No abstract

Abkürzung Erläuterung BR grenzwertig resektabel (Engl.: borderline resectable) BRCA 1/2 Brustkrebsgen1/2 (Engl.: Breast Cancer Associated Gene 1/2) BRPC Borderline-resezierbarer Bauchspeicheldrüsenkrebs (Engl.: Borderline resectable pancreatic cancer) CA19-9 Kohlenhydrat-Antigen 19-9 (Engl.: Carbohydrate-Antigen 19-9) CALGP Chirurgische Arbeitsgemeinschaft für Leber-, Galle-und Pankreaserkrankungen CAO-V Chirurgische Arbeitsgemeinschaft Onkologie CAPS Internationales Konsortium für Vorsorgeuntersuchungen beim Bauchspeicheldrüsenkrebs (Engl.: International Cancer of the Pancreas Screening Consortium) CDKN2A Cyclin-abhängiger Kinase-Inhibitor 2A (Engl.: Cyclin Dependent Kinase Inhibitor 2A) CDR Clinical Decision Rule CEA Karzinoembryonales Antigen (Engl.: Carcinoembryonic antigen) CGS Clinical Guideline Service CONKO Charité Onkologie CR Vollständiges Ansprechen (Engl.: Complete Response) CRM Zirkumferentieller Resektionsrand (Engl.: Circumferential resection margin) CT Computertomographie DEGRO Deutsche Gesellschaft für Radioonkologie DEGUM Deutsche Gesellschaft für Ultraschall in der Medizin DFS Krankheitsfreies Überleben (Engl.: Disease-free survival) * am häufigsten assoziierte Karzinome.

In its most trending interpretation, empowerment in health care is implemented as a patient-centered approach. In the same sense, many mobile health (mHealth) apps are being developed with a primary focus on the individual user. The integration of mHealth apps into the health care system has the potential to counteract existing challenges, including incomplete or nonstandardized medical data and lack of communication, especially in the intersectional context (eg, patients, medical forces). However, concerns about data security and privacy, regional differences in regulations, lack of accessibility, and nontransparent apps hinder the successful integration of mHealth into the health care system. One approach to address this is to rethink the interpretation of empowerment. On that basis, we here examine existing approaches of individual empowerment and subsequently analyze a different view of empowerment in digital health, namely interaction empowerment. Such a change of perspective could positively influence intersectoral communication and facilitate secure data and knowledge sharing. We discuss this novel viewpoint on empowerment, focusing on more efficient integration and development of mHealth approaches. A renewed interpretation of empowerment could thus buffer current limitations of individual empowerment while also advancing digitization of the health system.

The occurrence of adverse events frequently accompanies tumor treatments. Side effects should be detected and treated as soon as possible to maintain the best possible treatment outcome. Besides the standard reporting system Common Terminology Criteria for Adverse Events (CTCAE), physicians have recognized the potential of patient-reporting systems. These are based on a more subjective description of current patient reporting symptoms. Patient-reported symptoms are essential to define the impact of a given treatment on the quality of life and the patient’s wellbeing. They also act against an underreporting of side effects which are paramount to define the actual value of a treatment for the individual patient. Here, we present a study protocol for a clinical trial that assesses the potential of a smartphone application for CTCAE conform symptom reporting and tracking that is adjusted to the standard clinical reporting system rather than symptom oriented descriptive trial tools. The presented study will be implemented in two parts, both lasting over six months. The first part will assess the feasibility of the application with 30 patients non-randomly divided into three equally-sized age groups (<55years, 55-75years, >75years). In the second part 36 other patients will be randomly assigned to two groups, one reporting using the smartphone and one not. This prospective second part will compare the impact of smartphone reported adverse events regarding applied therapy doses and quality of life to those of patients receiving standard care. We aim for early detection and treatment of adverse events in oncological treatment to improve patients’ safety and outcomes. For this purpose, we will capture frequent adverse events of chemotherapies, immunotherapies, or other targeted therapies with our smartphone application. The presented trial is registered at the U.S. National Library of Medicine ClinicalTrials.gov (NCT04493450) on July 30, 2020.

HAK acknowledges funding was provided by the Ministry of Science and Art Baden-Württemberg (Zentrum für Innovative Versorgung, ZIV), the German Federal Ministry of Education and Research (BMBF) as part of the DIFUTURE project (Medical Informatics Initiative, grant number 01ZZ1804I), and the Ministry of Social Affairs and Integration Baden-Württemberg as part of the project feelBack (networked, digital, patient-related feedback psycho-oncology).