ePRO

ePRO
  • 文章类型: Journal Article
    通常通过电话进行健康调查以评估外周血干细胞收获(PBSCH)后的不良事件,但是电话对于进行频繁的调查来说并不理想。我们开发了一个基于Web的应用程序(捐赠者应用程序),使捐赠者能够将其健康状况作为电子患者报告结果(ePRO)告知医疗保健专业人员(HCP)。在这项前瞻性观察研究中,我们比较了这个捐献者应用程序与电话进行健康调查的有用性。应用程序用户每天报告EPRO,HCPs呼叫的患者每周至少报告一次他们的健康状况。观察期为首次给予粒细胞集落刺激因子至PBSCH后首次随访,不包括住院期间。每组由8个供体组成,中位年龄为32岁(范围:19-58)。9名(56.3%)为女性。电话呼叫组中有8名相关捐赠者,捐赠者应用程序组中有4名相关捐赠者。在观察期间,HCP从应用程序用户那里获得健康状况报告的频率高于从电话接收者那里获得健康状况报告的频率(在观察期间报告的天数的平均比例,27.0%vs53.5%;p<0.05)。使用捐献者应用程序时,HCP进行一次随访和总随访的平均时间均明显缩短。捐赠者负担或对捐赠的满意度没有差异。我们的研究表明,使用捐赠者应用程序可以提供更详细的健康调查数据,而不会增加捐赠者和HCP的负担。
    Health surveys to assess adverse events after peripheral blood stem cell harvest (PBSCH) have conventionally been conducted by phone, but phone calls are suboptimal for conducting frequent surveys. We developed a web-based application (donor app) that enables donors to inform healthcare professionals (HCPs) of their health status as an electronic patient-reported outcome (ePRO). In this prospective observational study, we compared the usefulness of this donor app to phone calls for conducting health surveys. App users reported ePRO daily, and patients called by HCPs reported their health status at least once a week when called. The observation period was from the first administration of granulocyte colony-stimulating factor to the first follow-up visit after PBSCH, excluding the hospitalization period. Each group consisted of eight donors with a median age of 32 years (range: 19-58). Nine (56.3%) were female. There were eight related donors in the phone call group and four in the donor app group. During the observation period, HCPs obtained health status reports more frequently from app users than from phone call recipients (mean proportion of days with reports made during the observation period, 27.0% vs 53.5%; p<0.05). Average time spent by the HCPs for one follow-up and total follow-ups were both significantly shorter when the donor app was used. There were no differences in donor burden or satisfaction with donation. Our study suggests that use of a donor app could provide more detailed health survey data without increasing the burden on donors and HCPs.
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  • 文章类型: Journal Article
    电子患者报告结果(ePRO)系统有望彻底改变癌症患者与各种护理环境中的医疗保健提供者之间的沟通。这篇系统的综述探讨了ePROs在癌症护理中的多面性,包括他们的优势,缺点,潜在风险,和改进的机会。
    在我们的系统综述中,我们在Scopus进行了严格的搜索,WebofScience,和PubMed,为EPRO和癌症采用全面的医学主题标题术语,到2024年没有日期限制。根据纳入和排除标准对研究进行了批判性评估和主题分析,包括对优势的考虑,缺点,机遇,和威胁。
    分析85篇文章,发现69个主题分为四个关键领域。优势(n=14)主要由“改善生活质量和护理”等主题主导。“缺点(n=26)包括限制访问和技术问题。“安全问题和缺乏技术技能是突出的威胁(n=10)。机会(n=19)强调了症状管理的进步和技术挑战的潜在解决方案。
    这篇综述强调了持续探索的关键作用,一体化,ePRO系统的创新,以优化癌症护理中的患者结果。除了传统的临床环境,ePROs有望在幸存者中应用,姑息治疗,和远程监控。通过解决现有的限制和利用机会,EPRO可以赋予患者权力,加强沟通,并最终改善整个癌症护理领域的护理服务。
    UNASSIGNED: Electronic patient-reported outcome (ePRO) systems hold promise for revolutionizing communication between cancer patients and healthcare providers across various care settings. This systematic review explores the multifaceted landscape of ePROs in cancer care, encompassing their advantages, disadvantages, potential risks, and opportunities for improvement.
