Program development through compilation of patient self-reported symptom burden.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 78-78
Author(s):  
Diane Denny ◽  
Brandon Bosch ◽  
Kayla Alston ◽  
Maurie Markman
Keyword(s):  
Program Development ◽  
Assessment Tool ◽  
Symptom Burden ◽  
Clinical Intervention ◽  
Assessment Instrument ◽  
Free Text ◽  
Cancer Type ◽  
National Network ◽  
Symptom Inventory ◽  
Md Anderson

78 Background: Cancer Treatment Centers of America, (CTCA) is a national network of five hospitals that specialize in the treatment of patients fighting complex or advanced-stage cancer. The Symptom Inventory Tool (SIT) is an assessment tool that captures the patients’ perceived symptom burden for real time clinical intervention and provides longitudinal data to demonstrate how effectively we meet our patient’s needs, from the point of no intervention (baseline) and every 21 days or greater. The SIT is comprised of 27 questions utilizing the MD Anderson Symptom Inventory tool, a validated assessment instrument with 8 questions added and a free text box by CTCA. The SIT became an integral part of patient care at CTCA in September 2012. Methods: A multidisciplinary team convened to evaluate how best to deliver the SIT data to facility leadership to assist with program development. The data needed to perform each calculation was obtained using analytical software that interfaces the database, electronic health record, and cancer registry. A Quality Research Associate prepares the operational summary providing a monthly update for the leadership at each facility with data included for the previous month, cumulatively for the facility, and cumulatively for the network. Results: The summary includes mean time to complete an assessment, assessments by timeframe (i.e. baseline, 2nd, 3rd assessments, etc.), gender and age percentages, and patients categorized by cancer type. The top three average scoring symptoms and interference issues by baseline, 2nd, and 3rd assessment are highlighted along with the top areas of improvement and diminishment in score defined by a change of 2 or more points reflecting clinical relevance. The top areas scored at 8 or greater that improved and the top areas where patients continued to score at 8 or greater on return are presented to focus upon the most severe needs. Graphs and tables are accompanied by explanation. Conclusions: In addition to consistency in presentation of the data across centers, the SIT operational summary provides visibility and insight on key emerging trends. Meaningful discussion of programmatic opportunities for focus on the most problematic and severe symptom by patient group has occurred.

Use of an automated notification tool to drive real-time patient symptom intervention.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 160-160
Author(s):  
Scott Hartman ◽  
Brandon Bosch ◽  
Diane Denny ◽  
Maurie Markman
Keyword(s):  
Real Time ◽  
Assessment Tool ◽  
Assessment Instrument ◽  
Free Text ◽  
Team Members ◽  
National Network ◽  
Symptom Inventory ◽  
Support Team ◽  
E Mail

160 Background: Cancer Treatment Centers of America, Inc. (CTCA) is a national network of hospitals that specialize in the treatment of patients fighting complex or advanced-stage cancer. The Symptom Inventory Tool (SIT) is an assessment tool that captures the patients’ perceived symptom burden for real-time clinical intervention, from baseline and every 21 days thereafter. The SIT is comprised of questions utilizing the M.D. Anderson Symptom Inventory tool, a validated assessment instrument with questions added and a free text box by CTCA. Methods: An e-mail notification system associated with the SIT was established to allow efficient communication with specialists and support team members who would not traditionally see the patient without such a trigger signifying a need. While the SIT report is housed within the EHR, an automated e-mail profile may be established for each clinician and or team, tailored to the clinical specialty, based on symptom(s) of interest. Patients completing the SIT and scoring a particular symptom(s) at or above a threshold will “trigger” notification of that their score along with information allowing follow-up. Notifications can be set at 15 minute intervals, hourly, daily, etc. Results: 31 users/groups, representing a wide variety of disciplines and multiple care teams, currently utilize the SIT e-mail functionality including: Pain, Distress, Mind Body Medicine, Survivorship, Physical Therapy, and Sleep. The content of the e-mail consists of the patient name, medical record number, and (self-defined) symptom scores of interest. These same patients triggering a notification may be readily tracked for follow-up by the support team throughout their course of treatment or seen only once depending upon patient preference and identified need. Conclusions: The e-mail notification process has promoted communication with specialists and other support team members outside of the core team, cognizant of their different communication needs. Moreover, it allows for effective alignment of resources based on clinician expertise.

