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Impact of assessment frequency of patient-reported outcomes: an observational study using an eHealth platform in cancer patients


Background and aim

The evaluation of patient-reported outcomes (PRO) in cancer has proven relevant positive clinical impact on patients’ communication with healthcare professionals, decision-making for management, well-being, and overall survival. However, the optimal frequency of PRO assessment has yet to be defined. Based on the assumption that more frequent sampling would enhance accuracy, we aimed at identifying the optimal sampling frequency that does not miss clinically relevant insight.


We used pilot data from 31 advanced cancer patients who completed once daily the 19-item MD Anderson Symptom Inventory at home. The resulting dataset allowed us to compare different PRO assessment frequencies to daily sampling, i.e., alternate days (q2d), every third day (q3d), or once a week (q1w). We evaluated the sampling frequencies for two main outcomes: average symptom intensity and identification of severe symptoms.


The majority of the differences between corresponding averages of daily data and those for q2d, q3d, and q1w datasets were close to 0, yet the extremes exceeded 5. Clinically meaningful differences, i.e., > 1, were observed in 0.76% of patient items for q2d, in 2.72% for q3d, and in 11.93% for q1w. Moreover, median values of missed instances of a severe symptom (i.e., > 6) were 14.6% for q2d, 27.8% for q3d, and 55.6% for q1w.


Our analysis suggests that in patients receiving chemotherapy for advanced cancer, increasing the density of PRO collection enhances the accuracy of PRO assessment to a clinically meaningful extent. This is valid for both computations of averages symptom burden and for the recognition of episodes of severe symptom intensity.

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Fig. 1

Data availability

The data that support the findings of this study are available from the corresponding author, PFI, upon reasonable request.

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We are sincerely grateful to the patients who participated in the inCASA pilot, to the other oncologists who enrolled the patients under their care, to the nurses involved in data collection, and to the members of the inCASA European project. The clinical dataset used was collected within a pilot study from a research project supported by the European Union through the Seventh Framework Programme.

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Authors and Affiliations



P.F.I.: conception and design, data acquisition, analysis and interpretation, figure plotting; manuscript drafting, and final editing;

S.K.: data analysis and interpretation, manuscript drafting, and final editing;

R.D.: data interpretation, figure plotting, and manuscript final editing;

N.I.W.: data interpretation and manuscript final editing;

M.B.: data acquisition, manuscript drafting, and final editing;

A.K.: data acquisition and analysis and manuscript final editing;

A.U.: data acquisition and manuscript final editing;

C.P.S.: data interpretation and manuscript final editing;

D.S.: conception and design, data interpretation, manuscript drafting, and final editing;

F.A.L.: conception and design, data acquisition, analysis and interpretation, manuscript drafting, and final editing.

Corresponding author

Correspondence to Pasquale F. Innominato.

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Ethics approval

No specific ethical approval was necessary for this study. The patient-generated dataset was part of a pilot study (inCASA: Integrated Network for Completely Assisted Senior Citizen’s Autonomy), which was approved by the local institutional review board (Villejuif, France).

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The authors declare no competing interests.

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Innominato, P.F., Komarzynski, S., Dallmann, R. et al. Impact of assessment frequency of patient-reported outcomes: an observational study using an eHealth platform in cancer patients. Support Care Cancer 29, 6167–6170 (2021).

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