    UNASSIGNED: In our systematic review, we conducted a rigorous search in Scopus, Web of Science, and PubMed, employing comprehensive medical subject heading terms for ePRO and cancer, with no date limitations up to 2024. Studies were critically appraised and thematically analyzed based on inclusion and exclusion criteria, including considerations of advantages, disadvantages, opportunities, and threats.
    UNASSIGNED: Analyzing 85 articles revealed 69 themes categorized into four key areas. Advantages (n = 14) were dominated by themes like \"improved quality of life and care.\" Disadvantages (n = 26) included \"limited access and technical issues.\" Security concerns and lack of technical skills were prominent threats (n = 10). Opportunities (n = 19) highlighted advancements in symptom management and potential solutions for technical challenges.
    UNASSIGNED: This review emphasizes the crucial role of continuous exploration, integration, and innovation in ePRO systems for optimizing patient outcomes in cancer care. Beyond traditional clinical settings, ePROs hold promise for applications in survivorship, palliative care, and remote monitoring. By addressing existing limitations and capitalizing on opportunities, ePROs can empower patients, enhance communication, and ultimately improve care delivery across the entire cancer care spectrum.
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  • 文章类型: Journal Article
    基于生物标志物的疗法越来越多地用于临床试验之外的癌症患者。有必要对患者报告结果(PRO)进行系统评估,以便在基于生物标志物的治疗过程中考虑患者的观点。我们通过智能手机应用程序评估了电子PRO评估的可行性。
    一个跨学科专家小组开发了一种智能手机应用程序,该应用程序基于292例神经肿瘤患者的回顾性分析中报告的症状负担和与健康相关的生活质量(HRQoL)指标。该应用程序包括对健康相关生活质量(HRQoL)的验证评估,症状的负担,和心理压力。可行性和可用性在一项试点研究中进行了测试。对患者和医疗保健专业人员(HCP)进行了半结构化访谈,转录,并根据Mayring的定性内容分析进行分析。此外,我们评估了ePro的依从性和描述性数据。
    共招募了14名患者,(9名女性,5男)。共4个HCP,9名患者,和1名护理人员就可用性/可行性进行了访谈。主要优点是可以在家中完成问卷并在日常生活中舒适地执行。合规性很高,例如,每周分发的NCCN遇险温度计问卷中,82%的人按时回答,然而,具有个体差异。我们观察到中位痛苦评分为5分(范围0-10,197个结果,n=12,每周评估),根据EORTCQLQ-C30仪器,全球健康评分中位数为58.3(范围为16.7-100,77个结果,n=12,每月评估)。
    这项试点研究证明了该应用程序的可行性和接受度。因此,我们将在生物标志物指导治疗期间扩大其应用,以实现系统的PRO评估。
    UNASSIGNED: Biomarker-based therapies are increasingly used in cancer patients outside clinical trials. Systematic assessment of patient-reported outcomes (PRO) is warranted to take patients\' perspectives during biomarker-based therapies into consideration. We assessed the feasibility of an electronic PRO assessment via a smartphone application.
    UNASSIGNED: An interdisciplinary expert panel developed a smartphone application based on symptom burden and health-related quality of life (HRQoL) metrics reported in a retrospective analysis of 292 neuro-oncological patients. The app included validated assessments of health-related quality of life (HRQoL), the burden of symptoms, and psychological stress. Feasibility and usability were tested in a pilot study. Semi-structured interviews with patients and health care professionals (HCP) were conducted, transcribed, and analyzed according to Mayring´s qualitative content analysis. Furthermore, we assessed compliance and descriptive data of ePROs.
    UNASSIGNED: A total of 14 patients have been enrolled, (9 female, 5 male). A total of 4 HCPs, 9 patients, and 1 caregiver were interviewed regarding usability/feasibility. The main advantages were the possibility to complete questionnaires at home and comfortable implementation in daily life. Compliance was high, for example, 82% of the weekly distributed NCCN distress thermometer questionnaires were answered on time, however, with interindividual variability. We observed a median distress score of 5 (range 0-10, 197 results, n = 12, weekly assessed) and a median Global health score of 58.3 according to the EORTC QLQ-C30 instrument (range 16.7-100, 77 results, n = 12, monthly assessed).
