Digital health for optimal supportive care in oncology: benefits, limits, and future perspectives

M Aapro, P Bossi, A Dasari, L Fallowfield, P Gascón, M Geller, K Jordan, J Kim, K Martin, S Porzig, M Aapro, P Bossi, A Dasari, L Fallowfield, P Gascón, M Geller, K Jordan, J Kim, K Martin, S Porzig

Abstract

Background: Digital health provides solutions that capture patient-reported outcomes (PROs) and allows symptom monitoring and patient management. Digital therapeutics is the provision to patients of evidence-based therapeutic interventions through software applications aimed at prevention, monitoring, management, and treatment of symptoms and diseases or for treatment optimization. The digital health solutions collecting PROs address many unmet needs, including access to care and reassurance, increase in adherence and treatment efficacy, and decrease in hospitalizations. With current developments in oncology including increased availability of oral drugs and reduced availability of healthcare professionals, these solutions offer an innovative approach to optimize healthcare resource utilization.

Design: This scoping review clarifies the role and impact of the digital health solutions in oncology supportive care, with a view of the current segmentation according to their technical features (connection to sensors, PRO collection, remote monitoring, self-management in real time…), and identifies evidence from clinical studies published about their benefits and limitations and drivers and barriers to adoption. A qualitative summary is presented.

Results: Sixty-six studies were identified and included in the qualitative synthesis. Studies supported the use of 38 digital health solutions collecting ePROs and allowing remote monitoring, with benefits to patients regarding symptom reporting and management, reduction in symptom distress, decrease in unplanned hospitalizations and related costs and improved quality of life and survival. Among those 38 solutions 21 provided patient self-management with impactful symptom support, improvement of QoL, usefulness and reassurance. Principal challenges are in developing and implementing digital solutions to suit most patients, while ensuring patient compliance and adaptability for use in different healthcare systems and living environments.

Conclusions: There is growing evidence that digital health collecting ePROs provide benefits to patients related to clinical and health economic endpoints. These digital solutions can be integrated into routine supportive care in oncology practice to provide improved patient-centered care.

Keywords: Digital therapeutics; Integrative oncology; Patient-reported outcomes; Self-management; Symptom monitoring; eHealth.

Figures

Fig. 1
Fig. 1
Digital health definitions
Fig. 2
Fig. 2
PRISMA statement. PRISMA Preferred Reporting Items for Systematic Reviews and Meta-Analyses, RCT randomized controlled trial
Fig. 3
Fig. 3
Benefits and limitations of digital solutions in the healthcare system. FDA US Food and Drug Administration, HCP healthcare professional, IT information technology
Fig. 4
Fig. 4
Ideal digital health solution

References

    1. Ferlay J, Colombet M, Soerjomataram I, Mathers C, Parkin DM, Piñeros M, Znaor A, Bray F. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int J Cancer. 2019;144:1941–1953.
    1. Allemani C, Matsuda T, Di Carlo V, et al. Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet. 2018;391:1023–1075.
    1. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136:E359–E386.
    1. Cook R. Economic and clinical impact of multiple myeloma to managed care. J Manag Care Pharm. 2008;14:19–25.
    1. Jordan K, Aapro M, Kaasa S, Ripamonti CI, Scotté F, Strasser F, Young A, Bruera E, Herrstedt J, Keefe D, Laird B, Walsh D, Douillard JY, Cervantes A. European Society for Medical Oncology (ESMO) position paper on supportive and palliative care. Ann Oncol. 2018;29:36–43.
    1. Kaasa S, Loge JH, Aapro M, Albreht T, Anderson R, Bruera E, Brunelli C, Caraceni A, Cervantes A, Currow DC, Deliens L, Fallon M, Gómez-Batiste X, Grotmol KS, Hannon B, Haugen DF, Higginson IJ, Hjermstad MJ, Hui D, Jordan K, Kurita GP, Larkin PJ, Miccinesi G, Nauck F, Pribakovic R, Rodin G, Sjøgren P, Stone P, Zimmermann C, Lundeby T. Integration of oncology and palliative care: a Lancet Oncology Commission. Lancet Oncol. 2018;19:e588–e653.
