Implementation of an ePRO Application for Health-Related Quality of Life (HrQoL) in Breast Cancer Patients: Evaluation and Usability Analysis (Preprint)

BACKGROUND One in eight women is diagnosed with breast cancer in the course of her life. As systematic palliative treatment has an only limited effect on survival rates, the concept of Health-related Quality of Life (HRQoL). Various studies have already demonstrated the reliability of paper-based PRO (pPRO) and ePRO and that the two means of assessment are equally valid. OBJECTIVE The aim of this study was to analyze the acceptance and evaluation of a tablet-based ePRO applica-tion for breast cancer patients and to examine its suitability, effort, and difficulty in the context of HRQoL and sociodemographic factors. METHODS In all, 106 women with adjuvant or advanced breast cancer were included in a two-center study at two major university hospitals in Germany. Patients were asked to answer HRQoL (EORTC QLQ-C 30, FACT-B) and PRO questionnaires both on a tablet on-site using a specific eHealth assessment website and on paper. The suitability, effort, and difficulty of the application and self-reported technical skills were also assessed. Only the results of the electronically acquired data are presented here, results of reliability to pPRO data have already been published elsewhere. RESULTS Patients regarded the ePRO assessment as more suitable (74.8%), less stressful (69.8%), and less difficult than pPRO (65.2%). The majority of patients stated that ePRO improves health care in hospitals (82.1%). However, evaluation of ePRO depends on the level of education (p=0.003) and patients’ experience in using a computer (p=0.041). The application was rated highly in all categories. HRQoL data did not show significant correlations to the application’s evaluation parameters. CONCLUSIONS The results indicate that ePRO surveys are also feasible for measuring HRQoL in breast cancer pa-tients and that those patients prefer ePRO to pPRO assessment. It can also be seen that patients consider ePRO to be improve hospital health care. However, studies with larger numbers of patients are needed to develop applications that address the needs of patients with lower levels of education and technical skills.