    UNASSIGNED: This pilot study proved the feasibility and acceptance of the app. We will therefore expand its application during biomarker-guided therapies to enable systematic PRO assessments.
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  • 文章类型: Journal Article
    背景:在癌症患者的临床研究中越来越多地使用电子患者报告结果(ePRO)的评估,并能够在患者的日常生活中进行结构化和标准化的数据收集。到目前为止,很少有研究或分析关注ePROs对患者的医疗益处。
    目的:当前的探索性分析旨在初步表明,与不使用真实世界护理应用程序的对照组相比,使用ConsiliumCare应用程序(最近更名为medidux;mobileHealthAG)对ePro的副作用进行结构化和定期自我评估对癌症患者的计划外咨询和住院的发生率具有可识别的影响。为了分析这一点,使用ConsiliumCare应用程序记录的癌症患者的计划外会诊和住院治疗的发生率,作为患者报告结局(PRO)研究的一部分,我们将其与在标准护理治疗期间在瑞士2个肿瘤中心收集的癌症患者的可比人群的相应数据进行回顾性比较.
    方法:PRO研究中接受新辅助或非治疗性全身治疗的癌症患者(本分析中包括178例)通过ConsiliumCare应用程序在90天的观察期内对副作用进行了自我评估。在这个时期,参与医师记录了计划外(紧急)会诊和住院情况.将这些事件的发生率与从瑞士2个肿瘤中心获得的一组癌症患者的回顾性数据进行比较。
    结果:两组患者在年龄和性别比例方面具有可比性,以及癌症实体和癌症分期联合委员会的分布。总的来说,每组139例患者接受化疗,39例接受其他治疗。看着所有的病人,Consilium组和对照组在每位患者的事件中没有发现显著差异(比值比0.742,90%CI0.455~1.206).然而,多元回归模型显示,Consilium组和"化疗"因子之间的相互作用项在5%水平上显著(P=.048).这激发了相应的亚组分析,表明在接受化疗的患者亚组中,干预组的风险相关降低。相应的比值比为0.53,90%CI0.288-0.957相当于Consilium组患者的风险减半,并表明临床相关效应在双侧10%水平上显著(P=.08,Fisher精确检验)。
    结论:PRO研究的计划外会诊和住院情况与来自癌症患者的可比队列的回顾性数据的比较表明,定期使用基于应用程序的ePRO对接受化疗的患者具有积极作用。这些数据将在正在进行的随机PRO2研究(在ClinicalTrials.gov;NCT05425550注册)中得到验证。
    背景:ClinicalTrials.govNCT03578731;https://www.clinicaltrials.gov/ct2/show/NCT03578731.
    RR2-10.2196/29271。
    BACKGROUND: The evaluation of electronic patient-reported outcomes (ePROs) is increasingly being used in clinical studies of patients with cancer and enables structured and standardized data collection in patients\' everyday lives. So far, few studies or analyses have focused on the medical benefit of ePROs for patients.
    OBJECTIVE: The current exploratory analysis aimed to obtain an initial indication of whether the use of the Consilium Care app (recently renamed medidux; mobile Health AG) for structured and regular self-assessment of side effects by ePROs had a recognizable effect on incidences of unplanned consultations and hospitalizations of patients with cancer compared to a control group in a real-world care setting without app use. To analyze this, the incidences of unplanned consultations and hospitalizations of patients with cancer using the Consilium Care app that were recorded by the treating physicians as part of the patient reported outcome (PRO) study were compared retrospectively to corresponding data from a comparable population of patients with cancer collected at 2 Swiss oncology centers during standard-of-care treatment.
    METHODS: Patients with cancer in the PRO study (178 included in this analysis) receiving systemic therapy in a neoadjuvant or noncurative setting performed a self-assessment of side effects via the Consilium Care app over an observational period of 90 days. In this period, unplanned (emergency) consultations and hospitalizations were documented by the participating physicians. The incidence of these events was compared with retrospective data obtained from 2 Swiss tumor centers for a matched cohort of patients with cancer.