    1. Basch E, Deal AM, Dueck AC, Scher HI, Kris MG, Hudis C, Schrag D. Overall survival results of a trial assessing patient-reported outcomes for symptom monitoring during routine cancer treatment. JAMA. 2017;318:197–198.
    1. Basch E, Deal AM, Kris MG, Scher HI, Hudis CA, Sabbatini P, Rogak L, Bennett AV, Dueck AC, Atkinson TM, Chou JF, Dulko D, Sit L, Barz A, Novotny P, Fruscione M, Sloan JA, Schrag D. Symptom monitoring with patient-reported outcomes during routine cancer treatment: a randomized controlled trial. J Clin Oncol. 2016;34:557–565.
    1. Beaton L, Bandula S, Gaze MN, Sharma RA. How rapid advances in imaging are defining the future of precision radiation oncology. Br J Cancer. 2019;120:779–790.
    1. Kaufman HL, Atkins MB, Subedi P, Wu J, Chambers J, Joseph Mattingly T, Campbell JD, Allen J, Ferris AE, Schilsky RL, Danielson D, Lichtenfeld JL, House L, Selig WKD. The promise of immuno-oncology: implications for defining the value of cancer treatment. J Immunother Cancer. 2019;7:129.
    1. Galligioni E, Piras EM, Galvagni M, Eccher C, Caramatti S, Zanolli D, Santi J, Berloffa F, Dianti M, Maines F, Sannicolò M, Sandri M, Bragantini L, Ferro A, Forti S. Integrating mHealth in oncology: experience in the province of Trento. J Med Internet Res. 2015;17:e114.
    1. Shah CP, Moreb JS. Cardiotoxicity due to targeted anticancer agents: a growing challenge. Ther Adv Cardiovasc Dis. 2019;13:1753944719843435.
    1. McCarthy PL, Holstein SA, Petrucci MT, et al. Lenalidomide maintenance after autologous stem-cell transplantation in newly diagnosed multiple myeloma: a meta-analysis. J Clin Oncol. 2017;35:3279–3289.
    1. Partridge AH, Wang PS, Winer EP, Avorn J. Nonadherence to adjuvant tamoxifen therapy in women with primary breast cancer. J Clin Oncol. 2003;21:602–606.
    1. Barquín-García A, Molina-Cerrillo J, Garrido P, Garcia-Palos D, Carrato A, Alonso-Gordoa T. New oncologic emergencies: what is there to know about immunotherapy and its potential side effects? Eur J Intern Med. 2019;66:1–8.
    1. American Society of Clinical Oncology. The state of cancer care in America, 2016: a report by the American Society of Clinical Oncology. 2016. 10.1200/jop.2015.010462. Accessed September 24, 2019
    1. Meskó B, Drobni Z, Bényei É, Gergely B, Győrffy Z. Digital health is a cultural transformation of traditional healthcare. Mhealth. 2017;3:38.
    1. Kruse CS, Goswamy R, Raval Y, Marawi S. Challenges and opportunities of big data in health care: a systematic review. JMIR Med Inform. 2016;4:e38.
    1. Schneeweiss S, Eichler HG, Garcia-Altes A, Chinn C, Eggimann AV, Garner S, Goettsch W, Lim R, Löbker W, Martin D, Müller T, Park BJ, Platt R, Priddy S, Ruhl M, Spooner A, Vannieuwenhuyse B, Willke RJ. Real-world data in adaptive biomedical innovation: a framework for generating evidence fit for decision-making. Clin Pharmacol Ther. 2016;100:633–646.
    1. van Roessel I, Reumann M, Brand A. Potentials and challenges of the health data cooperative model. Public Health Genomics. 2017;20:321–331.
    1. Raposo VL. Telemedicine: the legal framework (or the lack of it) in Europe. GMS Health Technol Assess 2016; 12: Doc03
    1. Rajkomar A, Dean J, Kohane I. Machine learning in medicine. N Engl J Med. 2019;380:1347–1358.
    1. Fallowfield LJ. Quality of life assessment using patient-reported outcome (PRO) measures: still a Cinderella outcome? Ann Oncol. 2018;29:2286–2287.
