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Electronic Patient Reported Outcomes significantly improved toxicity data collection and were acceptable to both patients and clinicians in lung cancer radiotherapy outpatient clinics.

Annalie Shears, Matthew Barker-Hewitt, Neil Bayman, Margaret Harris, Kate Haslett, Jason Kennedy, Lip Lee, Ben Wilson, Paul Taylor, Corinne Faivre


Rationale: Toxicity after radiotherapy for lung cancer can be considerable and yet varies significantly between patients. In the future, it is hoped rapid learning techniques will be used to create decision support systems  that can determine individual patients’ outcomes and so help guide treatment choices accordingly. However, such research relies on the robust collection of prospective toxicity data. Electronic Patient Reported Outcomes (e-PROs) tools are an effective way of improving the quality and quantity of clinical data collection, yet there are currently none in routine use in UK lung cancer patients.

Methods: An e-PRO tool was designed to evaluate toxicity after lung cancer radiotherapy in outpatients at the Christie Hospital, Manchester, UK. Patients completed the e-PRO form on a tablet computer prior to consultation and both patients and clinicians completed feedback forms. e-PRO data was uploaded in real time to the electronic patient record. Subsequently, we evaluated the feasibility and acceptability of the use of the e-PRO tool and compared the completeness of toxicity recording with and without e-PROs.

Results: Eighty-seven patients completed e-PRO forms with 74 providing feedback. One hundred percent of patients were happy to complete e-PRO forms, 78.2% found the tablet easy to use and  71.5% felt that filling out e-PROs stimulated them to think of issues to discuss with the doctor. Sixty-eight feedback forms were returned by clinicians. One hundred percent used the PRO form and found it helpful, with 79.5% agreeing that it altered their consultation. The records of 38 patients who completed the e-PRO form were evaluated, this was a significant (p=0.0005) difference in toxicity recorded with and without the e-PRO form.

Conclusion: e-PROs are acceptable to patients and clinicians and improve the quality and quantity of clinical data collection. Future larger studies will need to validate these findings and assess the impact e-PROs have on decision-making and outcomes.


ePRO, lung cancer, patient reported outcomes, person-centered healthcare, questionnaire, radiotherapy, tablet, toxicity

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