported outcomes. J Natl Cancer Inst Monogr. 2007;(37):16-21. doi: 10.1093/jncimonographs/lgm005. |
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The Dana-Farber / Harvard Cancer Center encourages and supports the responsible and ethical sharing of data from clinical trials. De-identified participant data from the final research data set used in the published manuscript may only be shared under the terms of a Data Use Agreement. Requests may be directed to: [contact information for Sponsor Investigator or designee]. The protocol and statistical analysis plan will be made available on Clinicaltrials.gov only as required by federal regulation or as a condition of awards and agreements supporting the research
Data can be shared no earlier than 1 year following the date of publication
DFCI (Dana-Farber Cancer Institute) - Contact the Belfer Office for Dana-Farber Innovations (BODFI) at innovation@dfci.harvard.edu
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Eligible patients and stakeholders were recruited at the six participating sites between Jan. 2018 and Feb. 2023. As this was a stepped wedge trial, each period has distinct enrollment.
For the entire trial, grand total enrollment was 39,942 patients (21,112 control patients and 18,830 intervention patients).
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| ID | Title | Description |
|---|---|---|
| FG000 | Medical Oncology eSyM Site 1 | Periods 1-2: Transition phase with control & intervention participants enrolled Periods 3-7: eSyM Intervention participants enrolled |
| FG001 | Surgical eSyM Site 1 |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Period 1 (June 2018-August 2019) |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Aug 4, 2023 | May 7, 2025 |
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| OTHER |
| MaineHealth | OTHER |
| West Virginia University | OTHER |
| Lifespan | OTHER |
The primary study design is a hybrid effectiveness-implementation stepped-wedge cluster randomized trial involving several different research activities to assess outcomes.
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| Patient Qualitative Interviews | Other | A subset of trial intervention patients were asked to participate in a one-time patient interview to provide feedback on facilitators and barriers to eSyM implementation and adoption after the roll-out of eSyM. |
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| Stakeholder Qualitative Interviews | Other | A subset of eligible stakeholders at each site were asked to participate in a one-time interview to provide feedback on facilitators and barriers to eSyM implementation and adoption after the roll-out of eSyM. |
|
| Pilot Testing | Other | A subset of control patients at each site were selected to pilot test the eSyM intervention prior to trial start. |
|
| Cluster Randomized Trial (Control Patients) | No Intervention | These patients (and/or proxy) were seen at a participating site prior to the trial rollout of eSyM and were not exposed to the eSyM intervention. |
| Cluster Randomized Trial (Intervention Patients) | Experimental | These patients (and/or proxy) were seen at a participating site after the trial rollout of eSyM and were exposed to the eSyM intervention. |
|
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| Stakeholder Survey (Intervention Period) | Other | After eSyM go-live and on an ongoing basis, we will evaluate the implementation process at each of the sites with a focus on adoption, appropriateness, acceptability, sustainability, penetration, and scalability. We will do so through emailed surveys and/or discussions with health system leadership, clinicians, clinic support staff, and informatics/IT staff. |
|
| Qualitative Interview | Other | A small subset of patients and stakeholders were invited to take part in qualitative interviews after the eSyM trial rollout. |
|
| SASS Questionnaire | Other | A subset of control and intervention patients will be asked to complete a research questionnaire called the "SASS Questionnaire" asking about their Self-efficacy, Attainment of information needs, Symptom burden, and Satisfaction with care. |
|
| eSyM | Other | The electronic symptom management (eSyM) program is the EHR-integrated ePRO program being evaluated through this trial. |
|
| 90 days |
| Admissions Event Occurrence Status at Day 30 | This outcome will be defined in relation to the date of discharge from hospital (surgical cohort) or the initiation date of a new intravenous chemo regimen (medical oncology cohort). This is a binary outcome and we will analyze the absolute difference and odds ratio for the medical oncology and surgical cohorts combined and independently. | 30 Days |
| Admissions Event Occurrence Status at Day 90 | This outcome will be defined in relation to the date of discharge from hospital (surgical cohort) or the initiation date of a new intravenous chemo regimen (medical oncology cohort). This is a binary outcome and we will analyze the absolute difference and odds ratio for the medical oncology and surgical cohorts combined and independently. | 90 Days |
| Difference in Fatigue PROMIS Scores Reported by Participants Before and After eSyM Exposure | Difference in PROMIS fatigue scores between the pre-live and post-live eSyM cohorts. Since the two cohorts were comprised of different patients, comparisons were performed at the population level using mean T-scores. Fatigue was assessed using the PROMIS Fatigue 4-item short form with responses converted to T-scores (score range: 50 indicates the population mean with a standard deviation of 10; decrease in score indicates a positive change). All PROMIS items were scored using the standardized scoring tool kit. The differences in mean T-scores and the corresponding 95% confidence intervals (CI) were calculated for each PROMIS item, comparing the post-live versus pre-live cohort. When comparing group-level change in PROMIS scores, even trivial differences can be statistically significant if the sample size is large enough. The threshold to evaluate within-group change or to make a between-group comparison generally ranges between 2 and 6 T-score points (Terwee et al., 2021). | 30-90 days before and after eSyM go-live |