    1. Aapro M, Molassiotis A, Dicato M, Peláez I, Rodríguez-Lescure Á, Pastorelli D, Ma L, Burke T, Gu A, Gascon P, Roila F, PEER investigators The effect of guideline-consistent antiemetic therapy on chemotherapy-induced nausea and vomiting (CINV): the Pan European Emesis registry (PEER) Ann Oncol. 2012;23:1986–1992.
    1. Kearney N, McCann L, Norrie J, et al. Evaluation of a mobile phone-based, advanced symptom management system (ASyMS) in the management of chemotherapy-related toxicity. Support Care Cancer. 2009;17:437444.
    1. Maguire R, McCann L, Miller M, Kearney N. Nurse’s perceptions and experiences of using a mobile-phone-based Advanced Symptom Management System (ASyMS) to monitor and manage chemotherapy-related toxicity. Eur J Oncol Nurs. 2008;12:380–386.
    1. McCann L, Maguire R, Miller M, Kearney N. Patients’ perceptions and experiences of using a mobile phone-based advanced symptom management system (ASyMS) to monitor and manage chemotherapy related toxicity. Eur J Cancer Care (Engl) 2009;18:156–164.
    1. Maguire R, Ream E, Richardson A, Connaghan J, Johnston B, Kotronoulas G, Pedersen V, McPhelim J, Pattison N, Smith A, Webster L, Taylor A, Kearney N. Development of a novel remote patient monitoring system: the advanced symptom management system for radiotherapy to improve the symptom experience of patients with lung cancer receiving radiotherapy. Cancer Nurs. 2015;38:E37–E47.
    1. Breen S, Kofoed S, Ritchie D, Dryden T, Maguire R, Kearney N, Aranda S. Remote real-time monitoring for chemotherapy side-effects in patients with blood cancers. Collegian. 2017;24:541–549.
    1. Breen S, Ritchie D, Schofield P, et al. The Patient Remote Intervention and Symptom Management System (PRISMS) – a Telehealth-mediated intervention enabling real-time monitoring of chemotherapy side-effects in patients with haematological malignancies: study protocol for a randomised controlled trial. Trials. 2015;16:472.
    1. Furlong E, Darley A, Fox P, Buick A, Kotronoulas G, Miller M, Flowerday A, Miaskowski C, Patiraki E, Katsaragakis S, Ream E, Armes J, Gaiger A, Berg G, McCrone P, Donnan P, McCann L, Maguire R. Adaptation and implementation of a mobile phone-based remote symptom monitoring system for people with cancer in Europe. JMIR Cancer. 2019;5:e10813.
    1. Maguire R, Fox PA, McCann L, Miaskowski C, Kotronoulas G, Miller M, Furlong E, Ream E, Armes J, Patiraki E, Gaiger A, Berg GV, Flowerday A, Donnan P, McCrone P, Apostolidis K, Harris J, Katsaragakis S, Buick AR, Kearney N. The eSMART study protocol: a randomised controlled trial to evaluate electronic symptom management using the advanced symptom management system (ASyMS) remote technology for patients with cancer. BMJ Open. 2017;7:e015016.
    1. Spoelstra SL, Given BA, Given CW, Grant M, Sikorskii A, You M, Decker V. An intervention to improve adherence and management of symptoms for patients prescribed oral chemotherapy agents: an exploratory study. Cancer Nurs. 2013;36:18–28.
    1. Low CA, Dey AK, Ferreira D, Kamarck T, Sun W, Bae S, Doryab A. Estimation of symptom severity during chemotherapy from passively sensed data: exploratory study. J Med Internet Res. 2017;19:e420.
    1. Denis F, Voog E, Pointreau Y, Bourgeois H, Seegers V, le du K. Prospective study of a web-mediated management of febrile neutropenia related to chemotherapy (Bioconnect) Support Care Cancer. 2019;27:2189–2194.
