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Table 2 Details of intervention, outcomes, measures used and results

From: Using technology to deliver cancer follow-up: a systematic review

Study Intervention Primary and secondary outcomes Measures used Results including statistical values
Beaver et al. (2009) [11, 25] Telephone follow up by specialist nurses Psychological Morbidity State-trait anxietntdy inventory No difference for psychological morbidity
Participant’s need for information General Health Questionnaire Patients in telephone group more satisfied (intention to treat p < 0.001)
Participants’ satisfaction No difference for information needs
Clinical investigations ordered No difference for clinical investigations
Time to detection of recurrent disease Recurrences :- no differences between the two groups p = 0.295% CI (−3.33-2.07) – equivalence demonstrated. 28)
Davison et al. (2002) [15] Computer programme providing information and assisting decision making “Extent to which women achieved their preferred decisional roles” Control Preferences Scale (CPS) Intervention group was more passive in decision making than planned. (p < 0.0001)
Patient satisfaction Patient Satisfaction Questionnaire (PSQ) More women over 50 opted to play a more passive role. (p= > 0.002)
No difference found for the two groups for patient satisfaction. Both groups reported high levels
Harrison et al. (2011) [21] 5 telephone calls from a specialist colorectal nurse in 6 months after discharge Unmet supportive care needs SCNS-SF34 and FACT-C used for unmet supportive care needs and quality of life. CaSUN was used to measure these two outcomes at 6 months No difference was found for unmet supportive care needs at 6 months
Secondary outcomes: Patient asked to remember health service use in a telephone interview “Observed effect size for supportive care needs was 0.25“
Health service utilization Study was aiming for effect size of 0.75.
Quality of life Quality of life had improved by “twice as much” in the intervention group at six months. (size of difference = 5.7)
At 6 months in the intervention group; fewer “presentations to emergency departments (p = 0.23) and readmissions to hospital (p = 0.37)” compared with the control group. Intervention group patients had more contact with “hospital-based, specialist based and community services”. Differences for health service utilization were not statistically significant
Hegel et al. (2010) [16] 6 weekly session of telephone delivered problem solving occupational therapy Feasibility of conducting a RCT including patient satisfaction Study recruitment and retention data was gathered “67% recruitment rate (31/46)”
Secondary outcomes: At 12 weeks participants completed a satisfaction survey “81% retention rate”
Functional quality of life “92% of those receiving the intervention were “highly satisfied”
Emotional status 92% reported it to be “helpful/very helpful”
97% if planned sessions of the intervention were completed
Effect sizes were calculated for secondary outcomes but “study was not powered to detect treatment effects”. Main outcome was feasibility for study to be repeated as larger scale RCT. No CIs quoted
Kearney et al. (2008) [12] Mobile phone-based remote monitoring during chemotherapy “Chemotherapy-related morbidity” of six symptoms Electronic symptom questionnaire completed by patients in control and intervention group before the start of chemotherapy and prior to cycles 2, 3, 4 and 5 In the control group more report of fatigue (CI = 1.04-5.05, P = 0.040) and lower reporting of hand-foot syndrome (CI 0.17-0.92 P = 0.031) Severity and distress of symptoms were no different between the two groups except for hand-foot syndrome in the intervention group. (Severity CI −0.52 to −0.02 P = 0.033, Distress CI −0.33 to −0.02, P = 0.028). Other differences were not statistically significant
These were nausea, vomiting, fatigue, mucositis, hand-foot syndrome and diarrhoea”
Kimman et al., 2011 [17, 27] Nurse led telephone follow up or Health-related quality of life (HRQoL) HRQoL: EORTC QLQ-C30 No difference between the two groups for HRQoL. (P value = 0.42
Nurse led telephone follow up plus educational group programme (EGP) Secondary outcomes: Role and emotional functioning: EORTC QLQ-C30 subscales Confidence interval of 95% for the “estimated difference between mean HRQoL scores at 12 months after treatment” = −1.93-4.64)
Role and emotional functioning Anxiety: State Trait Anxiety Inventory (STAI) No differences between groups for all other secondary outcomes (all p values > 0.05)
Feelings of control and anxiety Perceived feelings of control: Mastery scale
Kroenke et al. (2010) [26] Centralized telecare management by a nurse-physican specialist team coupled with home-based symptom monitoring by interactive voice recording or internet Depression and pain Measured at baseline and at 1, 3, 6 and 12 months. Depression measured using the “20-item Hopkins Symptom Checklist (HSCL-20) and pain (BPI) severity Greater improvements in pain (p < 0.001) and depression (p < 0.001) in the intervention group.