| Difference in Depression PROMIS Scores Reported by Participants Before and After eSyM Exposure | Difference in PROMIS depression scores between the pre-live and post-live eSyM cohorts. Since the two cohorts were comprised of different patients, comparisons were performed at the population level using mean T-scores. Depression was assessed using the PROMIS Emotional Distress-Depression 4-item short form with responses converted to T-scores (score range: 50 indicates the population mean with a standard deviation of 10; decrease in score indicates a positive change). All PROMIS items were scored using the standardized scoring tool kit. The differences in mean T-scores and the corresponding 95% confidence intervals (CI) were calculated for each PROMIS item, comparing the post-live versus pre-live cohort. When comparing group-level change in PROMIS scores, even trivial differences can be statistically significant if the sample size is large enough. The threshold to evaluate within-group change or to make a between-group comparison generally ranges between 2 and 6 T-score points. | 30-90 days before and after eSyM go-live |
| Difference in Anxiety PROMIS Scores Reported by Participants Before and After eSyM Exposure | Difference in PROMIS anxiety scores between the pre-live and post-live eSyM cohorts. Since the two cohorts were comprised of different patients, comparisons were performed at the population level using mean T-scores. Anxiety was assessed using the PROMIS Emotional Distress-Anxiety 4-item short form with responses converted to T-scores (score range: 50 indicates the population mean with a standard deviation of 10; decrease in score indicates a positive change). All PROMIS items were scored using the standardized scoring tool kit. The differences in mean T-scores and the corresponding 95% confidence intervals (CI) were calculated for each PROMIS item, comparing the post-live versus pre-live cohort. When comparing group-level change in PROMIS scores, even trivial differences can be statistically significant if the sample size is large enough. The threshold to evaluate within-group change or to make a between-group comparison generally ranges between 2 and 6 T-score points. | 30-90 days before and after eSyM go-live |
| Difference in Pain Interference PROMIS Scores Reported by Participants Before and After eSyM Exposure | Difference in PROMIS pain interference scores between the pre-live and post-live eSyM cohorts. Since the two cohorts were comprised of different patients, comparisons were performed at the population level using mean T-scores. Pain interference was assessed using the PROMIS Pain Interference 4-item short form with responses converted to T-scores (score range: 50 indicates the population mean with a standard deviation of 10; decrease in score indicates a positive change). All PROMIS items were scored using the standardized scoring tool kit. The differences in mean T-scores and the corresponding 95% confidence intervals (CI) were calculated for each PROMIS item, comparing the post-live versus pre-live cohort. When comparing group-level change in PROMIS scores, even trivial differences can be statistically significant if the sample size is large enough. The threshold to evaluate within-group change or to make a between-group comparison generally ranges between 2 and 6 T-score points. | 30-90 days before and after eSyM go-live |
| Difference in Self-Efficacy PROMIS Scores Reported by Participants Before and After eSyM Exposure | Difference in PROMIS self-efficacy scores between pre-live and post-live eSyM cohorts. Since the two cohorts were comprised of different patients, comparisons were performed at the population level using mean T-scores. Self-efficacy was assessed using the PROMIS Self-Efficacy for Managing Symptoms 8-item short form with responses converted to T-scores (score range: 50 indicates the population mean with a standard deviation of 10; decrease in score indicates a positive change). All PROMIS items were scored using the standardized scoring tool kit. The differences in mean T-scores and the corresponding 95% confidence intervals were calculated for each PROMIS item, comparing the post-live versus pre-live cohort. When comparing group-level change in PROMIS scores, even trivial differences can be statistically significant if the sample size is large enough. The threshold to evaluate within-group change or to make a between-group comparison generally ranges between 2 and 6 T-score points. | 30-90 days before and after eSyM go-live |
| Difference in Physical Function PROMIS Scores Reported by Participants Before and After eSyM Exposure | Difference in PROMIS physical function scores between the pre-live and post-live eSyM cohorts. Since the two cohorts were comprised of different patients, comparisons were performed at the population level using mean T-scores. Physical function was assessed using the PROMIS Physical Function 4-item short form with responses converted to T-scores (score range: 50 indicates the population mean with a standard deviation of 10; decrease in score indicates a positive change). All PROMIS items were scored using the standardized scoring tool kit. The differences in mean T-scores and the corresponding 95% confidence intervals (CI) were calculated for each PROMIS item, comparing the post-live versus pre-live cohort. When comparing group-level change in PROMIS scores, even trivial differences can be statistically significant if the sample size is large enough. The threshold to evaluate within-group change or to make a between-group comparison generally ranges between 2 and 6 T-score points). | 30-90 days before and after eSyM go-live |
| Emergency Department Treat/Release [EDTR] Event Occurrence Status at Day 30 (Comparing eSyM Intervention Responders Versus Non-Responders) | The secondary study outcome of the stepped wedge cluster RCT (randomized controlled trial) is the difference in the EDTR rate between eSyM responders and non-responders. This outcome will be defined in relation to the date of discharge from hospital (surgical cohort) or the initiation date of a new intravenous chemo regimen (medical oncology cohort). This is a binary outcome and we will analyze the absolute difference and odds ratio for the medical oncology and surgical cohorts combined and independently. NOTE: The total number of intervention participants in this analysis is greater than the number of intervention participants included in the primary analyses (outcomes 1-4). For outcomes outcomes 1-4, we used the patient's first event during the entire study period. To conduct this analysis of eSyM responders, we used the patient's first event during the intervention period. Approximately 10% of patients in this analysis were counted as a control event in the prior analyses. | 30 days |