    1. van den Berg SW, Gielissen MF, Custers JA, et al. BREATH: web-based self-management for psychological adjustment after primary breast cancer--results of a multicenter randomized controlled trial. J Clin Oncol. 2015;33:2763–2771.
    1. Ventura F, Koinberg I, Sawatzky R, Karlsson P, Öhlén J. Exploring the person-centeredness of an innovative e-supportive system aimed at person-centered care: prototype evaluation of the care expert. Comput Inform Nurs. 2016;34:231–239.
    1. Ruland CM, White T, Stevens M, Fanciullo G, Khilani SM. Effects of a computerized system to support shared decision making in symptom management of cancer patients: preliminary results. J Am Med Inform Assoc. 2003;10:573–579.
    1. Ruland CM. Clinicians’ perceived usefulness of a support system for patient-centered cancer care. Stud Health Technol Inform. 2006;124:624–630.
    1. Ruland CM, Holte HH, Røislien J, et al. Effects of a computer-supported interactive tailored patient assessment tool on patient care, symptom distress, and patients’ need for symptom management support: a randomized clinical trial. J Am Med Inform Assoc. 2010;17:403–410.
    1. Lucas AR, Bass MB, Rothrock NE, O'Connor ML, Sorkin MR, Nawyn J, Albinali F, Wagner LI. Development of an eHealth system to capture and analyze patient sensor and self-report data: mixed-methods assessment of potential applications to improve cancer care delivery. JMIR Med Inform. 2018;6:e46.
    1. Liu JF, Lee JM, Strock E, Phillips R, Mari K, Killiam B, Bonam M, Milenkova T, Kohn EC, Ivy SP. Technology applications: use of digital health technology to enable drug development. JCO Clin Cancer Inform. 2018;2:1–12.
    1. Galiano-Castillo N, Cantarero-Villanueva I, Fernández-Lao C, Ariza-García A, Díaz-Rodríguez L, del-Moral-Ávila R, Arroyo-Morales M. Telehealth system: a randomized controlled trial evaluating the impact of an internet-based exercise intervention on quality of life, pain, muscle strength, and fatigue in breast cancer survivors. Cancer. 2016;122:3166–3174.
    1. Baggott C, Gibson F, Coll B, Kletter R, Zeltzer P, Miaskowski C. Initial evaluation of an electronic symptom diary for adolescents with cancer. JMIR Res Protoc. 2012;1:e23.
    1. Berry DL, Hong F, Halpenny B, Partridge AH, Fann JR, Wolpin S, Lober WB, Bush NE, Parvathaneni U, Back AL, Amtmann D, Ford R. Electronic self-report assessment for cancer and self-care support: results of a multicenter randomized trial. J Clin Oncol. 2014;32:199–205.
    1. Berry DL, Hong F, Halpenny B, Partridge A, Fox E, Fann JR, Wolpin S, Lober WB, Bush N, Parvathaneni U, Amtmann D, Ford R. The electronic self-report assessment and intervention for cancer: promoting patient verbal reporting of symptom and quality of life issues in a randomized controlled trial. BMC Cancer. 2014;14:513.
    1. Berry DL, Blonquist TM, Patel RA, et al. Exposure to a patient-centered, Web-based intervention for managing cancer symptom and quality of life issues: impact on symptom distress. J Med Internet Res. 2015;17:e136.
    1. Head BA, Studts JL, Bumpous JM, Gregg JL, Wilson L, Keeney C, Scharfenberger JA, Pfeifer MP. Development of a telehealth intervention for head and neck cancer patients. Telemed J E Health. 2009;15:44–52.
    1. Head BA, Keeney C, Studts JL, Khayat M, Bumpous J, Pfeifer M. Feasibility and acceptance of a telehealth intervention to promote symptom management during treatment for head and neck cancer. J Support Oncol. 2011;9:e1–e11.
    1. Pfeifer MP, Keeney C, Bumpous J, Schapmire T, Studts J, Myers J, Head B. Impact of a telehealth intervention on quality of life and symptom distress in patients with head and neck cancer. J Community Support Oncol. 2015;13:14–21.
