Results Summary

What was the research about?

Surgery can treat many types of cancer. Patients who have cancer surgery often stay in the hospital for one day or less. These patients and their caregivers manage recovery by themselves at home, which can be stressful. Support for managing patient symptoms at home may reduce symptoms and anxiety. It may also prevent unplanned visits to the hospital or emergency room, or ER.

In this study, the research team compared two approaches to help patients manage symptoms at home after cancer surgery. In both, patients entered details about their symptoms and anxiety in an online survey each day for 10 days. Then, for those 10 days, patients received information in one of two ways:

  • Team monitoring. Healthcare providers, such as doctors or nurses, called patients if their symptoms were above a certain level.
  • Enhanced feedback. Patients received a report right after completing the survey. It showed how their symptoms compared with those of other patients who had similar cancer surgery.

All patients received an alert to seek health care if reported symptoms were too severe.

What were the results?

Patients who received enhanced feedback made fewer calls to nurses in the month after surgery than patients who received team monitoring. Also, anxiety decreased faster for patients who received enhanced feedback.

The two approaches didn’t differ in:

  • The number of patients who went to the ER or returned to the hospital in the month after surgery
  • The number of patients who received referrals to manage pain in the month after surgery
  • Adverse events from surgery, such as infection
  • Patients’ confidence in managing their health two months after surgery
  • Caregiver burden two months after surgery

Who was in the study?

The study included 2,624 patients receiving cancer surgery at an outpatient surgery center in New York City and their caregivers. Patients had surgery for breast, reproductive, urinary, or head and neck cancer. Of these patients, 81 percent were White, 6 percent were African American, 6 percent were Asian, and 3 percent were another race; 7 percent were Hispanic. The average age was 54, and 72 percent were women.

What did the research team do?

The research team assigned patients by chance to receive team monitoring or enhanced feedback. The team reviewed health records to track healthcare use for one month after surgery. The daily online survey had questions about anxiety. Two months after surgery, patients completed surveys about their confidence in managing their health. Caregivers also filled out a survey about burden.

Patients, caregivers, providers, researchers, and hospital staff helped design and conduct the study.

What were the limits of the study?

Patients at outpatient surgery centers are generally healthier and have less complex follow-up care needs than patients who have cancer surgery in hospital settings. The results may not apply to patients having surgery in hospitals.

Future studies could include patients having surgery in hospital settings.

How can people use the results?

Surgery centers can use the results when considering how to help patients manage their symptoms after cancer surgery.

Final Research Report

This project's final research report is expected to be available by August 2022.

Peer-Review Summary

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

Conflict of Interest Disclosures

Project Information

Brett Simon, MD, PhD, and Andrea Pusic, MD, MS
Larissa Temple, MD
Memorial Sloan Kettering Cancer Center

Key Dates

61 months
December 2016
December 2021

Study Registration Information


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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.

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Last updated: November 2, 2021