Improving Quality of Life Based on Electronic Patient Reported Outcomes in Patients with CLL and MDS: The Mypal Study
Notice bibliographique
Résumé
Introduction: Palliative care is a critical component of care for patients with chronic hematological malignancies. Leveraging eHealth approaches can potentially facilitate the delivery of palliative care, leading to improved quality of life (QoL). Methods: The MyPal study (NCT04370457) is a randomized controlled clinical trial assessing an eHealth intervention on QoL of patients. The study was conducted according to the Declaration of Helsinki. The ethical aspects of the study, given the vulnerability of the patients, were addressed with diligence and approvals were obtained from the appropriate Research Ethics Committees. Patients who were receiving or had previously received treatment for CLL or MDS were randomly assigned (1:1) to access the MyPal platform versus standard of care. The MyPal platform included a smartphone application used to report QoL status (ePRO questionnaires) and symptoms. The primary endpoint was QoL at 12 months, assessed by the European Organization for Research and Treatment of Cancer (EORTC) quality of life QLQ-C30 General Questionnaire and the Euroqol 5-dimension (Euroqol EQ-5D-3L). Secondary endpoints included physical and emotional functioning, measured by the Integrated Palliative Care Outcome Scale (IPOS), satisfaction with care, measured by the EORTC Patient Satisfaction with Cancer Care questionnaire PATSAT-C33 (PATSAT-C33), and overall survival (OS). Additionally, the Edmonton Symptom Assessment System (ESAS), the Brief Pain Inventory (BPI), and the Emotion Thermometers (ET) QoL questionnaires were assessed only in the intervention group. Results: A total of 171 patients (97 and 74 in the control and intervention arms, respectively) who answered multiple questionnaires were included in the analysis. The intervention group reported a significant decrease in pain (β2=-0.48 (-0.77, -0.19), p<0.001) compared to the control group (β1=0.3 (0.09, 0.5), p=0.01) as measured by the EORTC QLQ-C30. Communication and pain as measured by IPOS reduced equally in both groups [β2=0 (-0.03, 0.02), p=0.82; β2=-0.01 (-0.02, 0), p=0.1, respectively]. Family involvement significantly increased over time only for the intervention group [β2=0.32 (0.01, 0.64), p=0.042]. The other items of EORTC QLQ-C30, Euroqol EQ-5D-3L, IPOS, and PATSAT-C33 remained unchanged in both groups. The intervention group displayed a statistically significant improvement in all ESAS, BPI, and ET scales. The estimated absolute improvement between the first and last assessment was 1.68, 2.16, 0.96, 1.44, 1.68, and 0.96 points for pain, tiredness, nausea, drowsiness, appetite loss, and shortness of breath, respectively, and 0.96, 1.2 and 1.2 for depression, anxiety, and well-being, respectively. The estimated absolute improvement between the first and last assessment for both pain severity and the interference items of the BPI was 1.2 points. Finally, distress, anxiety, depression, anger, and need for help showed a statistically significant reduction over time and an absolute improvement between the first and last assessment of 1.68, 1.92, 1.2, 1.2, and 0.72 points, respectively. After 12 months, in the ITT, 6 (6.2%) patients died in the control arm and 5 (6.3%) in the intervention arm. Conclusion: The MyPal tools improved several aspects of QoL for patients with CLL and MDS while also promoting family involvement in palliative care.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,005 | 0,007 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,002 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,001 | 0,002 |
| Science ouverte | 0,001 | 0,003 |
| Intégrité de la recherche | 0,001 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».