    RESULTS: Both patient groups were comparable in terms of age and gender ratio, as well as the distribution of cancer entities and Joint Committee on Cancer stages. In total, 139 patients from each group were treated with chemotherapy and 39 with other therapies. Looking at all patients, no significant difference in events per patient was found between the Consilium group and the control group (odds ratio 0.742, 90% CI 0.455-1.206). However, a multivariate regression model revealed that the interaction term between the Consilium group and the factor \"chemotherapy\" was significant at the 5% level (P=.048). This motivated a corresponding subgroup analysis that indicated a relevant reduction of the risk for the intervention group in the subgroup of patients who underwent chemotherapy. The corresponding odds ratio of 0.53, 90% CI 0.288-0.957 is equivalent to a halving of the risk for patients in the Consilium group and suggests a clinically relevant effect that is significant at a 2-sided 10% level (P=.08, Fisher exact test).
    CONCLUSIONS: A comparison of unplanned consultations and hospitalizations from the PRO study with retrospective data from a comparable cohort of patients with cancer suggests a positive effect of regular app-based ePROs for patients receiving chemotherapy. These data are to be verified in the ongoing randomized PRO2 study (registered on ClinicalTrials.gov; NCT05425550).
    BACKGROUND: ClinicalTrials.gov NCT03578731; https://www.clinicaltrials.gov/ct2/show/NCT03578731.
    UNASSIGNED: RR2-10.2196/29271.
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  • 文章类型: Journal Article
    轴性脊柱关节炎(axSpA)患者需要密切监测以实现疾病持续缓解的目标。远程医疗可以促进持续护理,同时缓解稀缺的医疗保健资源。在混合方法概念验证研究中,我们调查了6个月以上疾病稳定患者的混合远程医疗保健axSpA途径.患者使用医疗应用程序记录疾病活动(BASDAI和PtGA每两周一次,每周耀斑问卷)。要启用远程ASDAS-CRP(TELE-ASDAS-CRP),患者在家中使用毛细血管自取样装置。讨论了监测结果,并通过共同决策决定是否需要预先计划的3个月现场预约(T3)。10名患者完成了这项研究,八名患者还完成了额外的电话采访。问卷依从性高;BASDAI(82.3%),耀斑(74.8%),所有患者均成功完成TELE-ASDAS-CRP进行T3评估.在T3时,9/10的患者处于缓解或低疾病活动状态,所有患者均拒绝提供可选的T3现场预约。患者对所有研究成分的接受度很高,自我采样的净启动子评分(NPS)为50%(平均NPS8.8±1.5),电子问卷为70%(平均NPS9.0±1.6),T3远程咨询为90%(平均NPS9.7±0.6)。在采访中,患者报告的好处,如更好地概述他们的病情,易于使用的远程医疗工具,更大的自主权,and,最重要的是,节省旅行时间。据我们所知,这是第一项研究采用混合方法对axSpA患者进行随访,包括自我取样.在这项可扩展的概念验证研究中观察到的积极结果值得进行更大的验证性研究。
    Patients with axial spondyloarthritis (axSpA) require close monitoring to achieve the goal of sustained disease remission. Telehealth can facilitate continuous care while relieving scarce healthcare resources. In a mixed-methods proof-of-concept study, we investigated a hybrid telehealth care axSpA pathway in patients with stable disease over 6 months. Patients used a medical app to document disease activity (BASDAI and PtGA bi-weekly, flare questionnaire weekly). To enable a remote ASDAS-CRP (TELE-ASDAS-CRP), patients used a capillary self-sampling device at home. Monitoring results were discussed and a decision was reached via shared decision-making whether a pre-planned 3-month on-site appointment (T3) was necessary. Ten patients completed the study, and eight patients also completed additional telephone interviews. Questionnaire adherence was high; BASDAI (82.3%), flares (74.8%) and all patients successfully completed the TELE-ASDAS-CRP for the T3 evaluation. At T3, 9/10 patients were in remission or low disease activity and all patients declined the offer of an optional T3 on-site appointment. Patient acceptance of all study components was high with a net promoter score (NPS) of +50% (mean NPS 8.8 ± 1.5) for self-sampling, +70% (mean NPS 9.0 ± 1.6) for the electronic questionnaires and +90% for the T3 teleconsultation (mean NPS 9.7 ± 0.6). In interviews, patients reported benefits such as a better overview of their condition, ease of use of telehealth tools, greater autonomy, and, most importantly, travel time savings. To our knowledge, this is the first study to investigate a hybrid approach to follow-up axSpA patients including self-sampling. The positive results observed in this scalable proof-of-concept study warrant a larger confirmatory study.
