In order to increase stakeholder uptake of patient reported outcome measures and other forms of phenotyping that involve collection of various measurements, new technology is required to increase efficiency while reducing patient survey/measurement burn out.
Research question:How can technology improve measurement of outcome phenotypes? Phenotypes are clinically-relevant classifications of various important health outcomes or disease states. Examples of phenotypes include developing of a second primary cancer, quality of life, vital status (i.e., being alive versus dead), and hearing loss.
Summary:Each pilot project is a separate project that follows a standardized implementation science framework, the CIHR Knowledge-to-Action framework that guides systematic collection of the processes of implementation. The phenotype data being collected is being used and analyzed for scientific purposes, but the implementation strategies are also being studied, to help with future roll-out and implementation in other institutions.
Representative past, current, and future projects include:
(1) Adaptation of a University Health Network inhouse-developed electronic smoking cessation tool (CEASE tool, PIs Meredith Giuliani and Jennifer Jones) for lung cancer screening, and expansion into other University of Toronto-affiliated institutions.
(2) Pilot implementation of the mobile phone-based ASyMs Self-Management platform (with PI Doris Howell) in breast, colorectal, and lymphoma clinics
(3) Pilot implementation of a commercially available remote symptom reporting tool (Lifeguard Rx) in lung and sarcoma clinics
(4) Pilot implementation of point-of-care routine hearing tests using tablet technology and noise-cancelling headphones for patients receiving high dose cisplatin (head and neck and lung cancer), in collaboration with Shoebox Audiometry, Inc.
(5) Pilot implementation of the OCEANS electronic platform for combined pre-screening for COPD, lung cancer, and smoking cessation coupled with rapid, semi-automated referral for appropriate formal screening/management.
(6) Adaptation of electronic CEASE to include second-hand exposure.
(7) Development and pilot implementation of an electroniv esophageal cancer intake demographic and epidemiologic questionnaire routine in clinic using tablet technology.
(8) Development and prospective evaluation of a branching logic, electronic-screening survey, CAPLET, a cancer ambulatory patient physical function longitudinal evaluation tool for routine clinical practice.
(9) Development and evaluation of electronic screening dysphagia tools for observational studies and routine care in cancer patients.
(10) Validation of a one-page patient-reported Charlson comorbidity index questionnaire for upper aerodigestive tract cancer patients with an electronic-enabled version.
(11) Point-of-care evaluation of breath (see Breathomics for details)
(1) To systematically document the processes for piloting and implementing new technology into clinical practice.
(2) Using objective criteria, to determine whether the pilot implementation is deemed a success or failure, followed by an analysis of the reasons behind each determination.
(3) To utilize the data collected from these pilots to answer important research and clinical questions, thus demonstrating the value of the collected data.
Funding Sources:Cancer Care Ontario and Ontario Institute for Cancer Research, Department of Medicine and Division of Medical Oncology, University of Toronto through its Comprehensive Research Experiment for Medical Students (CREMS) program, and the GDipHR (Graduate Diploma for Health Research) program.