A single-center cohort study found that electronic monitoring of symptoms was useful among pediatric patients with cancer, according to results published in JAMA Network Open.

Patient-reported outcome measurements (PROMs) are becoming more widely used in adult oncology to improve supportive care. To date, less than 1% of pediatric clinics use PROMs as a primary endpoint. To adapt PROMs for the pediatric setting, investigators at the Medical University of Innsbruck in Austria created the web-based approach for daily child self-reporting and parent-based proxy reporting (ePROtect) tool. Between 2020 and 2021, patients aged 5 to 18 years or proxies for patients aged 1 to 4 years who received chemotherapy were trained to use ePROtect. Use of the software and adverse effects were evaluated.

The median age of the 40 pediatric patients was 9.1 years; 65.0% were male and 100% were White.

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A total of 4410 daily questionnaires on 7082 therapy days were completed, indicating a median fulfillment of 60.1%. Completion rates were similar between 3 age groups and in general, completion declined after 90 days on therapy (65.6% vs 42.9%).

A total of 251 PROMs associated with health deterioration and adverse events. Among these PROMs, 50.3% led to immediate counsel, 34.7% supported medication change, and 15.0% a referral to the emergency department.

Compared with the day before an unplanned admission, at admission patients reported lower pain, nausea and appetite loss, physical function, sleep disturbance, and global scores.

PROM scores of 50 or less were associated with mucositis (odds ratio [OR], 3.65; 95% CI, 1.54-8.62; P =.005) the following day.

The major limitation of this study was the lack of a comparator arm.

This study found the ePROtect software was well received and was able to provide early detection of toxic effects and prediction of admissions or medical interventions in the pediatric setting.

Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.


Meryk A, Kropshofer G, Hetzer B, et al. Use of daily patient-reported outcome measurements in pediatric cancer care. JAMA Netw Open. 2022;5:e2223701. doi:10.1001/jamanetworkopen.2022.23701