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  • 文章类型: Journal Article
    目的:患者报告的结果指标(PROMs)用于收集疾病症状数据,以支持临床试验终点。临床研究可以持续一年或更长时间,患者对每日家庭问卷的依从性和响应时间可能会随着时间的推移而显著变化。这项研究的目的是了解患者在纵向临床研究中完成每日PROM的模式和变化。
    方法:收集了1342例患者的数据,这些患者随机分为3项呼吸临床试验(NCT03401229、NCT03347279和NCT03406078)。PROM由患者使用收集开始和完成时间的电子手持设备完成。使用贝叶斯广义线性混合效应模型来识别与患者的PROM依从性和响应时间相关的无偏系数,site,和日历功能作为协变量。
    结果:随机化后,依从性随着时间的推移而下降,年轻患者的下降率较高。在整个研究中,14天的随机化前依从性与依从性相关。与非工作日相比,工作日患者的依从性也更高。在整个研究中,年龄最大的患者花费了两倍的时间来完成PROM;然而,在研究的第1个月,所有患者的应答时间均减少,而与年龄无关.在预定的诊所就诊日期之前和之后以及患者报告的症状负担较高时,响应时间增加了7天。
    结论:对临床试验中每日PROMs的依从性和响应时间进行详细分析,可以为具有高基线依从性的纵向临床研究中患者行为趋势提供重要见解。
    OBJECTIVE: Patient-reported outcome measures (PROMs) are used to collect data on disease symptoms in support of clinical trial endpoints. Clinical studies can last a year or more, and the patients\' adherence and response time to daily at-home questionnaires may vary significantly over time. The aim of this study was to understand patterns and changes in patients\' completion of daily PROMs during longitudinal clinical studies.
    METHODS: Data were collected from 1342 patients randomized into three respiratory clinical trials (NCT03401229, NCT03347279, and NCT03406078). PROMs were completed by patients using electronic handheld devices that collected the starting and completion times. A Bayesian generalized linear mixed-effects model was used to identify unbiased coefficients associated with PROM adherence and response time using patient, site, and calendar features as covariates.
    RESULTS: Adherence decreased over time after randomization, and the rate of decrease was higher in younger patients. The 14-day pre-randomization adherence was correlated with adherence throughout the study. Patients were also more adherent during working days compared to non-working days. Oldest patients took twice as long to complete PROMs throughout the study; however, the response time for all patients decreased during the first month of the study regardless of age. Response time increased 7 days before and after the date of a scheduled clinic visit and when a patient-reported higher symptom burden.
    CONCLUSIONS: Detailed analyses of adherence and response time for daily PROMs in clinical trials can provide significant insights about trends of patient behavior in longitudinal clinical studies with high baseline adherence.
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  • 文章类型: Journal Article
    背景:曲妥珠单抗对人类表皮生长因子受体2(HER2)阳性乳腺癌(BC)的治疗产生了重大影响。抗HER2生物类似物如Ogivri在临床试验中已证明与曲妥珠单抗(使用赫赛汀作为参考产品)的安全性和临床等效性。据我们所知,对于使用电子患者报告结局(ePROs)的生物仿制药治疗患者的副作用和生活质量(QoL),目前尚无真实报道.
