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Congruence of multiple patient-related outcomes within a single day

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Abstract

Objective

Clinic-based collection of patient-reported outcome (PRO) quantifying symptom burden provide crucial information for effective care. We have pioneered point-of-care electronic assessment using the Edmonton Symptom Assessment Scale (ESAS) with direct linkage to the electronic medical record (EMR) which has been readily adopted by our oncology patients. As some patients may complete more than one ESAS per day in different clinics, the goal of the current analyses was to compare the within-patient congruence of ESAS assessments completed on the same day.

Methods

A total of 9621 ESAS records from 4021 patients of the Supportive Care Medicine and Radiation Oncology clinics between February and November 2017 were retrieved from the EMR. Patients completed the ESAS-r-CSS, which added sleep disturbance, constipation, and spiritual well-being domains to the standard ESAS-r.

Results

A total of 65 patients provided more than one ESAS report within the same day. The data were curated, removing those sporadic missing data and those with obvious technical error. This process left 130 samples for analysis. There was no statistical difference among different ESAS collection intervals for domains of tiredness, nausea, appetite, overall well-being, spiritual well-being, constipation, and difficulty sleeping, but there was a significant difference for pain, drowsiness, shortness of breath, depression, and anxiety. Repeat tests that occurred within 1 h of one another demonstrated higher congruence than those completed over longer periods.

Conclusion

Patients reported significant worsening of several symptoms over the course of the day, with greatest concordance observed within smaller time periods.

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Authors and Affiliations

  1. Radiation Oncology Department, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL, 33612, USA

    Peter A. S. Johnstone & Hsiang-Hsuan Michael Yu

  2. Health Outcomes & Behavior Department, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL, 33612, USA

    Peter A. S. Johnstone, Hailey W. Bulls & Heather Jim

  3. Biostatistics and Bioinformatics Department, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL, 33612, USA

    Jun-Min Zhou & Jae K. Lee

  4. Supportive Care Medicine Department, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL, 33612, USA

    Diane Portman

Authors
  1. Peter A. S. Johnstone
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  2. Hailey W. Bulls
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  3. Jun-Min Zhou
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  4. Jae K. Lee
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  5. Diane Portman
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  6. Hsiang-Hsuan Michael Yu
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  7. Heather Jim
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Corresponding author

Correspondence to Peter A. S. Johnstone.

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Conflict of interest

Dr. Johnstone has nothing to disclose. Dr. Bulls has nothing to disclose. Dr. Lee has nothing to disclose. Dr. Zhou has nothing to disclose. Dr. Portman has nothing to disclose. Dr. Yu reports personal fees from UpToDate, Inc. Dr. Jim has nothing to disclose.

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Johnstone, P.A.S., Bulls, H.W., Zhou, JM. et al. Congruence of multiple patient-related outcomes within a single day. Support Care Cancer 27, 867–872 (2019). https://doi.org/10.1007/s00520-018-4372-1

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  • DOI: https://doi.org/10.1007/s00520-018-4372-1

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