| Emergency Department Treat/Release [EDTR] Event Occurrence Status at Day 90 (Comparing eSyM Intervention Responders Versus Non-Responders) | This outcome will be defined in relation to the date of discharge from hospital (surgical cohort) or the initiation date of a new intravenous chemo regimen (medical oncology cohort). This is a binary outcome and we will analyze the absolute difference and odds ratio for the medical oncology and surgical cohorts combined and independently. NOTE: The total number of intervention participants in this analysis is greater than the number of intervention participants included in the primary analyses (outcomes 1-4). For outcomes outcomes 1-4, we used the patient's first event during the entire study period. To conduct this analysis of eSyM responders, we used the patient's first event during the intervention period. Approximately 10% of patients in this analysis were counted as a control event in the prior analyses. | 90 days |
| Admissions Event Occurrence Status at Day 30 (Comparing eSyM Intervention Responders Versus Non-Responders) | This outcome will be defined in relation to the date of discharge from hospital (surgical cohort) or the initiation date of a new intravenous chemo regimen (medical oncology cohort). This is a binary outcome and we will analyze the absolute difference and odds ratio for the medical oncology and surgical cohorts combined and independently. NOTE: The total number of intervention participants in this analysis is greater than the number of intervention participants included in the primary analyses (outcomes 1-4). For outcomes outcomes 1-4, we used the patient's first event during the entire study period. To conduct this analysis of eSyM responders, we used the patient's first event during the intervention period. Approximately 10% of patients in this analysis were counted as a control event in the prior analyses. | 30 Days |
| Admissions Event Occurrence Status at Day 90 (Comparing eSyM Intervention Responders Versus Non-Responders) | This outcome will be defined in relation to the date of discharge from hospital (surgical cohort) or the initiation date of a new intravenous chemo regimen (medical oncology cohort). This is a binary outcome and we will analyze the absolute difference and odds ratio for the medical oncology and surgical cohorts combined and independently. NOTE: The total number of intervention participants in this analysis is greater than the number of intervention participants included in the primary analyses (outcomes 1-4). For outcomes outcomes 1-4, we used the patient's first event during the entire study period. To conduct this analysis of eSyM responders, we used the patient's first event during the intervention period. Approximately 10% of patients in this analysis were counted as a control event in the prior analyses. | 90 Days |
| Boston |
| Massachusetts |
| 02115 |
| United States |
| Dartmouth-Hitchcock Medical Center | Lebanon | New Hampshire | 03756 | United States |
| Brown University Health (formerly Lifespan Cancer Institute) | Providence | Rhode Island | 02905 | United States |
| Baptist Memoiral HealthCare | Memphis | Tennessee | 38120 | United States |
| West Virginia University Medical Center | Morgantown | West Virginia | 26506 | United States |
| 17573451 | Background | Hofman M, Ryan JL, Figueroa-Moseley CD, Jean-Pierre P, Morrow GR. Cancer-related fatigue: the scale of the problem. Oncologist. 2007;12 Suppl 1:4-10. doi: 10.1634/theoncologist.12-S1-4. |
| 17509812 | Background | Teunissen SC, Wesker W, Kruitwagen C, de Haes HC, Voest EE, de Graeff A. Symptom prevalence in patients with incurable cancer: a systematic review. J Pain Symptom Manage. 2007 Jul;34(1):94-104. doi: 10.1016/j.jpainsymman.2006.10.015. Epub 2007 May 23. |
| 16512977 | Background | Temel JS, Pirl WF, Lynch TJ. Comprehensive symptom management in patients with advanced-stage non-small-cell lung cancer. Clin Lung Cancer. 2006 Jan;7(4):241-9. doi: 10.3816/CLC.2006.n.001. |
| 16580563 | Background | Janjan N. Palliation and supportive care in radiation medicine. Hematol Oncol Clin North Am. 2006 Feb;20(1):187-211. doi: 10.1016/j.hoc.2006.01.010. |
| 15263052 | Background | Fleishman SB. Treatment of symptom clusters: pain, depression, and fatigue. J Natl Cancer Inst Monogr. 2004;(32):119-23. doi: 10.1093/jncimonographs/lgh028. |
| 28657940 | Background | Hernandez-Boussard T, Graham LA, Desai K, Wahl TS, Aucoin E, Richman JS, Morris MS, Itani KM, Telford GL, Hawn MT. The Fifth Vital Sign: Postoperative Pain Predicts 30-day Readmissions and Subsequent Emergency Department Visits. Ann Surg. 2017 Sep;266(3):516-524. doi: 10.1097/SLA.0000000000002372. |
| 25891437 | Background | Kenzik KM, Ganz PA, Martin MY, Petersen L, Hays RD, Arora N, Pisu M. How much do cancer-related symptoms contribute to health-related quality of life in lung and colorectal cancer patients? A report from the Cancer Care Outcomes Research and Surveillance (CanCORS) Consortium. Cancer. 2015 Aug 15;121(16):2831-9. doi: 10.1002/cncr.29415. Epub 2015 Apr 17. |
| 35710449 | Background | Hassett MJ, Wong S, Osarogiagbon RU, Bian J, Dizon DS, Jenkins HH, Uno H, Cronin C, Schrag D; SIMPRO Co-Investigators. Implementation of patient-reported outcomes for symptom management in oncology practice through the SIMPRO research consortium: a protocol for a pragmatic type II hybrid effectiveness-implementation multi-center cluster-randomized stepped wedge trial. Trials. 2022 Jun 16;23(1):506. doi: 10.1186/s13063-022-06435-1. |
| 34985914 | Result | Hassett MJ, Cronin C, Tsou TC, Wedge J, Bian J, Dizon DS, Hazard-Jenkins H, Osarogiagbon RU, Wong S, Basch E, Austin T, McCleary N, Schrag D. eSyM: An Electronic Health Record-Integrated Patient-Reported Outcomes-Based Cancer Symptom Management Program Used by Six Diverse Health Systems. JCO Clin Cancer Inform. 2022 Jan;6:e2100137. doi: 10.1200/CCI.21.00137. |
| 38445744 | Result | Paudel R, Enzinger AC, Uno H, Cronin C, Wong SL, Dizon DS, Hazard Jenkins H, Bian J, Osarogiagbon RU, Jensen RE, Mitchell SA, Schrag D, Hassett MJ. Effects of a change in recall period on reporting severe symptoms: an analysis of a pragmatic multisite trial. J Natl Cancer Inst. 2024 Jul 1;116(7):1137-1144. doi: 10.1093/jnci/djae049. |
| 38011613 | Result | Paudel R, Tramontano AC, Cronin C, Wong SL, Dizon DS, Jenkins HH, Bian J, Osarogiagbon RU, Schrag D, Hassett MJ. Assessing Patient Readiness for an Electronic Patient-Reported Outcome-Based Symptom Management Intervention in a Multisite Study. JCO Oncol Pract. 2024 Jan;20(1):77-84. doi: 10.1200/OP.23.00339. Epub 2023 Nov 27. |
| 31452053 | Result | Ivatury SJ, Hazard-Jenkins HW, Brooks GA, McCleary NJ, Wong SL, Schrag D. Translation of Patient-Reported Outcomes in Oncology Clinical Trials to Everyday Practice. Ann Surg Oncol. 2020 Jan;27(1):65-72. doi: 10.1245/s10434-019-07749-2. Epub 2019 Aug 26. |
| 31463699 | Result | Phillips JD, Wong SL. Patient-Reported Outcomes in Surgical Oncology: An Overview of Instruments and Scores. Ann Surg Oncol. 2020 Jan;27(1):45-53. doi: 10.1245/s10434-019-07752-7. Epub 2019 Aug 28. |