    目的:这项前瞻性观察性研究(OGIPRO研究)的主要目的是比较在接受曲妥珠单抗生物相似物Ogivri(前瞻性队列)治疗的HER2阳性BC患者中,与治疗副作用相关的ePRO数据。从单独使用Herceptin或联合使用Pertuzinmab和/或N2007CT031N35ctoalv治疗的历史
    方法:患者在(新)辅助和姑息治疗中单独使用Ogivri或与帕妥珠单抗和/或化疗和激素疗法联合使用。患者使用medidux应用程序动态记录症状(根据不良事件通用术语标准[CTCAE]),幸福感(根据东部肿瘤协作组绩效状态量表),QoL(使用EQ-5D-5L问卷),认知能力,和重要参数超过6周。主要终点是平均CTCAE评分。关键次要终点包括平均幸福感评分。将该前瞻性队列的数据与历史队列的数据进行比较(n=38例患者;中位年龄51,范围31-78岁)。
    结果:总体而言,53名中位年龄为54岁(范围31-87岁)的女性患者被纳入OGIPRO研究。分析了50例患者的平均CTCAE评分,这些患者有关于症状的可用数据,而在有可用数据的52例患者中评估了平均幸福感评分。两个队列中最常见的症状包括疲劳,味觉障碍,恶心,腹泻,粘膜干燥,关节不适,刺痛,睡眠障碍,头痛,和食欲减退。大多数患者在两个队列中都经历了轻微(0级)或轻度(1级)毒性。前瞻性和历史队列的平均CTCAE评分具有可比性(分别为29.0和30.3;平均差-1.27,95%CI-7.24至4.70;P=.68)。同样,曲妥珠单抗生物相似物Ogivri和赫赛汀治疗组的平均健康评分无显著差异(分别为74.3和69.8;平均差异4.45,95%CI-3.53~12.44;P=.28).
    结论:用曲妥珠单抗生物仿制药Ogivri治疗HER2阳性BC患者可产生等效症状,不良事件,以及通过ePRO数据确定的接受赫赛汀治疗的患者的健康状况。因此,当调查真实世界的耐受性和类似治疗化合物的结果时,将ePRO系统集成到研究和临床实践中可以提供可靠的信息.
    背景:ClinicalTrials.govNCT05234021;https://clinicaltrials.gov/study/NCT05234021。
    BACKGROUND: Trastuzumab has had a major impact on the treatment of human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC). Anti-HER2 biosimilars such as Ogivri have demonstrated safety and clinical equivalence to trastuzumab (using Herceptin as the reference product) in clinical trials. To our knowledge, there has been no real-world report of the side effects and quality of life (QoL) in patients treated with biosimilars using electronic patient-reported outcomes (ePROs).
    OBJECTIVE: The primary objective of this prospective observational study (OGIPRO study) was to compare the ePRO data related to treatment side effects collected with the medidux app in patients with HER2-positive BC treated with the trastuzumab biosimilar Ogivri (prospective cohort) to those obtained from historical cohorts treated with Herceptin alone or combined with pertuzumab and/or chemotherapy (ClinicalTrials.gov NCT02004496 and NCT03578731).
    METHODS: Patients were treated with Ogivri alone or combined with pertuzumab and/or chemotherapy and hormone therapy in (neo)adjuvant and palliative settings. Patients used the medidux app to dynamically record symptoms (according to the Common Terminology Criteria for Adverse Events [CTCAE]), well-being (according to the Eastern Cooperative Oncology Group Performance Status scale), QoL (using the EQ-5D-5L questionnaire), cognitive capabilities, and vital parameters over 6 weeks. The primary endpoint was the mean CTCAE score. Key secondary endpoints included the mean well-being score. Data of this prospective cohort were compared with those of the historical cohorts (n=38 patients; median age 51, range 31-78 years).
    RESULTS: Overall, 53 female patients with a median age of 54 years (range 31-87 years) were enrolled in the OGIPRO study. The mean CTCAE score was analyzed in 50 patients with available data on symptoms, while the mean well-being score was evaluated in 52 patients with available data. The most common symptoms reported in both cohorts included fatigue, taste disorder, nausea, diarrhea, dry mucosa, joint discomfort, tingling, sleep disorder, headache, and appetite loss. Most patients experienced minimal (grade 0) or mild (grade 1) toxicities in both cohorts. The mean CTCAE score was comparable between the prospective and historical cohorts (29.0 and 30.3, respectively; mean difference -1.27, 95% CI -7.24 to 4.70; P=.68). Similarly, no significant difference was found for the mean well-being score between the groups treated with the trastuzumab biosimilar Ogivri and Herceptin (74.3 and 69.8, respectively; mean difference 4.45, 95% CI -3.53 to 12.44; P=.28).