    1. Collins A, Burns CL, Ward EC, Comans T, Blake C, Kenny L, Greenup P, Best D. Home-based telehealth service for swallowing and nutritional management following head and neck cancer treatment. J Telemed Telecare. 2017;23:866–872.
    1. Velikova G, Booth L, Smith AB, Brown PM, Lynch P, Brown JM, Selby PJ. Measuring quality of life in routine oncology practice improves communication and patient well-being: a randomized controlled trial. J Clin Oncol. 2004;22:714–724.
    1. Cleeland CS, Wang XS, Shi Q, Mendoza TR, Wright SL, Berry MD, Malveaux D, Shah PK, Gning I, Hofstetter WL, Putnam JB, Jr, Vaporciyan AA. Automated symptom alerts reduce postoperative symptom severity after cancer surgery: a randomized controlled clinical trial. J Clin Oncol. 2011;29:994–1000.
    1. Langius-Eklöf A, Crafoord MT, Christiansen M, Fjell M, Sundberg K. Effects of an interactive mHealth innovation for early detection of patient-reported symptom distress with focus on participatory care: protocol for a study based on prospective, randomised, controlled trials in patients with prostate and breast cancer. BMC Cancer. 2017;17:466.
    1. Gustavell T, Langius-Eklöf A, Wengström Y, Segersvärd R, Sundberg K. Development and feasibility of an interactive smartphone app for early assessment and management of symptoms following pancreaticoduodenectomy. Cancer Nurs. 2019;42:E1–E10.
    1. Anderson KO, Palos GR, Mendoza TR, Cleeland CS, Liao KP, Fisch MJ, Garcia-Gonzalez A, Rieber AG, Nazario LA, Valero V, Hahn KM, Person CL, Payne R. Automated pain intervention for underserved minority women with breast cancer. Cancer. 2015;121:1882–1890.
    1. Peltola MK, Lehikoinen JS, Sippola LT, et al. A novel digital patient-reported outcome platform for head and neck oncology patients-a pilot study. Clin Med Insights Ear Nose Throat. 2016;9:1–6.
    1. Benze G, Nauck F, Alt-Epping B, Gianni G, Bauknecht T, Ettl J, Munte A, Kretzschmar L, Gaertner J. PROutine: a feasibility study assessing surveillance of electronic patient reported outcomes and adherence via smartphone app in advanced cancer. Ann Palliat Med. 2019;8:104–111.
    1. Denis F, Viger L, Charron A, Voog E, Dupuis O, Pointreau Y, Letellier C. Detection of lung cancer relapse using self-reported symptoms transmitted via an internet web-application: pilot study of the sentinel follow-up. Support Care Cancer. 2014;22:1467–1473.
    1. Denis F, Yossi S, Septans AL, Charron A, Voog E, Dupuis O, Ganem G, Pointreau Y, Letellier C. Improving survival in patients treated for a lung cancer using self-evaluated symptoms reported through a web application. Am J Clin Oncol. 2017;40:464–469.
    1. Denis F, Lethrosne C, Pourel N, Molinier O, Pointreau Y, Domont J, Bourgeois H, Senellart H, Trémolières P, Lizée T, Bennouna J, Urban T, el Khouri C, Charron A, Septans AL, Balavoine M, Landry S, Solal-Céligny P, Letellier C (2017) Randomized trial comparing a web-mediated follow-up with routine surveillance in lung cancer patients. J Natl Cancer Inst 109
    1. Denis F, Basch EM, Lethrosne C, et al. Randomized trial comparing a web-mediated follow-up via patient-reported outcomes (PRO) vs. routine surveillance in lung cancer patients: final results. J Clin Oncol. 2018;36:abstract 6500.
    1. Basch E, Dueck AC, Rogak LJ et al (2018) Feasibility of implementing the patient-reported outcomes version of the Common Terminology Criteria for Adverse Events in a multicenter trial: NCCTG N1048. J Clin Oncol 36. 10.1200/JCO.2018.78.8620
    1. Gilbertson-White S, Yeung CW, Saeidzadeh S, Tykol H, Vikas P, Cannon A. Engaging stakeholders in the development of an eHealth intervention for cancer symptom management for rural residents. J Rural Health. 2019;35:189–198.