Secondary outcomes: Health related quality of life: SF-12 Effect size “for between-group differences” at 12 months for pain were 0.39 (95% CI, 0.01-0.77) and for depression, 0.41 (95% CI, 0.08-0.72)
Health-related quality of life “Quality of life – single item 0-10” No difference for health-related quality of life and health-care use. Difference for “other pain treatments” (p = 0.03).
Disability Anxiety – “7-item Generalised Anxiety Disorder scale”
Cointerventions “Physical symptom burden – 22-item somatic symptom scale”
Self reported health care use Fatigue- “SF 36 vitality scale”
Disability – “3- item Sheehan Disability Scale”
“Self-report health care use: treatment survey”
Marcus et al. (2009) [18] 16 session telephone counselling post treatment Cancer specific Distress Cancer specific Distress – Impact of Event Scale (IES). No differences found for depression and distress unless end points were “dichotomized at cutpoints suggestive of the need for clinical referral”. A 50% reduction in depression and distress was demonstrated in the intervention group compared to the control. (p = 0.07)
Depression Depression – Centre for Epidermiologic Studies Depression Scale (CES-D) “Significant effects” shown in sexual dysfunction and personal growth for the intervention group
Sexual dysfunction Sexual Dysfunction – 25 items (designed for study) When endpoints dichotomized- no change in the control group (depression: p = 0.41, distress = 0.86). Intervention group (depression p = 0.0007, distress p = 0.0007)
Personal Growth Personal growth – 5 items (designed for study) Group differences at 18 months were significant
Depression: p = 0.06 and Distress: p = 0.07 “with effect sizes of 0.23 and 0.24”
Sexual dysfunction: at 18 months, “significant improvement intervention group” p = 0.04, effect size = 0.23
Personal growth- both groups improved but more in the intervention group. (At 18 months p = 0.03, effect size =0.22)
Matthew et al. (2007) [20] PDA survey followed by paper Data quality International Prostate Symptom Score (IPSS) Internal consistency found to be high
PDA followed by PDA survey. (3 groups) Feasibility Patient Orientated Prostate cancer Utility Survey (PORPUS) International Index of Erectile Function-5 (IIEF-5) either in paper or PDA forms Test re-test reliability high. (p < 0.01)
Scores across modalities were correlated demonstrating “concurrent validity (p < 0.01)”
No differences in levels of participation
Preference was highest for the PDA version of the questionnaire. (58.6%)
Age did not have an impact on preference (p = 0.12)
Age did not have an impact of difficulty using PDA. (p = 0.08)
Confidence intervals quoted in the paper for each of the data items within the questionnaire
Sandgren et al. (2003) [19] 6×30 min telephone therapy sessions that involved either cancer education or emotional expressions Mood Quality of Life – Functional Assessment of Cancer Therapy-Breast Instrument (FACT-B) Cancer Education group – greater perceived control (p < 0.01)
Quality of Life Mood – Profile of Mood States No difference for mood (p > 0.12) or quality of life (p > 0.12) found
Perceived control Perceived control – Perceived Stress Scale No CIs quoted- only standard deviations, means and p values
Sikorskii et al. (2007) [22] Automated telephone symptom management Severity of symptoms 17 symptoms scored for severity – designed for the study. Analysed using a RASCH model Both groups had a reduction in symptom severity. No difference found between 2 groups
Effect sizes were almost the same for NASM (0.56) and ATSM (0.59)
Sikorskii et al. (2009) [23] Automated voice response symptom reporting Severity of symptoms – difference depending on mode of assessment 14 cancer related symptoms – scored for severity. Designed for the study AVR group reported more severe symptoms of “nausea, vomiting, diarrhoea, poor appetite, pain and alopecia (p values less than 0.05)”
Varied with age with older patients reporting higher severity in the nurse led group (effect sizes greater or equal to 0.35”)
Yun et al. 2012 Seoul, Korea [24] Internet based, individually tailored cancer related fatigue education program Level of fatigue Brief Fatigue Inventory (BFI) Intervention group reported an improvement in fatigue with a significantly greater decrease in BFI global score (−0.66 points, 95% CI −1.04 to −0.27), FSS total score (−0.49;95% CI, 0.78 to −0.21) and HADS score
Anxiety and depression Fatigue Severity Scale (FSS) Participants with moderate or greater fatigue reported a significantly greater decrease in HADS Anxiety score (−0.90; 95%CI, −1.51 to −0.29) as well as global quality of life (5.22; 95% CI, 0.93 to 9.50) and several functioning scores of the EORTC QLQ_C30
Global quality of life Hospital Anxiety and Depression Scale (HADS)
European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ_C30)