Use of self-reporting outcomes to inform patient care.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 176-176
Author(s):  
Brandon Bosch ◽  
Diane Denny ◽  
Maurie Markman
Keyword(s):  
Patient Care ◽  
Real Time ◽  
Treatment Plan ◽  
Symptom Burden ◽  
Assessment Instrument ◽  
Free Text ◽  
Data Set ◽  
Symptom Inventory ◽  
Starting Point ◽  
E Mail

176 Background: Cancer Treatment Centers of America, Inc (CTCA) is a national network of hospitals that specialize in the treatment of patients fighting complex or advanced-stage cancer. The Symptom Inventory Tool (SIT) is an assessment tool that captures the patients’ perceived symptom burden for real-time clinical intervention, from the point of no intervention (baseline) and every 21 days or greater. The SIT is comprised of 27 questions utilizing the MD Anderson Symptom Inventory tool, a validated assessment instrument with eight questions added and a free text box by CTCA. The SIT became an integral part of patient care at CTCA beginning in 2012. Methods: Non-clinical stakeholders administer the SIT via an electronic tablet. Upon completion of the assessment, a trending graph known as Symptoms-at-a-Glance (SAG) report is auto populated and available to clinicians in the EHR or may be printed at the point of care. The SAG provides run graphs for each symptom including arrows identifying clinically relevant changes in score. An accompanying e-mail notification system was created for physicians to review specific symptoms of interest at a threshold of their choosing, and refer patients to other specialties deemed integral for the patient’s treatment plan. Results: The SIT assessment is utilized by the nurse as a starting point from which they can initiate a more pointed conversation with the patient including the need for appropriate intervention including follow-up with the oncologist and/or referral to a member of the extended integrative care team. The percentage of new and returning patients completing an assessment is at 94.94% and 84.81%, respectively, for patients (1/1/14-6/9/14) across CTCA suggesting this process is useful for both patient and clinicians. Patients comment that the time for self-reflection is a healthy exercise enabled by the user-friendly tablet. Clinicians value both the ease of administration/use as well as the ability to create a large data set for quality improvement. Conclusions: With a majority of new and returning patients participating in the SIT, the SAG report fully implemented into the EHR along with the use of an e-mail functionality, clinicians and physicians can now better manage symptom burden real time

Engaging patients with their self-reported symptom outcomes trended data.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 69-69
Author(s):  
Scott Hartman ◽  
Diane Denny ◽  
Carmon Greene ◽  
Morgan Hannaford ◽  
Maurie Markman
Keyword(s):  
Real Time ◽  
Assessment Tool ◽  
Graphical Representation ◽  
Wide Spectrum ◽  
Care Physician ◽  
Interdisciplinary Teams ◽  
Care Team ◽  
Assessment Instrument ◽  
Free Text ◽  
Symptom Inventory

69 Background: Cancer Treatment Centers of America, Inc. (CTCA) is a national network of hospitals that specialize in the treatment of patients fighting complex or advanced-stage cancer. The Symptom Inventory Tool (SIT) is an assessment tool that captures the patients’ perceived symptom burden for real-time clinical intervention. Patients take a baseline SIT assessment at new patient intake and are eligible to take the SIT every 21 days. The SIT is comprised of the M.D. Anderson Symptom Inventory tool, a validated assessment instrument, along with additional questions and a free text box that were created by CTCA. The SIT became an integral part of patient care at CTCA beginning in 2012. Recognizing the value of the SIT data in real time patient intervention, a project was undertaken to engage the patient with his/her results and facilitate dialogue with his/her care team. Methods: Upon completing the SIT, patients were provided with their Symptoms-At-a-Glance (SAG) report, which is a graphical representation of trended outcomes of their SIT data, along with education on how to interpret the document. Patients were encouraged to review the SAG with their care team as a communication facilitation tool promoting open dialog on those symptoms identified as the most severe and or frequent. Pre and post evaluations of the process were completed via a brief questionnaire for patients and staff to evaluate efficacy of the exchange. Results: A total of 272 patients completed the SIT during the initial 30 days. 80.5% of patients utilized the SAG report during their Medical Oncology appointments and/or took their report with them for subsequent reference. Utilization of the SAG report by interdisciplinary teams for patient intervention showed an increase of 103%. Patients responded favorably to the project and reported that the SAG is a valuable tool which will be shared with their primary care physician and used to update family members. Conclusions: The project was successful in creating improved integration of the SIT outcomes and driving more focused and complete discussions between patients and their providers on a wide spectrum of quality of life issues.