    1. Duman-Lubberding S, van Uden-Kraan CF, Peek N, Cuijpers P, Leemans CR, Verdonck-de Leeuw IM. An eHealth application in head and neck cancer survivorship care: health care professionals’ perspectives. J Med Internet Res. 2015;17:e235.
    1. Duman-Lubberding S, van Uden-Kraan CF, Jansen F, Witte BI, van der Velden LA, Lacko M, Cuijpers P, Leemans CR, Verdonck-de Leeuw IM. Feasibility of an eHealth application “OncoKompas” to improve personalized survivorship in cancer care. Support Care Cancer. 2016;24:2163–2171.
    1. Melissant HC, Verdonck-de Leeuw IM, Lissenberg-Witte BI, Konings IR, Cuijpers P, van Uden-Kraan CF. ‘Oncokompas’, a web-based self-management application to support patient activation and optimal supportive care: a feasibility study among breast cancer survivors. Acta Oncol. 2018;57:924–934.
    1. van der Hout A, van Uden-Kraan CF, Witte BI, Coupé VMH, Jansen F, Leemans CR, Cuijpers P, van de Poll-Franse LV, Verdonck-de Leeuw IM. Efficacy, cost-utility and reach of an eHealth self-management application ‘Oncokompas’ that helps cancer survivors to obtain optimal supportive care: study protocol for a randomised controlled trial. Trials. 2017;18:228.
    1. Weaver A, Young AM, Rowntree J, Townsend N, Pearson S, Smith J, Gibson O, Cobern W, Larsen M, Tarassenko L. Application of mobile phone technology for managing chemotherapy-associated side-effects. Ann Oncol. 2007;18:1887–1892.
    1. Larsen ME, Rowntree J, Young AM, et al. Chemotherapy side-effect management using mobile phones. Conf Proc IEEE Eng Med Biol Soc. 2008;2008:5152–5155.
    1. Yap KY, Low HX, Koh KS, et al. Feasibility and acceptance of a pharmacist-run tele-oncology service for chemotherapy-induced nausea and vomiting in ambulatory cancer patients. Telemed J E Health. 2013;19:387–395.
    1. Kroenke K, Theobald D, Norton K, Sanders R, Schlundt S, McCalley S, Harvey P, Iseminger K, Morrison G, Carpenter JS, Stubbs D, Jacks R, Carney-Doebbeling C, Wu J, Tu W. The Indiana Cancer Pain and Depression (INCPAD) trial design of a telecare management intervention for cancer-related symptoms and baseline characteristics of study participants. Gen Hosp Psychiatry. 2009;31:240–253.
    1. Kroenke K, Theobald D, Wu J, Norton K, Morrison G, Carpenter J, Tu W. Effect of telecare management on pain and depression in patients with cancer: a randomized trial. JAMA. 2010;304:163–171.
    1. Timmerman JG, Dekker-van Weering MGH, Stuiver MM, et al. Ambulant monitoring and web-accessible home-based exercise program during outpatient follow-up for resected lung cancer survivors: actual use and feasibility in clinical practice. J Cancer Surviv. 2017;11:720–731.
    1. Wheelock AE, Bock MA, Martin EL, Hwang J, Ernest ML, Rugo HS, Esserman LJ, Melisko ME. : A randomized controlled trial evaluating a web-based system for symptom management after treatment of breast cancer. Cancer. 2015;121:893–899.
    1. Yount SE, Rothrock N, Bass M, Beaumont JL, Pach D, Lad T, Patel J, Corona M, Weiland R, del Ciello K, Cella D. A randomized trial of weekly symptom telemonitoring in advanced lung cancer. J Pain Symptom Manag. 2014;47:973–989.
    1. Mooney KH, Beck SL, Wong B, Dunson W, Wujcik D, Whisenant M, Donaldson G. Automated home monitoring and management of patient-reported symptoms during chemotherapy: results of the symptom care at home RCT. Cancer Med. 2017;6:537–546.