    CONCLUSIONS: Treatment of patients with HER2-positive BC with the trastuzumab biosimilar Ogivri resulted in equivalent symptoms, adverse events, and well-being as found for patients treated with Herceptin as determined by ePRO data. Hence, integration of an ePRO system into research and clinical practice can provide reliable information when investigating the real-world tolerability and outcomes of similar therapeutic compounds.
    BACKGROUND: ClinicalTrials.gov NCT05234021; https://clinicaltrials.gov/study/NCT05234021.
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  • 文章类型: Journal Article
    UNASSIGNED: Many studies using Patient-reported outcomes (PRO) data have been conducted to monitor symptoms and health-related quality of life during follow-up after cancer treatment. However new ways of using (e)PROs have emerged. We aimed to explore the Danish landscape of the use of PRO in a research setting, where PRO is used actively in cancer patients undergoing treatment, and give an overview of how it is embraced by patients and clinicians.
    UNASSIGNED: A literature search was performed in June 2023, using the keywords Denmark, cancer, and patient-reported outcomes. An expert on literature searches identified the search terms, and double screening was performed at both abstract and screening levels and full-text stage. The software tool Covidence was used.
    UNASSIGNED: 467 articles were retrieved and 19 studies were included. They described the type of ePRO instrument used and the application of active ePRO i.e. a dialogue tool in the clinical encounter, release of alerts to clinicians, and enhancement of self-management. Finally, a development in the use of active ePROs over time is elucidated and we show how it is embraced by patients and clinicians.
    UNASSIGNED: This mini-review gives an overview of how ePRO solutions are tested in oncological research in Denmark and embraced by patients and clinicians. ePRO solutions in a Danish setting seem well-suited for self-management. However, if more impact is warranted, clinicians need to engage in reviewing and using ePROs. Moreover, for successful implementation, the integration of ePROs in electronic health records must be supported by IT specialists and management.
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  • 文章类型: Journal Article
    背景:检查比替格拉韦/恩曲他滨/替诺福韦阿拉酚胺(BIC/FTC/TAF)方案在人类免疫缺陷病毒(HIV)感染中的长期治疗结果的前瞻性研究仍然有限。这项研究评估了中国西南地区BIC/FTC/TAF在HIV感染者中的实际疗效和安全性。
    方法:这是一个单中心,前瞻性研究纳入2022年3月至2022年8月接受BIC/FTC/TAF治疗的首次接受ART(n=32)和接受ART(n=177)HIV感染患者.数据收集到2023年2月28日。记录病毒学反应和治疗不良事件,以电子患者报告结果(ePRO)的形式收集患者的主观感受。主要终点是在第24周时HIV病毒载量<50拷贝/mL的患者的比率。
    结果:在第24周时,87.5%和95.5%的未接受ART和接受ART的HIV患者的病毒载量<50拷贝/mL,分别。首次接受ART和接受ART治疗的患者的CD4细胞计数显着增加了163.5个细胞/μL(p=0.002)和55.0个细胞/μL(p=0.022),分别。到第24周,没有患者由于不良事件而停止BIC/FTC/TAF治疗。根据EPRO数据,未接受ART和接受ART治疗的患者在第24周有稳定的疾病症状负担,生活质量,BIC/FTC/TAF治疗后的抑郁水平。
    结论:BIC/FTC/TAF降低了具有高病毒载量的ART初治患者以及具有残留病毒血症的ART经历患者的病毒载量。BIC/FTC/TAF治疗后,患者的主观体验保持稳定。这项研究还揭示了BIC/FTC/TAF药物相关副作用的发生率非常低。
    Prospective studies examining long-term therapeutic outcomes of the Bictegravir/Emtricitabine/Tenofovir Alafenamide (BIC/FTC/TAF) regimen in human immunodeficiency virus (HIV) infection remain limited. This study assessed the actual efficacy and safety of BIC/FTC/TAF in HIV-infected individuals in southwest China.
