Development and Validation of a Multidisciplinary Mobile Care System for Patients With Advanced Gastrointestinal Cancer: Interventional Observation Study

Abstract

BackgroundMobile health apps have emerged as supportive tools in the management of advanced cancers. However, only a few apps have self-monitoring features, and they are not standardized and validated.ObjectiveThis study aimed to develop and validate a multidisciplinary mobile care system with self-monitoring features that can be useful for patients with advanced gastrointestinal cancer.MethodsThe development of the multidisciplinary mobile health management system was divided into 3 steps. First, the service scope was set up, and the measurement tools were standardized. Second, the service flow of the mobile care system was organized. Third, the mobile app (Life Manager) was developed. The app was developed to achieve 3 major clinical goals: support for quality of life, nutrition, and rehabilitation. Three main functional themes were developed to achieve clinical goals: a to-do list, health education, and in-app chat. Thirteen clinically oriented measures were included: the modified Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events questionnaire, Scored Patient-Generated Subjective Global Assessment (PG-SGA), distress, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, International Physical Activity Questionnaire–Short Form, Low anterior resection syndrome score, satisfaction rate, etc. To validate the system, a prospective observational study was conducted. Patients with gastric cancer or colon cancer undergoing chemotherapy were recruited. We followed the subjects for 12 weeks, and selected clinical measures were taken online and offline.ResultsAfter the development process, a multidisciplinary app, the Life Manager, was launched. For evaluation, 203 patients were recruited for the study, of whom 101 (49.8%) had gastric cancer, and 102 (50.2%) were receiving palliative care. Most patients were in their fifties (35.5%), and 128 (63.1%) were male. Overall, 176 subjects (86.7%) completed the study. Among subjects who dropped out, the most common reason was the change of patient’s clinical condition (51.9%). During the study period, subjects received multiple health education sessions. For the gastric cancer group, the “general gastric cancer education” was most frequently viewed (322 times), and for the colon cancer group, the “warming-up exercise” was most viewed (340 times). Of 13 measurements taken from subjects, 9 were taken offline (response rate: 52.0% to 90.1%), and 3 were taken online (response rate: 17.6% to 57.4%). The overall satisfaction rate among subjects was favorable and ranged from 3.93 (SD 0.88) to 4.01 (SD 0.87) on the 5-point Likert scale.ConclusionsA multidisciplinary mobile care system for patients with advanced gastrointestinal cancer was developed with clinically oriented measures. A prospective study was performed for its evaluation, which showed favorable satisfaction.

Dr. Answer AI for prostate cancer: Clinical outcome prediction model and service

“…developing a mHealth management platform for patients [22][23][24], has contributed to the development of the Dr. Answer AI SW for PCa.…”

A Review of AI and Data Science Support for Cancer Management

“…PROs were added to this table when used in 3 or more papers. In this review, the most commonly used validated PRO questionnaire for collecting HRQoL data is the EORTC QLQ-C30, used in 28% of the 50 included papers [10][11][12][13][14][15][16][17][18][19][20][21][22]. It is a European widely used core generic questionnaire for cancer patients, and comprises most dimensions of wellbeing as described by Linton et al [6], excluding spiritual wellbeing and personal circumstances.…”

“…These modules are specific to tumour site, treatment modality, or a HRQoL dimension, to be administered in addition to the core questionnaire (EORTC QLQ-C30) [39]. Furthermore, the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) was a commonly used (10%) questionnaire to capture information on symptomatic adverse events [11,12,28,40,41]. The PRO-CTCAE Item Library includes 124 items representing 78 symptomatic toxicities drawn from the Common Terminology Criteria for Adverse Events (CTCAE), reported by patients [42].…”

“…The first group includes simple systems where a smartphone or a tablet is expanded with a wearable device, typically a consumer smartband. Soh et al [11] described an app providing self-monitoring for gastrointestinal cancer patients. In addition to electronic questionnaires, patients were equipped with wearable bands connected to the app via Bluetooth and used to collect physical activity (PA) information, such as steps count and burned calories.…”

“…As can be seen from the above examples, the majority of systems measure the PA of patients. This information is collected based on step count, step speed, which are collected by accelerometers [11,21,43] and burned calories [11]. Solutions that are more complex measure heart rate, oxygen saturation [43] or weight, blood pressure, oxygen saturation, pulse and temperature [45].…”