Addressing patient needs through compilation of self-reported verbatim comments.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 111-111
Author(s):  
Scott Hartman ◽  
Diane Denny ◽  
Sarah Hizon ◽  
Danielle Kendrick ◽  
Maurie Markman
Keyword(s):  
Symptom Burden ◽  
Free Text ◽  
Patient Needs ◽  
Dual Processes ◽  
Text Data ◽  
National Network ◽  
Symptom Inventory ◽  
Advanced Stage Cancer ◽  
Multi Disciplinary Team

111 Background: Cancer Treatment Centers of America, Inc. (CTCA) is a national network of five hospitals that specialize in the treatment of patients fighting complex or advanced-stage cancer. The Symptom Inventory Tool (SIT) is an assessment that captures the patients’ perceived symptom burden, from baseline and every 21 days thereafter. The SIT is comprised of questions utilizing the M.D. Anderson Symptom Inventory tool, with eight questions and a free text box added by CTCA. Patient comments are provided in approximately 5% of all assessments (representing 3,700 comments) since initiation of the SIT. Methods: Patients answer the question, “Is there anything else that you would like to tell us or are there additional concerns you would like addressed?” within a free text field. In addition to availability to the care team to address any identified urgent need, each comment is classified into 15 defined categories to allow trending. The report is disseminated monthly to a multi-disciplinary team for follow-up on service delivery and consideration in program development. Results: The table represents the top five patient comment categories along with “other”. In addition, a sample of last quarter's data revealed that 84% of comments required immediate follow-up that may have otherwise been missed without text data mining. Conclusions: Verbatim comments are of significant value and can be best managed via dual processes to ensure timely follow-up and to support programmatic alignment, continuously analyzing data for areas of improvement. [Table: see text]

Evaluation of self-reported symptoms and interference issues in prostate cancer patients.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 283-283
Author(s):  
Mahdi Taha
Keyword(s):  
Prostate Cancer ◽  
Sexual Dysfunction ◽  
Cancer Patients ◽  
Large Body ◽  
Symptom Burden ◽  
The United States ◽  
Assessment Instrument ◽  
Cancer Center ◽  
Free Text ◽  
Symptom Inventory

283 Background: Prostate cancer is a leading cause of global morbidity and mortality and in the next few years is expected to be the leading cause of death among men in the United States. Both the disease and its treatments produce a variety of symptoms that impact prostate cancer outcomes, of which the more common symptoms are in relation to sexual dysfunction. A large body of literature has established that systematic patient reporting of symptoms during routine oncology care leads to clinical benefits. At our comprehensive community cancer center we evaluate patients’ reported symptoms using the Symptom Inventory Tool (SIT), an assessment tool that captures the patients' perceived symptom burden for real-time clinical intervention taken at the point of no intervention and every ≥ 21 days thereafter. Methods: The 27-question SIT is comprised of the M.D. Anderson Symptom Inventory Tool (MDASI), a validated assessment instrument, with 8 supplementary questions and a free-text box added by Cancer Treatment Centers of America. Symptoms are rated “at the worst” on a numeric scale ranging from 0 to 10, as experienced by pts in the past 24 hours. The SIT became an integral part of patient care at CTCA beginning in 2012. Results: Over a 45 month period (9/1/2012 to 05/31/2016), prostate cancer pts at CTCA completed the SIT at intake and again ≥ 21 days after. A total of 2,937 assessments were analyzed. The assessments consisted of 1,065 completed at baseline, 1,065 completed at the 2nd follow up (FU), and 807 completed at 3rd FU or greater. Further analysis of baseline SIT identified the pts who rated the above symptoms as “very burdensome” with a score of ≥ 5. 2nd SIT results from these PC patients revealed that those with a heavier symptoms burden at baseline would be more likely to experience a significant decrease in their symptoms burden than the average PC patient population. Conclusions: The SIT was successful in identifying symptoms burden and interference with life issues in prostate cancer patients. Sexual dysfunction and disturbed sleep were the most common reported symptoms. Early identification of patients with heavy symptom-burden allowed immediate intervention and improvement in approximately a one-fourth to two-thirds of patients.

