Results Summary

What was the research about?

Patients treated for metastatic cancer, or cancer that has spread to another part of the body, often have symptoms from cancer and its treatment. They may feel tired, depressed, or nauseous. They may find it hard to do their usual activities. Better tracking of symptoms may help improve patients’ care. For example, symptom tracking could quickly alert doctors when a patient may need a different medicine.

In this study, the research team compared use of a weekly electronic symptom tracking system versus usual care for patients with cancer. Patients receiving usual care could report their symptoms to their care team during regular clinic visits. The research team wanted to see if the tracking system helped patients live longer, have a better quality of life, or go to the hospital or emergency room less often.

What were the results?

After two years, patients who used the tracking system to report symptoms survived about as long as patients who received usual care.

After three months, compared with patients who received usual care, patients who used the tracking system:

  • Were better able to do their usual activities
  • Had better quality of life
  • Had fewer and less severe symptoms

After a year, patients who used the tracking system went to the hospital and emergency room less often than patients who received usual care. Other outcomes did not differ.

Who was in the study?

The study included 1,191 patients with metastatic cancer. Of these, 80 percent were White, 17 percent were Black, and 2 percent were American Indian or Alaska Native; 4 percent were Hispanic. The average age was 62, and 58 percent were women. All received care at one of 52 cancer clinics.

What did the research team do?

The research team assigned clinics by chance to weekly electronic symptom tracking or usual care. Patients received the method assigned to their clinic. Patients who took part in symptom tracking got training on how to report their symptoms. They answered questions by phone or on the internet every week for a year or until they stopped cancer treatment. If their symptoms got worse, the symptom tracking system sent patients advice on how to manage their symptoms. Also, a clinic nurse received an alert and could contact the patient to follow up.

All patients completed surveys about their symptoms at the start of the study and every three months at clinic visits.

Patients with cancer, doctors, and hospital administrators provided input throughout the study.

What were the limits of the study?

Because the symptom tracking system wasn’t part of the electronic health record, it may have been inconvenient for clinic staff to monitor patients’ reports of their symptoms. Also, clinics may have managed patients’ symptoms in different ways.

Future studies could see if connecting symptom tracking systems to patients’ health records improves patients’ health outcomes.

How can people use the results?

Clinics can use these results when considering how to monitor and manage symptoms and improve care for patients with metastatic cancer.

Final Research Report

This project's final research report is expected to be available by August 2024.

Journal Citations

Article Highlight: Patients with advanced cancer who used telehealth to regularly report symptoms improved their overall well-being, compared with those who were seen less frequently via in-person clinical visits, according to results from this study. The findings were published online in the Journal of the American Medical Association (JAMA)* and presented at the 2022 American Society of Clinical Oncology annual meeting on June 5, 2022. In the trial involving 1,191 participants across 52 clinical sites in 25 states, patients who used telehealth to communicate about their symptoms on a weekly basis said they experienced improved physical function, better control of their symptoms, and improved quality of life, compared with those who were evaluated less frequently, during in-person clinical visits.

Peer-Review Summary

The Peer-Review Summary for this project will be posted here soon.

Conflict of Interest Disclosures

Project Information

Ethan Basch, MD, MSc
The Alliance for Clinical Trials In Oncology Foundation
Electronic Patient Reporting of Symptoms during Outpatient Cancer Treatment: A US National Randomized Controlled Trial

Key Dates

July 2016
November 2023

Study Registration Information

*JAMA has made the full text of this journal publication available free of charge.


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Health Conditions Health Conditions These are the broad terms we use to categorize our funded research studies; specific diseases or conditions are included within the appropriate larger category. Note: not all of our funded projects focus on a single disease or condition; some touch on multiple diseases or conditions, research methods, or broader health system interventions. Such projects won’t be listed by a primary disease/condition and so won’t appear if you use this filter tool to find them. View Glossary
Intervention Strategy Intervention Strategies PCORI funds comparative clinical effectiveness research (CER) studies that compare two or more options or approaches to health care, or that compare different ways of delivering or receiving care. View Glossary
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Last updated: December 20, 2023