| 39533260 | Result | Hassett M, Dias S, Cronin C, Schrag D, McCleary N, Simpson J, Poirier-Shelton T, Bian J, Reich J, Dizon D, Begnoche M, Jenkins HH, Tasker L, Wong S, Pearson L, Paudel R, Osarogiagbon RU. Strategies for implementing an electronic patient-reported outcomes-based symptom management program across six cancer centers. BMC Health Serv Res. 2024 Nov 12;24(1):1386. doi: 10.1186/s12913-024-11536-5. |
| 39486014 | Result | Paudel R, Dias S, Wade CG, Cronin C, Hassett MJ. Use of Patient-Reported Outcomes in Risk Prediction Model Development to Support Cancer Care Delivery: A Scoping Review. JCO Clin Cancer Inform. 2024 Nov;8:e2400145. doi: 10.1200/CCI-24-00145. Epub 2024 Nov 1. |
| 40257368 | Result | Mallow J, Bailey A, Tasker L, Hazard H, Hassett M, Cronin C, Paudel R, Bian J, Dizon DS, Osarogiagbon RU, Schrag D, Wong SL. Perceptions of an Electronic Patient Symptom Reporting Tool by Clinicians. Comput Inform Nurs. 2026 Jan 1;44(1):e01313. doi: 10.1097/CIN.0000000000001313. |
| 40631021 | Result | Beqari J, Hurd J, Tramontano AC, Cronin C, Potter A, Wong S, Schrag D, Dizon DS, Bian J, Osarogiagbon RU, Hazard-Jenkins H, Phillips JD, Abbas AE, Warikoo IM, Anderson M, Seastedt KP, Lanuti M, Colson YL, Wright CD, Hassett M, Jeffrey Yang CF. The implementation of an electronic symptom management system to monitor postoperative pain in thoracic surgery patients: A multicenter evaluation. JTCVS Open. 2025 Feb 25;25:485-499. doi: 10.1016/j.xjon.2025.02.010. eCollection 2025 Jun. |
| Result | Cronin, C., Barrett, F., Dias, S., Wong, S. L., Pearson, L., Hazard-Jenkins, H., Bian, J. J., Dizon, D. S., Osarogiagbon, R. U., Schrag, D., & Hassett, M. J. (2024). Electronic Patient-Reported Outcomes in Oncology: Lessons from Six Cancer Centers. NEJM Catalyst Innovations in Care Delivery, 5(2). https://doi.org/10.1056/cat.23.0331 |
| 41941188 | Derived | Paudel R, Wright AA, Cronin C, Uno H, Barrett F, Brooks G, Jenkins HH, Wong SL, Dizon DS, Bian J, Osarogiagbon RU, Schrag D, Hassett MJ. Longitudinal Patterns of Symptoms in Patients Undergoing Chemotherapy: A Secondary Analysis of a Cluster Randomized Clinical Trial. JAMA Netw Open. 2026 Apr 1;9(4):e264996. doi: 10.1001/jamanetworkopen.2026.4996. |
| 40524282 | Derived | Kuharic M, Merle JL, Cella D, Mitchell SA, DiMartino L, Ridgeway JL, Dizon DS, Paudel R, Austin JD, Wong SL, Flores AM, Cheville AL, Smith JD; IMPACT Consortium. Psychometric evaluation of the NoMAD instrument in cancer care settings: assessing factorial validity, measurement invariance, and differential item functioning. Implement Sci Commun. 2025 Jun 16;6(1):72. doi: 10.1186/s43058-025-00756-3. |
Period 1-6: No eSyM Intervention (Control Period) Period 7: Transition phase with control and intervention participants enrolled
| FG002 | Medical Oncology eSyM Site 2 | Periods 1-2: No eSyM Intervention (Control Period) Period 3: Transition phase with both control and intervention participants enrolled Periods 4-7: eSyM Intervention Period |
| FG003 | Surgical eSyM Site 2 | Periods 1-5: No eSyM Intervention (Control Period) Periods 6: Transition phase with both control and intervention participants enrolled Period 7: eSyM intervention participants enrolled |
| FG004 | Medical Oncology eSyM Site 3 | Periods 1-3: No eSyM Intervention (Control Period) Period 4: Transition phase with both control and intervention participants enrolled Periods 5-7: eSyM Intervention Period |
| FG005 | Surgical eSyM Site 3 | Periods 1-4: No eSyM Intervention (Control Period) Period 5: Transition phase with control and intervention participants enrolled Periods 6-7: eSyM Intervention Period |
| FG006 | Medical Oncology eSyM Site 4 | Periods 1-5: No eSyM Intervention (Control Period) Period 6: Transition phase with control and intervention participants enrolled Periods 7: eSyM Intervention Period |
| FG007 | Surgical eSyM Site 4 | Periods 1-3: No eSyM Intervention (Control Period) Period 4: Transition phase with control and intervention participants enrolled Periods 5-7: eSyM Intervention Period |
| FG008 | Medical Oncology eSyM Site 5 | Periods 1-5: No eSyM Intervention (Control Period) Period 6: Transition phase with control and intervention participants enrolled Period 7: eSyM Intervention Period |
| FG009 | Surgical eSyM Site 5 | Periods 1-2: No eSyM Intervention (Control Period) Period 3: Transition phase with control and intervention participants enrolled Periods 4-7: eSyM Intervention Period |
| FG010 | Medical Oncology eSyM Site 6 | Periods 1-6: No eSyM Intervention (Control Period) Periods 7: Transition phase with control and intervention participants |
| FG011 | Surgical eSyM Site 6 | Periods 1: No eSyM Intervention (Control Period) Period 2: Transition phase with control and intervention participants enrolled Periods 3-7: eSyM Intervention Period |
| COMPLETED |
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| NOT COMPLETED |
|
| Period 2 (September 2019-February 2020) |
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| Period 3 (March 2020-August 2020) |
|
| Period 4 (September 2020-February 2021) |
|
| Period 5 (March 2021-August 2021) |
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| Period 6 (September 2021-February 2022) |
|
| Period 7 (March 2022-February 2023) |
|
Please note: demographics for both medical oncology and surgical patients are combined because the primary analysis evaluated the entire cohort combined together. The pre-specified analysis plan in the study protocol was to report baseline characteristics data for medical oncology and surgery combined.
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| ID | Title | Description |
|---|---|---|
| BG000 | eSyM Control Participants (Medical Oncology and Surgery Participants Combined) | These patients (and/or proxy) were seen at a participating site prior to the trial rollout of eSyM and were not exposed to the eSyM intervention. This group includes the following trial subsets:
Please note: demographics for both medical oncology and surgical patients are combined because the primary analysis evaluated the entire cohort combined together. |
| BG001 | eSyM Intervention Participants (Medical Oncology and Surgery Participants Combined) | These patients (and/or proxy) were seen at a participating site after the trial rollout of eSyM and were exposed to the eSyM intervention. This group includes the following trial subsets:
Please note: demographics for both medical oncology and surgical patients are combined because the primary analysis evaluated the entire cohort combined together. |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Median | Inter-Quartile Range | years |
| |||||||||||||||
| Sex/Gender, Customized | Count of Participants | Participants |