scholarly journals Translation and validation of the Chinese version of the MD Anderson Symptom Inventory for measuring perioperative symptom burden in patients with gynecologic cancer

2021 ◽  
Author(s):  
Ting Zhang ◽  
Ying-ying Zheng ◽  
Zhi-rong Yang ◽  
Qiuling Shi ◽  
Xin Shelley Wang ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Symptom Severity ◽  
Assessment Tool ◽  
Gynecologic Cancer ◽  
Symptom Burden ◽  
Chinese Version ◽  
Chinese Patients ◽  
Gynecologic Cancers ◽  
Symptom Inventory ◽  
Md Anderson

Abstract Background: Gynecologic cancers are among the most prevalent malignancies in China, and millions of gynecologic cancer patients are expected to undergo open abdominal surgery as initial treatment. The tumor- and surgery-related symptom burden are not well studied owing to a lack of a standardized and validated assessment tool in Chinese. The study was to translate and validate the MD Anderson Symptom Inventory for measuring perioperative symptom burden in gynecologic cancer patients (MDASI-PeriOp-GYN) and examine the utility of the Chinese version.Methods: The MDASI-PeriOp-GYN was translated in a stepwise manner. First, two native speakers independently translated the 9 PeriOp-GYN symptom items. Then the 9 items were translated back into English by another two bilingual translators. After discussion and revision, the four translators reached an agreement. The finalized Chinese version was administered to women with three common gynecologic cancer types (cervical, ovarian, and endometrial cancers) recruited from the gynecological oncology department of Sichuan Cancer Hospital & Institute between July and October 2019. Reliability and validity of the translated version were assessed. Results: Overall, 324 women with gynecologic cancers were enrolled. Cronbach’s α values were 0.826 and 0.735 for the symptom severity and interference scales, respectively. Test-retest reliability values were 0.885, 0.873, and 0.914 for the symptom severity, PeriOp-GYN, and interference scales, respectively. Significant correlations were found between the MDASI-PeriOp-GYN-C and EORTC QLQ-C30 along with the QLQ-OV28 module (-0.608–0.871, P<0.001). Known-group validity was supported by significant differences in the scores of the four scales grouped by time intervals, surgery type, and functional status (all P<0.01). Conclusions: The MDASI-PeriOp-GYN-C is a valid and reliable tool for measuring symptoms in Chinese patients undergoing surgery for gynecologic cancers. The tool could be used in clinical practice and clinical trials to instantly gather patients’ health and quality of life data.

A review of patient self-reported symptom data with a focus on pain.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 79-79
Author(s):  
Diane Denny ◽  
Swetha B. Nutakki ◽  
Kayla Alston ◽  
Maurie Markman
Keyword(s):  
Severe Pain ◽  
Assessment Tool ◽  
Sexual Interest ◽  
Disease Process ◽  
Symptom Burden ◽  
Chiropractic Care ◽  
Baseline Assessment ◽  
National Network ◽  
Symptom Inventory