    This was a single-center, prospective study enrolling ART-naïve (n = 32) and ART-experienced (n = 177) HIV-infected patients administered BIC/FTC/TAF treatment between March 2022 and August 2022. The data were collected until February 28, 2023. Virological reactions and adverse events to the treatment were recorded, and patient subjective feelings in the form of Electronic Patient Reporting Outcome (ePRO) were collected. The primary endpoint was the rate of patients with HIV viral load <50 copies/mL at Week 24.
    At Week 24, 87.5% and 95.5% of ART-naïve and ART-experienced HIV patients had a viral load <50 copies/mL, respectively. CD4 cell counts in ART-naïve and ART-experienced patients increased significantly by 163.5 cells/μL (p = .002) and 55.0 cells/μL (p = .022), respectively. By Week 24, no patients had discontinued the BIC/FTC/TAF treatment due to adverse events. Based on ePRO data, ART-naïve and ART-experienced patients at Week 24 had stable disease symptom burden, quality of life, and depression level after treatment with BIC/FTC/TAF.
    BIC/FTC/TAF reduces the viral load in ART-naïve patients with high viral load as well as ART-experienced patients with residual viremia. The patient\'s subjective experience was maintained stable after treatment with BIC/FTC/TAF. This study also revealed a very low incidence for BIC/FTC/TAF drug-related side effects.
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  • 文章类型: Journal Article
    我们旨在调查(1)由学生主导的诊所和(2)电子患者报告的结果(ePROs),以加速诊断和治疗轴性脊柱关节炎(axSpA)患者。疑似axSpA的患者在计划的实际风湿病专家访问(T0)之前完成了最初的学生主导的诊所访问(T-1)。加速患者预约和NSAID治疗开始,诊断结果的可用性,并评估T0时的治疗反应。从T-1开始,患者每2周完成一次电子BASDAI问卷。评估了纸质和电子BASDAI的一致性。使用净启动子评分(NPS)测量患者对ePRO报告和学生主导诊所的接受度。17/36(47.2%)患者被诊断为axSpA。以学生为主导的诊所(T-1)显着加快了患者的预约时间超过2个月(T0,T-1,p<0.0001),并且axSpA指南符合NSAID治疗(p<0.0001)。在T0时,所有患者均完成了诊断检查,7/17(41.2%)axSpA患者表现出临床上重要的改善或缓解。34/36(94.4%)患者在T-1和T0之间完成了至少80%的ePro。电子和纸质给药的BASDAI相关性良好(r=0.8p<0.0001)。NPS评分分别为+62.0%(平均值±SD9.2/10.0±0.9)和+30.5%(平均值±SD8.0/10.0±1.7),分别。总之,学生主导的诊所和ePRO监测被广泛接受,加速axSpA患者的诊断检查和治疗。
    We aimed to investigate (1) student-led clinics and (2) electronic patient-reported outcomes (ePROs) to accelerate diagnosis and treatment of patients with axial spondyloarthritis (axSpA). Patients with suspected axSpA completed an initial student-led clinic visit (T-1) prior to their planned actual rheumatologist visit (T0). Acceleration of patient appointment and NSAID therapy start, availability of diagnostic findings, and treatment response at T0 were evaluated. Beginning at T-1, patients completed electronic BASDAI questionnaires every 2 weeks. Concordance of paper-based and electronic BASDAI was evaluated. Patient acceptance of ePRO reporting and student-led clinics was measured using the net promoter score (NPS). 17/36 (47.2%) included patients were diagnosed with axSpA. Student-led clinics (T-1) significantly accelerated patient appointments by more than 2 months (T0, T-1, p < 0.0001) and axSpA guideline-conform NSAID treatment (p < 0.0001). At T0, diagnostic workup was completed for all patients and 7/17 (41.2%) axSpA patients presented with a clinically important improvement or were in remission. 34/36 (94.4%) patients completed at least 80% of the ePROs between T-1 and T0. Electronic and paper-administered BASDAI correlated well (r = 0.8 p < 0.0001). Student-led clinics and ePROs were well accepted by patients with NPS scores of + 62.0% (mean ± SD 9.2/10.0 ± 0.9) and + 30.5% (mean ± SD 8.0/10.0 ± 1.7), respectively. In conclusion, student-led clinics and ePRO monitoring were well accepted, accelerated diagnostic workup and treatment in patients with axSpA.
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