| ||||||||||||||||
| Race/Ethnicity, Customized | Count of Participants | Participants |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Primary | Emergency Department Treat/Release [EDTR] Event Occurrence Status at Day 30 | The primary study outcome of the stepped wedge cluster RCT (randomized controlled trial) is the EDTR rate. This outcome will be defined in relation to the date of discharge from hospital (surgical cohort) or the initiation date of a new intravenous chemo regimen (medical oncology cohort). This is a binary outcome and we will analyze the absolute difference and odds ratio for the medical oncology and surgical cohorts combined and independently. | The primary analysis included data from both medical oncology and surgery. As a secondary analysis, we analyzed the data from MO and Surg separately and estimated the intervention effect for each outcome. Results for both combined and separate analyses are reported below. | Posted | Number | percentage of patients with event | 30 days |
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| Secondary | Emergency Department Treat/Release [EDTR] Event Occurrence Status at Day 90 | This outcome will be defined in relation to the date of discharge from hospital (surgical cohort) or the initiation date of a new intravenous chemo regimen (medical oncology cohort). This is a binary outcome and we will analyze the absolute difference and odds ratio for the medical oncology and surgical cohorts combined and independently. | The primary analysis included data from both medical oncology and surgery. As a secondary analysis, we analyzed the data from MO and Surg separately and estimated the intervention effect for each outcome. Results for both combined and separate analyses are reported below. | Posted | Number | percentage of patients with event | 90 days |
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| Secondary | Admissions Event Occurrence Status at Day 30 | This outcome will be defined in relation to the date of discharge from hospital (surgical cohort) or the initiation date of a new intravenous chemo regimen (medical oncology cohort). This is a binary outcome and we will analyze the absolute difference and odds ratio for the medical oncology and surgical cohorts combined and independently. | The primary analysis included data from both medical oncology and surgery. As a secondary analysis, we analyzed the data from MO and Surg separately and estimated the intervention effect for each outcome. Results for both combined and separate analyses are reported below. | Posted | Number | percentage of patients with event | 30 Days |
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| Secondary | Admissions Event Occurrence Status at Day 90 | This outcome will be defined in relation to the date of discharge from hospital (surgical cohort) or the initiation date of a new intravenous chemo regimen (medical oncology cohort). This is a binary outcome and we will analyze the absolute difference and odds ratio for the medical oncology and surgical cohorts combined and independently. | The primary analysis included data from both medical oncology and surgery. As a secondary analysis, we analyzed the data from MO and Surg separately and estimated the intervention effect for each outcome. Results for both combined and separate analyses are reported below. | Posted | Number | percentage of patients with event | 90 Days |
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| Secondary | Difference in Fatigue PROMIS Scores Reported by Participants Before and After eSyM Exposure | Difference in PROMIS fatigue scores between the pre-live and post-live eSyM cohorts. Since the two cohorts were comprised of different patients, comparisons were performed at the population level using mean T-scores. Fatigue was assessed using the PROMIS Fatigue 4-item short form with responses converted to T-scores (score range: 50 indicates the population mean with a standard deviation of 10; decrease in score indicates a positive change). All PROMIS items were scored using the standardized scoring tool kit. The differences in mean T-scores and the corresponding 95% confidence intervals (CI) were calculated for each PROMIS item, comparing the post-live versus pre-live cohort. When comparing group-level change in PROMIS scores, even trivial differences can be statistically significant if the sample size is large enough. The threshold to evaluate within-group change or to make a between-group comparison generally ranges between 2 and 6 T-score points (Terwee et al., 2021). | Since only a subset of eSyM patients completed the SASS questionnaire which included PROMIS measures, the analyzed population is smaller than other analytic populations. Distinct surveys were given to medical oncology and surgical patients to account for differences in their care, so the analytic cohorts below are distinct. Results for both the medical oncology and surgical subsets are included below. | Posted | Geometric Mean | Standard Deviation | T-Score | 30-90 days before and after eSyM go-live |
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| Secondary | Difference in Depression PROMIS Scores Reported by Participants Before and After eSyM Exposure | Difference in PROMIS depression scores between the pre-live and post-live eSyM cohorts. Since the two cohorts were comprised of different patients, comparisons were performed at the population level using mean T-scores. Depression was assessed using the PROMIS Emotional Distress-Depression 4-item short form with responses converted to T-scores (score range: 50 indicates the population mean with a standard deviation of 10; decrease in score indicates a positive change). All PROMIS items were scored using the standardized scoring tool kit. The differences in mean T-scores and the corresponding 95% confidence intervals (CI) were calculated for each PROMIS item, comparing the post-live versus pre-live cohort. When comparing group-level change in PROMIS scores, even trivial differences can be statistically significant if the sample size is large enough. The threshold to evaluate within-group change or to make a between-group comparison generally ranges between 2 and 6 T-score points. | Since only a subset of eSyM patients completed the SASS questionnaire which included PROMIS measures, the analyzed population is smaller than other analytic populations. Distinct surveys were given to medical oncology and surgical patients to account for differences in their care, so the analytic cohorts below are distinct. Results for both the medical oncology and surgical subsets are included below. | Posted | Geometric Mean | Standard Deviation | T-Score | 30-90 days before and after eSyM go-live |
