Improvement in Quality of Life After Early Interactive Human Coaching via a Mobile App in Postgastrectomy Patients With Gastric Cancer: Prospective Randomized Controlled Trial
Notice bibliographique
Résumé
BACKGROUND: Patients undergoing gastrectomy usually experience postgastrectomy syndrome and face difficulties adapting to a regular diet. Human health coaching via a mobile app has recently been applied to patients with chronic metabolic diseases, with significant improvements being observed in clinical outcomes. OBJECTIVE: This study aimed to compare the quality of life and nutritional outcomes of human health coaching via a mobile app with those of conventional face-to-face counseling in postgastrectomy patients with gastric cancer. METHODS: This was a prospective randomized controlled trial, and patients were enrolled between May 2020 and August 2022. The mobile coaching group received health coaching that provides personalized advice based on self-recorded health data via a mobile app from assigned coaches for 3 months after discharge, and the conventional counseling group underwent dietary consultations with a clinical dietitian 1 and 3 months postoperatively. The primary end point for sample size calculation was the eating restriction score on the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire gastric cancer module 1 month postoperatively. Secondary end points included changes in other subscales of the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and gastric cancer module, as well as nutritional outcomes assessed preoperatively and 1, 3, 6, and 12 months postoperatively. RESULTS: Data from 88.9% (160/180) of enrolled patients were analyzed after excluding dropouts. In the mobile coaching group (n=76), 66% (n=50) of patients who used the mobile app for ≥8 weeks were classified as active users. No significant difference in eating restriction 1 month postoperatively was found between the mobile coaching and conventional counseling groups. However, the mobile coaching group reported less dyspnea during the entire period (P=.01), less eating restriction at 6 months (P=.045), and less negative body image 3 months postoperatively (P=.04) than the conventional counseling group (n=84). Exploratory subgroup analyses based on age, sex, and operation type indicated that younger patients (<60 years), female patients, and those who underwent distal gastrectomy had better quality of life from mobile coaching. In the mobile coaching group, exploratory subgroup analyses based on mobile activity showed that active users had a better global health status than inactive users (P=.005). However, no significant differences in body composition or nutritional parameters were observed between the mobile coaching and conventional counseling groups or between active and inactive users in the mobile coaching group. CONCLUSIONS: Although this trial did not show a significant difference in eating restriction 1 month postoperatively, human coaching via a mobile app was associated with fewer symptoms in some scales compared to conventional counseling in postgastrectomy patients with gastric cancer. The intervention might help patients manage their symptoms and adapt to their diet. TRIAL REGISTRATION: ClinicalTrials.gov NCT04394585; https://clinicaltrials.gov/study/NCT04394585.
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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 | 0,002 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,004 | 0,003 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,006 | 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 ».