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Review
. 2022 Feb:6:e2100154.
doi: 10.1200/CCI.21.00154.

Gynecologic Survivorship Tool: Development, Implementation, and Symptom Outcomes

Jeanne Carter  1   2   3 , Nadeem R Abu-Rustum  1   4 , Sally Saban  1 , Ling Y Chen  5 , Andrew J Vickers  5 , Amy L Tin  5 , Gabriela Billanti  1 , Nicole A Connors  1 , Vance Broach  1   4 , Carol L Brown  1   4 , Dennis S Chi  1   4 , Ginger J Gardner  1   4 , Deborah J Goldfrank  1   4 , Elizabeth L Jewell  1   4 , Mario M Leitao Jr  1   4 , Kara C Long Roche  1   4 , Jennifer J Mueller  1   4 , Yukio Sonoda  1   4 , Oliver Zivanovic  1   4
Affiliations
Review

Gynecologic Survivorship Tool: Development, Implementation, and Symptom Outcomes

Jeanne Carter et al. JCO Clin Cancer Inform. 2022 Feb.

Abstract

Purpose: To describe the development and implementation of a new digital health clinical tool (Gynecologic Survivorship Tool [GST]) for symptom management of women surgically treated for gynecologic cancer; to assess its feasibility; and to conduct a retrospective review of the data.

Materials and methods: The GST was developed on the basis of a comprehensive review of the literature, multidisciplinary expert opinion, and feedback from women with a history of gynecologic cancer. It is composed of 17 questions addressing six main categories-gynecologic health (abnormal bleeding/pain), lymphedema, vaginal/vulvar dryness, sexual health, menopause (hot flushes/sleep difficulties), and bowel/urinary issues. An electronic version using the Memorial Sloan Kettering Cancer Center Engage platform was piloted in two clinics for patients with endometrial or cervical cancer. Health information was generated into clinical summaries and identified concerns for actionable response. Associations of symptom and survey time point were assessed by longitudinal models using generalized estimating equations.

Results: From January 1, 2019, to February 29, 2020, 3,357 GST assessments were assigned to 1,405 patients, with a 71% completion rate (90% within 5 minutes). Sixty-eight percent were performed at home via a patient portal, 32% at follow-ups using a clinic iPad. The most common symptoms were bowel problems, swelling/fluid, pain during examination, vaginal or vulvar dryness, and vaginal bleeding. Implementation challenges included improving patient compliance and ensuring that reports were reviewed by all clinical teams. We developed screening e-mails detailing patients whose assessments were due, planned training sessions for multidisciplinary teams, and incorporated feedback on methods for reviewing symptoms reports.

Conclusion: The GST demonstrated feasibility, a high completion rate, and minimal time commitment. It was an effective electronic reporting mechanism for patients, enabling the medical team to develop specific strategies for alleviating bothersome symptoms during follow-up.

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Conflict of interest statement

Nadeem R. Abu-RustumHonoraria: Prime OncologyResearch Funding: Stryker/Novadaq (Inst), GRAIL (Inst)Travel, Accommodations, Expenses: Prime Oncology Ling Y. ChenEmployment: Lyra Andrew J. VickersStock and Other Ownership Interests: OPKO HealthConsulting or Advisory Role: OPKO Diagnostics, Insightec, Steba BiotechPatents, Royalties, Other Intellectual Property: I am named on a patent for a statistical method to detect prostate cancer. This method has been commercialized by OPKO as the 4Kscore. I receive royalties from sales of the 4KscoreTravel, Accommodations, Expenses: OPKO Health Vance BroachOpen Payments Link: https://openpaymentsdata.cms.gov/physician/1162364 Dennis S. ChiLeadership: CSurgeriesStock and Other Ownership Interests: Bovie Medical, Verthermia, Intuitive Surgical, TransenterixHonoraria: Biom'UpConsulting or Advisory Role: Bovie Medical, Verthermia, Biom'upTravel, Accommodations, Expenses: Biom'Up Ginger J. GardnerHonoraria: BioAscentTravel, Accommodations, Expenses: BioAscent Elizabeth L. JewellHonoraria: SurvivornetConsulting or Advisory Role: Intuitive Surgical, Covidien/MedtronicResearch Funding: Summit Biomedical Mario M. Leitao JrHonoraria: Intuitive SurgicalConsulting or Advisory Role: Intuitive Surgical, Ethicon/Johnson & Johnson, Medtronic, TakedaResearch Funding: KCITravel, Accommodations, Expenses: Intuitive Surgical Yukio SonodaPatents, Royalties, Other Intellectual Property: Pending patent for a surgical instrument (uterine manipulator)No other potential conflicts of interest were reported.

Figures

FIG 1.
FIG 1.
Clinical symptom summary report. NA, not available.
See this image and copyright information in PMC

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