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| Secondary | Difference in Anxiety PROMIS Scores Reported by Participants Before and After eSyM Exposure | Difference in PROMIS anxiety scores between the pre-live and post-live eSyM cohorts. Since the two cohorts were comprised of different patients, comparisons were performed at the population level using mean T-scores. Anxiety was assessed using the PROMIS Emotional Distress-Anxiety 4-item short form with responses converted to T-scores (score range: 50 indicates the population mean with a standard deviation of 10; decrease in score indicates a positive change). All PROMIS items were scored using the standardized scoring tool kit. The differences in mean T-scores and the corresponding 95% confidence intervals (CI) were calculated for each PROMIS item, comparing the post-live versus pre-live cohort. When comparing group-level change in PROMIS scores, even trivial differences can be statistically significant if the sample size is large enough. The threshold to evaluate within-group change or to make a between-group comparison generally ranges between 2 and 6 T-score points. | Since only a subset of eSyM patients completed the SASS questionnaire which included PROMIS measures, the analyzed population is smaller than other analytic populations. Distinct surveys were given to medical oncology and surgical patients to account for differences in their care, so the analytic cohorts below are distinct. Results for both the medical oncology and surgical subsets are included below. | Posted | Geometric Mean | Standard Deviation | T-Score | 30-90 days before and after eSyM go-live |
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| Secondary | Difference in Pain Interference PROMIS Scores Reported by Participants Before and After eSyM Exposure | Difference in PROMIS pain interference scores between the pre-live and post-live eSyM cohorts. Since the two cohorts were comprised of different patients, comparisons were performed at the population level using mean T-scores. Pain interference was assessed using the PROMIS Pain Interference 4-item short form with responses converted to T-scores (score range: 50 indicates the population mean with a standard deviation of 10; decrease in score indicates a positive change). All PROMIS items were scored using the standardized scoring tool kit. The differences in mean T-scores and the corresponding 95% confidence intervals (CI) were calculated for each PROMIS item, comparing the post-live versus pre-live cohort. When comparing group-level change in PROMIS scores, even trivial differences can be statistically significant if the sample size is large enough. The threshold to evaluate within-group change or to make a between-group comparison generally ranges between 2 and 6 T-score points. | Since only a subset of eSyM patients completed the SASS questionnaire which included PROMIS measures, the analyzed population is smaller than other analytic populations. Distinct surveys were given to medical oncology and surgical patients to account for differences in their care, so the analytic cohorts below are distinct. Results for both the medical oncology and surgical subsets are included below. | Posted | Geometric Mean | Standard Deviation | T-Score | 30-90 days before and after eSyM go-live |
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| Secondary | Difference in Self-Efficacy PROMIS Scores Reported by Participants Before and After eSyM Exposure | Difference in PROMIS self-efficacy scores between pre-live and post-live eSyM cohorts. Since the two cohorts were comprised of different patients, comparisons were performed at the population level using mean T-scores. Self-efficacy was assessed using the PROMIS Self-Efficacy for Managing Symptoms 8-item short form with responses converted to T-scores (score range: 50 indicates the population mean with a standard deviation of 10; decrease in score indicates a positive change). All PROMIS items were scored using the standardized scoring tool kit. The differences in mean T-scores and the corresponding 95% confidence intervals were calculated for each PROMIS item, comparing the post-live versus pre-live cohort. When comparing group-level change in PROMIS scores, even trivial differences can be statistically significant if the sample size is large enough. The threshold to evaluate within-group change or to make a between-group comparison generally ranges between 2 and 6 T-score points. | Since only a subset of eSyM patients completed the SASS questionnaire which included PROMIS measures, the analyzed population is smaller than other analytic populations. Distinct surveys were given to medical oncology and surgical patients to account for differences in their care, so the analytic cohorts below are distinct. Results for both the medical oncology and surgical subsets are included below. | Posted | Geometric Mean | Standard Deviation | T-Score | 30-90 days before and after eSyM go-live |
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| Secondary | Difference in Physical Function PROMIS Scores Reported by Participants Before and After eSyM Exposure | Difference in PROMIS physical function scores between the pre-live and post-live eSyM cohorts. Since the two cohorts were comprised of different patients, comparisons were performed at the population level using mean T-scores. Physical function was assessed using the PROMIS Physical Function 4-item short form with responses converted to T-scores (score range: 50 indicates the population mean with a standard deviation of 10; decrease in score indicates a positive change). All PROMIS items were scored using the standardized scoring tool kit. The differences in mean T-scores and the corresponding 95% confidence intervals (CI) were calculated for each PROMIS item, comparing the post-live versus pre-live cohort. When comparing group-level change in PROMIS scores, even trivial differences can be statistically significant if the sample size is large enough. The threshold to evaluate within-group change or to make a between-group comparison generally ranges between 2 and 6 T-score points). | Since only a subset of eSyM patients completed the SASS questionnaire which included PROMIS measures, the analyzed population is smaller than other analytic populations. Distinct surveys were given to medical oncology and surgical patients to account for differences in their care, so the analytic cohorts below are distinct. Results for both the medical oncology and surgical subsets are included below. | Posted | Geometric Mean | Standard Deviation | T-Score | 30-90 days before and after eSyM go-live |
