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. 2025 Jul 3;8(1):399.
doi: 10.1038/s41746-025-01812-x.

Effectiveness of symptom monitoring on electronic patient-reported outcomes (ePROs) among patients with lung cancer: a systematic review and meta-analysis

Yiqi Xia  1   2 , Xiaolong Guan  1   2 , Wenhui Zhu  1   2 , Yanshang Wang  1   2 , Zhenyu Shi  1   2 , Ping He  3
Affiliations

Effectiveness of symptom monitoring on electronic patient-reported outcomes (ePROs) among patients with lung cancer: a systematic review and meta-analysis

Yiqi Xia et al. NPJ Digit Med. .

Abstract

Symptom monitoring using electronic patient-reported outcomes (ePROs) has demonstrated benefits for patients with cancer, yet the systematic effects for lung cancer remains unknown. This study performed a literature search in Medline, Embase, Cochrane library, CINAHL and APA PsyInfo before April 23rd, 2025, and identified 5755 papers. 18 (0.31%) papers from 11 studies conducting symptom monitoring on ePROs and sending alerts of severe symptoms were included. The meta-analysis showed significant improvement in health-related quality of life (SMD = 2.44, P < 0.001) among patients with lung cancer, with an intervention duration of less than 6 months, 6 months and more than 6 months. When excluding studies that sent alerts to patients themselves, overall survival for lung cancer patients was significantly prolonged (HR = 0.54, 95% CI [0.22, 1.31], P = 0.031). Symptom burden, physical functioning, and healthcare service utilization was also advantaged, but implementation process and cost-effectiveness data was insufficient (Trial registration: CRD420251000397).

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Conflict of interest statement

Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Study selection flowchart.
Fig. 2
Fig. 2
Risk of bias summary of the included studies.
Fig. 3
Fig. 3. Results of meta-analysis for the effects of ePROs-based intervention on HRQoL.
a Presents the pooled effects for patients with lung cancer; b presents the results after including studies that involved lung cancer and clarified the number of lung cancer participants; c the results after including all studies that involved lung cancer and reported means and standard deviations, where the number of lung cancer participants were not reported, the number of thoracic cancer patients were used. ePROs electronic patient-reported outcomes, SD standard deviation, SMD standardized mean differences, HRQoL health related quality of life.
Fig. 4
Fig. 4. Subgroup analysis for effects of ePROs-based intervention on HRQoL.
a Shows the effects grouped by different duration of interventions, categorized as ‘less than 6 months’, ‘6 months’, ‘more than 6 months’; b shows the effects grouped by patients undergoing different treatments, classified as ‘chemotherapy’ and ‘all types of treatment’. ePROs electronic patient-reported outcomes, SD standard deviation, SMD standardized mean differences, HRQoL health related quality of life.
Fig. 5
Fig. 5. Results of meta-analysis the effects of ePROs-based intervention on overall survival.
a Presents the pooled effects for patients with lung cancer; b showed the results when including studies that used active alert approach; c showed the results when including all studies that involved lung cancer and reported hazard ratios. ePROs electronic patient-reported outcomes, HR hazard ratio.
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