79 Background: Cancer Treatment Centers of America, Inc (CTCA) is a national network of five hospitals that specialize in the treatment of patients fighting complex or advanced-stage cancer. The Symptom Inventory Tool (SIT) is an assessment tool that captures the patients’ perceived symptom burden. It includes the scientifically validated M. D. Anderson Symptom Inventory core items and is supplemented by CTCA clinician interested ‘custom 8’ (constipation, swelling, mouth soreness, bleeding, sexual interest, family, hope and Quality of Life). Methods: A baseline assessment is administered to new patients. Follow ups are assessed every 21 days or greater. The patients’ answers range from 0 to 10 and a score of 8 or higher was considered a severe symptom. A change of 2 points from baseline to 2nd follow up assessment is considered a clinically significant. Patients who had a severe pain score on a baseline assessment between April 2013 and March 2014 were closely followed. Results: There were 6,836 baseline assessments and 2,961 2nd follow up assessments between April 2013 and March 2014. Fatigue and sleep were the most reported symptoms while bleeding, mouth sores and vomiting were the least reported. Most of the patients had a decrease or stayed unchanged in their symptom scores. The patients who had a significant increase in symptoms at follow up ranged from 6% for bleeding to 28% for fatigue. There were 462 patients who reported severe pain on baseline assessment. Of the 462 patients, 295 patients (63.8%) had improvement in severity by the follow up assessment. After chart review, 447 patients (96.7%) had either improvement by follow up assessment (63.8%) or documented pain intervention (32.9%). Interventions included change to pain medication, addition of a Medtronic pain pump, physical therapy, palliative radiation therapy, cold laser therapy, and integrative therapies such as acupuncture, chiropractic care and massage therapy Conclusions: The SIT was successful in identifying symptom burden and interference with life issues in oncology patients. It has become an integral part of patient care at CTCA in providing exceptional pain and symptom management through the disease process creating visibility and focus.

scholarly journals Translation and validation of the Chinese version of the MD Anderson symptom inventory for measuring perioperative symptom burden in patients with gynecologic cancer

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ting Zhang ◽  
Ying-ying Zheng ◽  
Zhi-rong Yang ◽  
Qiuling Shi ◽  
Xin Shelley Wang ◽  
...  
Keyword(s):  
Symptom Severity ◽  
Assessment Tool ◽  
Uterine Cancer ◽  
Gynecologic Cancer ◽  
Symptom Burden ◽  
Chinese Version ◽  
Chinese Patients ◽  
Gynecologic Cancers ◽  
Symptom Inventory ◽  
Md Anderson

Abstract Background Gynecologic cancers are among the most prevalent malignancies in China. Cervical and uterine cancer respectively account for the sixth and eighth highest incidence of cancer among Chinese women. Abdominal surgery is one of the important treatment methods for gynecological tumors. However, the tumor- and surgery-related symptom burden are not well studied owing to a lack of a standardized and validated assessment tool in the Chinese population. The study aimed to translate and validate the MD Anderson Symptom Inventory for measuring perioperative symptom burden in gynecologic cancer patients (MDASI-PeriOp-GYN) and examine the utility of the Chinese version of MDASI-PeriOp-GYN. Methods The MDASI-PeriOp-GYN was translated in a stepwise manner. First, two native speakers independently translated the 9 PeriOp-GYN symptom items. Then the nine items were translated back into English by two different bilingual translators. After discussion and revision, the four translators reached an agreement. Finally, the finalized Chinese version was administered to women with three common gynecologic cancer types (cervical, ovarian, and endometrial cancers) recruited from the gynecological oncology department of Sichuan Cancer Hospital & Institute between July and October 2019. The reliability and validity of the translated version were assessed. Results Overall, 324 women with gynecologic cancers were enrolled. Cronbach’s α values were 0.826 and 0.735 for the symptom severity and interference scales, respectively. Test–retest reliability values were 0.885, 0.873, and 0.914 for symptom severity, PeriOp-GYN, and interference scales. Significant correlations were found between the MDASI-PeriOp-GYN-C and EORTC QLQ-C30 along with the QLQ-OV28 module (− 0.608–0.871, P < 0.001). Known-group validity was supported by significant differences in the scores of the four scales grouped by time intervals, surgery type, and functional status (all P < 0.01). Conclusions The MDASI-PeriOp-GYN-C is a valid and reliable tool for measuring symptoms in Chinese patients undergoing surgery for gynecologic cancers. The tool could be used in clinical practice and clinical trials to instantly gather patients’ health and quality of life data.

scholarly journals Validation of the Spanish version of the MD Anderson symptom inventory – heart failure (MDASI-HF-Spanish) module