    1. Kolb NA, Smith AG, Singleton JR, Beck SL, Howard D, Dittus K, Karafiath S, Mooney K. Chemotherapy-related neuropathic symptom management: a randomized trial of an automated symptom-monitoring system paired with nurse practitioner follow-up. Support Care Cancer. 2018;26:1607–1615.
    1. Rocque GB, Halilova KI, Varley AL, Williams CP, Taylor RA, Masom DG, Wright WJ, Partridge EE, Kvale EA. Feasibility of a telehealth educational program on self-management of pain and fatigue in adult cancer patients. J Pain Symptom Manag. 2017;53:1071–1078.
    1. Nimako K, Lu SK, Ayite B, Priest K, Winkley A, Gunapala R, Popat S, O'Brien MER. A pilot study of a novel home telemonitoring system for oncology patients receiving chemotherapy. J Telemed Telecare. 2013;19:148–152.
    1. Williams AR, Williams DD, Williams PD, Alemi F, Hesham H, Donley B, Kheirbek RE. The development and application of an oncology therapy-related symptom checklist for adults (TRSC) and children (TRSC-C) and e-health applications. Biomed Eng Online. 2015;14:S1.
    1. Graetz I, Anderson JN, McKillop CN, et al. Use of a web-based app to improve postoperative outcomes for patients receiving gynecological oncology care: a randomized controlled feasibility trial. Gynecol Oncol. 2018;150:311–317.
    1. Ruland CM, Andersen T, Jeneson A, Moore S, Grimsbø GH, Børøsund E, Ellison MC. Effects of an internet support system to assist cancer patients in reducing symptom distress: a randomized controlled trial. Cancer Nurs. 2013;36:6–17.
    1. Børøsund E, Cvancarova M, Ekstedt M, Moore SM, Ruland CM. How user characteristics affect use patterns in web-based illness management support for patients with breast and prostate cancer. J Med Internet Res. 2013;15:e34.
    1. Børøsund E, Cvancarova M, Moore SM, Ekstedt M, Ruland CM. Comparing effects in regular practice of e-communication and web-based self-management support among breast cancer patients: preliminary results from a randomized controlled trial. J Med Internet Res. 2014;16:e295.
    1. Marthick M, Dhillon HM, Alison JA, Cheema BS, Shaw T. An interactive web portal for tracking oncology patient physical activity and symptoms: prospective cohort study. JMIR Cancer. 2018;4:e11978.
    1. Denis F, Basch E, Septans AL, Bennouna J, Urban T, Dueck AC, Letellier C. Two-year survival comparing web-based symptom monitoring vs routine surveillance following treatment for lung cancer. JAMA. 2019;321:306–307.
    1. Strasser F, Blum D, von Moos R, Cathomas R, Ribi K, Aebi S, Betticher D, Hayoz S, Klingbiel D, Brauchli P, Haefner M, Mauri S, Kaasa S, Koeberle D. The effect of real-time electronic monitoring of patient-reported symptoms and clinical syndromes in outpatient workflow of medical oncologists: E-MOSAIC, a multicenter cluster-randomized phase III study (SAKK 95/06) Ann Oncol. 2016;27:324–332.
    1. Cherny NI, Dafni U, Bogaerts J, Latino NJ, Pentheroudakis G, Douillard JY, Tabernero J, Zielinski C, Piccart MJ, de Vries EGE. ESMO-magnitude of clinical benefit scale version 1.1. Ann Oncol. 2017;28:2340–2366.
    1. Atema V, van Leeuwen M, Oldenburg HSA, van Beurden M, Hunter MS, Aaronson NK. An internet-based cognitive behavioral therapy for treatment-induced menopausal symptoms in breast cancer survivors: results of a pilot study. Menopause. 2017;24:762–767.
    1. Alberts NM, Hadjistavropoulos HD, Dear BF, Titov N. Internet-delivered cognitive-behaviour therapy for recent cancer survivors: a feasibility trial. Psychooncology. 2017;26:137–139.

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