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| Secondary | Emergency Department Treat/Release [EDTR] Event Occurrence Status at Day 30 (Comparing eSyM Intervention Responders Versus Non-Responders) | The secondary study outcome of the stepped wedge cluster RCT (randomized controlled trial) is the difference in the EDTR rate between eSyM responders and non-responders. This outcome will be defined in relation to the date of discharge from hospital (surgical cohort) or the initiation date of a new intravenous chemo regimen (medical oncology cohort). This is a binary outcome and we will analyze the absolute difference and odds ratio for the medical oncology and surgical cohorts combined and independently. NOTE: The total number of intervention participants in this analysis is greater than the number of intervention participants included in the primary analyses (outcomes 1-4). For outcomes outcomes 1-4, we used the patient's first event during the entire study period. To conduct this analysis of eSyM responders, we used the patient's first event during the intervention period. Approximately 10% of patients in this analysis were counted as a control event in the prior analyses. | The primary analysis included data from both medical oncology and surgery. As a secondary analysis, we analyzed the data from MO and Surg separately and estimated the intervention effect for each outcome. Results for both combined and separate analyses are reported below. NOTE: To conduct this analysis of eSyM responders, we used the patient's first event during the intervention period. Approximately 10% of patients in this analysis were counted as a control event in outcomes 1-4. | Posted | Number | percentage of patients with event | 30 days |
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| Secondary | Emergency Department Treat/Release [EDTR] Event Occurrence Status at Day 90 (Comparing eSyM Intervention Responders Versus Non-Responders) | This outcome will be defined in relation to the date of discharge from hospital (surgical cohort) or the initiation date of a new intravenous chemo regimen (medical oncology cohort). This is a binary outcome and we will analyze the absolute difference and odds ratio for the medical oncology and surgical cohorts combined and independently. NOTE: The total number of intervention participants in this analysis is greater than the number of intervention participants included in the primary analyses (outcomes 1-4). For outcomes outcomes 1-4, we used the patient's first event during the entire study period. To conduct this analysis of eSyM responders, we used the patient's first event during the intervention period. Approximately 10% of patients in this analysis were counted as a control event in the prior analyses. | The primary analysis included data from both medical oncology and surgery. As a secondary analysis, we analyzed the data from MO and Surg separately and estimated the intervention effect for each outcome. Results for both combined and separate analyses are reported below. NOTE: To conduct this analysis of eSyM responders, we used the patient's first event during the intervention period. Approximately 10% of patients in this analysis were counted as a control event in outcomes 1-4. | Posted | Number | percentage of patients with event | 90 days |
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| Secondary | Admissions Event Occurrence Status at Day 30 (Comparing eSyM Intervention Responders Versus Non-Responders) | This outcome will be defined in relation to the date of discharge from hospital (surgical cohort) or the initiation date of a new intravenous chemo regimen (medical oncology cohort). This is a binary outcome and we will analyze the absolute difference and odds ratio for the medical oncology and surgical cohorts combined and independently. NOTE: The total number of intervention participants in this analysis is greater than the number of intervention participants included in the primary analyses (outcomes 1-4). For outcomes outcomes 1-4, we used the patient's first event during the entire study period. To conduct this analysis of eSyM responders, we used the patient's first event during the intervention period. Approximately 10% of patients in this analysis were counted as a control event in the prior analyses. | The primary analysis included data from both medical oncology and surgery. As a secondary analysis, we analyzed the data from MO and Surg separately and estimated the intervention effect for each outcome. Results for both combined and separate analyses are reported below. NOTE: To conduct this analysis of eSyM responders, we used the patient's first event during the intervention period. Approximately 10% of patients in this analysis were counted as a control event in outcomes 1-4. | Posted | Number | percentage of patients with event | 30 Days |
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| Secondary | Admissions Event Occurrence Status at Day 90 (Comparing eSyM Intervention Responders Versus Non-Responders) | This outcome will be defined in relation to the date of discharge from hospital (surgical cohort) or the initiation date of a new intravenous chemo regimen (medical oncology cohort). This is a binary outcome and we will analyze the absolute difference and odds ratio for the medical oncology and surgical cohorts combined and independently. NOTE: The total number of intervention participants in this analysis is greater than the number of intervention participants included in the primary analyses (outcomes 1-4). For outcomes outcomes 1-4, we used the patient's first event during the entire study period. To conduct this analysis of eSyM responders, we used the patient's first event during the intervention period. Approximately 10% of patients in this analysis were counted as a control event in the prior analyses. | The primary analysis included data from both medical oncology and surgery. As a secondary analysis, we analyzed the data from MO and Surg separately and estimated the intervention effect for each outcome. Results for both combined and separate analyses are reported below. NOTE: To conduct this analysis of eSyM responders, we used the patient's first event during the intervention period. Approximately 10% of patients in this analysis were counted as a control event in outcomes 1-4. | Posted | Number | percentage of patients with event | 90 Days |
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Deaths during the study period were assessed for all trial patients for 1 year. Study-related adverse events were not monitored or collected during the study period because this intervention was deployed as a part of routine clinical care and the study was deemed minimal risk. All-cause mortality was evaluated as a study outcome.