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Anecita Fadol ◽  
Joaquin Buitrago ◽  
Maria C. Diaz ◽  
Valerie Shelton ◽  
Carolyn Harty ◽  
...  
Keyword(s):  
Heart Failure ◽  
Internal Consistency ◽  
Symptom Assessment ◽  
Internal Consistency Reliability ◽  
The United States ◽  
Assessment Instrument ◽  
Symptom Inventory ◽  
Patients With Cancer ◽  
Spanish Speaking ◽  
Md Anderson

Abstract Background The lack of a validated symptom assessment instrument in Spanish for patients with cancer and heart failure (HF) can affect the care and impede the recruitment and participation of Spanish-speaking patients in clinical trials. Spanish is the second most common language spoken by the largest and most rapidly growing racial/ethnic minority group in the United States. To bridge the language barrier and improve symptom management in Spanish-speaking patients with cancer and HF, the MD Anderson Symptom Inventory-Heart Failure (MDASI-HF) was translated to Spanish (MDASI-HF- Spanish). Aim To validate the MDASI-HF-Spanish symptom assessment instrument. Methods Following standard forward and backward translation of the original and previously validated English version of the MDASI-HF, a cognitive debriefing with nine native Spanish speaking participants was conducted to evaluate the participants’ understanding and comprehension of the MDASI-HF-Spanish. To examine the comprehensibility, acceptability and psychometric properties of the translated instrument, the MDASI-HF-Spanish was tested in a convenience sample of 50 Spanish speaking patients with a diagnosis of cancer and HF. Evidence for the psychometric validity of the MDASI-HF-Spanish was demonstrated via its internal consistency reliability and known-group validity. Results Overall, the participants had no problems with the understandability, readability, or number of questions asked. The MDASI-HF-Spanish subscales showed good internal consistency reliability, with a Cronbach’s coefficient alpha of 0.94 (13 core cancer symptoms), 0.92 (8 heart failure symptoms), and 0.90 (6 interference items) respectively. The MDASI-HF-Spanish was able to differentiate the functional status between patients based on the New York Heart Association (NYHA) functional classification. Conclusions The MDASI-HF-Spanish is linguistically and psychometrically valid with ease of completion, relevance, and comprehensibility among the participants, and it can be a useful tool for clinical management and research purposes.

In search of the optimal outcome measure for patients with advanced cancer and gastrointestinal obstruction: A qualitative research study.

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 100-100 ◽  
Author(s):  
Brian D. Badgwell ◽  
Loretta A. Williams ◽  
Eduardo Bruera
Keyword(s):  
Qualitative Research ◽  
Advanced Cancer ◽  
Symptom Burden ◽  
Psychometric Testing ◽  
Symptom Assessment ◽  
Symptom Inventory ◽  
Gastrointestinal Obstruction ◽  
Item List ◽  
Md Anderson ◽  
Panel Rating

100 Background: Gastrointestinal obstruction (GIO) is the most common indication for palliative surgical consultation in patients with advanced cancer. The purpose of this study was to delineate the symptom burden and experience of patients with GIO. Methods: Twenty patients with advanced cancer and GIO described symptoms at the time of surgical consultation. We used content analysis of interview transcripts and symptoms were ranked by frequency and compared to a general symptom assessment survey (MD Anderson Symptom Inventory). Results: Malignancy type included colorectal (N = 9), gastric (N = 4), urothelial/renal (N = 3), and other (N = 4), while site of obstruction was small bowel in 11 (55%), gastric outlet in 3 (15%), and large bowel in 6 (30%). Thirteen patients (65%) had received chemotherapy within 6 weeks. Imaging evidence of a primary/recurrent tumor, carcinomatosis, or ascites was documented in 13 (65%), 11 (55%), and 16 (80%) patients, respectively. Thirty symptoms were identified on qualitative interviewing. MD Anderson Symptom Inventory symptoms of pain, nausea, and vomiting were frequently noted. Frequently mentioned GIO-specific symptoms included bloating, cramping, not having a bowel movement, and inability to eat. Conclusions: Qualitative research methodology can identify symptoms of importance to patients which can be used to assess improvement after treatment of GIO. Expert panel rating will be used to develop the final symptom item list prior to psychometric testing of the survey.

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