DESCRIPTION (provided by applicant): Symptoms are a major problem across all phases of the cancer experience. Despite the presence of effective therapies for pain and other symptoms including depression, anxiety, constipation, etc., survey data demonstrates a gap between routine cancer treatment and evidence based symptom management that leaves many patients' symptoms unrecognized and under-treated. I am applying for a K07 Career Award in order to master clinical trial and symptom assessment methodology in palliative and supportive oncology in order to discover new and best practices in the field. In line with these goals, I propose developing a computer-based system that will both acquire research-quality data from patients and support oncologists in managing their patients' symptoms. The intervention will combine systematic computer-aided symptom assessment and computer-generated printed symptom summaries for patients and oncologists accompanied by relevant recommendations from clinical practice guidelines. Extensive user testing will ensure that the summaries are maximally useful and easy-to-use. The specific aims for this proposal include determining whether oncologists using this system change their symptom assessment and symptom management practice patterns and determining whether intervention group patients have less symptom burden. I propose to pilot test the intervention in a clinical trial with a sequential group design involving 100 patients with androgen independent prostate cancer who are receiving chemotherapy. The main outcomes will be physicians' prescribing patterns for analgesic, antidepressant, and laxative medications, the number of symptoms documented in 'adverse events' logs and patients' charts, and patients' QLQ-C30 scores for pain, fatigue and global quality of life. The significance of the proposed research is that it will yield an integrated symptom assessment and clinical decision support tool and generate the validation and preliminary data necessary to justify a test of the computer-based system in a multi-center randomized controlled trial. |