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Patient- Generated Health Data to Predict Childhood Cancer Survivorship Outcomes

Recruiting
Conditions
Survivorship
Childhood Cancer
Registration Number
NCT05342155
Lead Sponsor
St. Jude Children's Research Hospital
Brief Summary

Some childhood cancer survivors have health problems as the result of previous cancer treatment. This study is being done to determine if we can better predict the risk a childhood cancer survivor might have for developing future health issues.

The goal of this study is to enable regular monitoring of patient-generated health data (PGHD), including symptoms, physical activity, energy expenditure, sleep behavior and heart rate variability, and utilize these data in predicting survivor-specific risk of late effects to improve survivorship care and outcomes.

Detailed Description

This study is designed to collect symptoms/other PGHD as risk factors of subsequent adverse outcomes, including PROs (impaired QOL, unplanned healthcare use) assessed via smartphones, and clinical outcomes (physical performance deficits, onset of/worsening CHCs) assessed at SJCRH's After Completion of Therapy (ACT) Clinic. Each survivor will be assessed at 6 timepoints over 2-year period: T0 (baseline: week 0) for assessing baseline PROs and clinical outcomes at ACT Clinic; T1 (7 days in week 1), T2 (7 days in week 5) and T3 (7 days in week 9) for collecting symptoms/PGHD and PROs in non-clinical, daily-living settings; T4 (week 60) and T5 (week 108) for collecting PRO and clinical outcomes at ACT Clinic. Survivors will report symptoms/PGHD over a 3-month period for a purpose of collecting risk factors.

Primary Objective

Aim 1: Use a mHealth platform to collect and integrate symptoms, activity, and health behavioral data, and develop/validate risk prediction models for future QOL outcomes using these dynamic data.

Aim 1a: Investigate variability of patient-generated health data (PGHD), i.e., symptoms (via smartphone), and physical activity, energy expenditure, sleep behavior and heart rate variability (via wearable accelerometer/biometric sensor) within and between survivors with special attention to their temporal change patterns.

Aim 1b: Assess associations and temporal patterns of the mHealth-collected PGHD while considering clinical (cancer treatment exposure/doses, age at cancer diagnosis, childhood cancer types, etc.) and socio-demographic (age at study, sex, educational attainment, income, etc.) factors.

Aim 1c: Develop risk prediction models for future QOL outcomes using training data with cross-validation and validate model performance using independent test data.

Aim 1d: Establish personalized risk prediction scores for potential use within clinical settings.

Secondary Objectives

Aim 2: Develop/validate risk prediction models and establish personalized risk prediction scores for other outcomes (unplanned care utilization including emergency room visits and hospitalizations, physical performance deficits, onset of chronic health conditions) using the same approach as Aim 1.

Aim 3: Create a web-based tool to calculate and report personalized outcome specific risks and facilitate integration of risk scores into the survivor's patient portal and hospital's EHR for potential future use/evaluation in clinical management.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
620
Inclusion Criteria
  • ≥18 years of age at the time of study
  • Enrolled on SJLIFE
  • ≥5 years from initial diagnosis of pediatric cancer/malignancy
  • Currently not receiving cancer therapies
  • Access to web-enabled smartphone
Exclusion Criteria
  • Known severe neurocognitive impairment (e.g., estimated intelligence score [FSIQ] <70), which requires proxies to complete daily symptom and PRO surveys;
  • <3rd-grade reading level or not able to communicate in English;
  • Currently pregnant or reports planning to become pregnant in the next two years;
  • Lack of access to web-enabled smartphone, or not able to use/access internet from the device.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Physical performance-Cardiopulmonary fitnessBaseline , week 60 and week 108

Cardiopulmonary fitness - six minute walk and cardiopulmonary exercise testing

Symptom logBaseline, week 1, week 5, week 9, week 60 and week 108, timeline for each survivor includes 6 timepoints over 2-year period

Log of patient reported symptoms

NIH PROMIS 45Baseline, week 1, week 5, week 9, week 60 and week 108, timeline for each survivor includes 6 timepoints over 2-year period

Patient report outcomes

Euro QoL 5DBaseline, week 1, week 5, week 9, week 60 and week 108, timeline for each survivor includes 6 timepoints over 2-year period

Quality of Life Survey

QLACSBaseline, week 1, week 5, week 9, week 60 and week 108, timeline for each survivor includes 6 timepoints over 2-year period

Quality of Life in Adult Cancer Survivors Survey

MEPS-US Medical Expenditure Panel SurveyBaseline, week 1, week 5, week 9, week 60 and week 108, timeline for each survivor includes 6 timepoints over 2-year period

Unplanned health care utilization (emergency room visits, hospitalization, unplanned primary care physician visit)

Chronic health conditions logBaseline, week 60 and week 108

Log of patient reported chronic health condition status

Physical performance-Balance and sensory integrityBaseline, week 60 and week 108

Balance and sensory integrity - Computerized dynamic posturography (SMART Equi Test)

Physical performance-Muscular strength and enduranceBaseline, week 60 and week 108

Muscular strength and endurance - Isometric grip strength, isokinetic knee extension and ankle dorsiflexion (Biodex System 4)

Physical performance-FlexibilityBaseline, week 60 and week 108

Flexibility - Sit and reach test (Flex-Tester), passive ankle range of motion

Physical performance-MobilityBaseline, week 60 and week 108

Mobility - Timed up and go test

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

St. Jude Children's Research Hospital

🇺🇸

Memphis, Tennessee, United States

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