Since this was a research study deployed as a part of routine clinical care, formal adverse event reporting was not conducted.
Not provided
| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
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| EG000 | eSyM Control Participants (Medical Oncology and Surgery Participants Combined) | These patients (and/or proxy) were seen at a participating site prior to the trial rollout of eSyM and were not exposed to the eSyM intervention. This group includes the following trial subsets:
| 4,898 | 21,112 | 0 | 0 | 0 | 0 |
| EG001 | eSyM Intervention Participants (Medical Oncology and Surgery Participants Combined) | These patients (and/or proxy) were seen at a participating site after the trial rollout of eSyM and were exposed to the eSyM intervention. This group includes the following trial subsets:
| 4,161 | 18,830 | 0 | 0 | 0 | 0 |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Michael Hassett | Dana-Farber Cancer Institute | 617-726-5200 | michael_hassett@dfci.harvard.edu |
| Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Jun 12, 2024 | May 7, 2025 | SAP_001.pdf |
| ID | Term |
|---|---|
| D005770 | Gastrointestinal Neoplasms |
| ID | Term |
|---|---|
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D004066 | Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
Not provided
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| Male |
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| Other |
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| Non-Hispanic Black |
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| Non-Hispanic White |
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| Other |
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| Surgery Cohort |
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| Medical Oncology + Surgery Combined Cohort |
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| Regression, Logistic |
| 0.565 |
| Odds Ratio (OR) |
| 0.927 |
| 2-Sided |
| 95 |
| 0.715 |
| 1.201 |
| Superiority |
| Adjusted analysis comparing control versus intervention patients (surgical patients only) | Regression, Logistic | 0.042 | Odds Ratio (OR) | 1.225 | 2-Sided | 95 | 1.008 | 1.490 | Superiority |
| Participants |
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| Participants |
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| OG001 | SASS Questionnaire Participants (Intervention Period) | A subset of trial intervention patients were asked to complete a research questionnaire called the SASS Questionnaire after the roll-out of eSyM to assess the impact on patient outcomes including self-efficacy, attainment of informational needs, symptom burden, and satisfaction with care. |
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| OG001 | SASS Questionnaire Participants (Intervention Period) | A subset of trial intervention patients were asked to complete a research questionnaire called the SASS Questionnaire after the roll-out of eSyM to assess the impact on patient outcomes including self-efficacy, attainment of informational needs, symptom burden, and satisfaction with care. |
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| OG001 | SASS Questionnaire Participants (Intervention Period) | A subset of trial intervention patients were asked to complete a research questionnaire called the SASS Questionnaire after the roll-out of eSyM to assess the impact on patient outcomes including self-efficacy, attainment of informational needs, symptom burden, and satisfaction with care. |
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| OG001 | SASS Questionnaire Participants (Intervention Period) | A subset of trial intervention patients were asked to complete a research questionnaire called the SASS Questionnaire after the roll-out of eSyM to assess the impact on patient outcomes including self-efficacy, attainment of informational needs, symptom burden, and satisfaction with care. |
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| OG001 | SASS Questionnaire Participants (Intervention Period) | A subset of trial intervention patients were asked to complete a research questionnaire called the SASS Questionnaire after the roll-out of eSyM to assess the impact on patient outcomes including self-efficacy, attainment of informational needs, symptom burden, and satisfaction with care. |
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| OG001 | SASS Questionnaire Participants (Intervention Period) | A subset of trial intervention patients were asked to complete a research questionnaire called the SASS Questionnaire after the roll-out of eSyM to assess the impact on patient outcomes including self-efficacy, attainment of informational needs, symptom burden, and satisfaction with care. |
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These patients (and/or proxy) were seen at a participating site after the trial rollout of eSyM. These patients were exposed to eSyM and used it to report symptoms. |
| OG001 | Cluster Randomized Trial (Intervention Patients - eSyM Non-Responders) | These patients (and/or proxy) were seen at a participating site after the trial rollout of eSyM. These patients were exposed to eSyM and did NOT use it to report symptoms. |
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| OG001 | Cluster Randomized Trial (Intervention Patients - eSyM Non-Responders) | These patients (and/or proxy) were seen at a participating site after trial rollout of eSyM. These patients were exposed to eSyM and did not use it to report symptoms. |
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| OG001 | Cluster Randomized Trial (Intervention Patients - eSyM Non-Responders) | These patients (and/or proxy) were seen at a participating site after the trial rollout of eSyM. These patients were exposed to eSyM and did not use it to report symptoms. |
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| OG001 | Cluster Randomized Trial (Intervention Patients - eSyM Non-Responders) | These patients (and/or proxy) were seen at a participating site after trial rollout of eSyM. These patients were exposed to eSyM and used it to report symptoms. |
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