INtegrating Systematic PatIent-Reported Evaluations in Multi-Disciplinary Tumor Boards: The INSPIRE Study

Study Type/Design This multi-methods study will include two participant groups: patient participants and clinician/provider participants. The patient portion includes an initial prospective observational cohort followed by a randomized controlled trial of the INSPIRE intervention, which involves inclusion of electronic patient-reported outcomes in tumor board discussions. The clinician/provider portion includes audio recording of multidisciplinary tumor board discussions and an optional post-study semi-structured interview with clinicians/providers to understand experiences with the INSPIRE intervention, including feasibility, usefulness, workflow considerations, and implementation challenges.

Patient Participants Patients who agree to participate will complete patient-reported questionnaires at baseline, 3 months, and 6 months. Questionnaires may be completed online by text or email, by phone with responses entered by a research assistant, in person on a tablet, or on paper, based on patient preference. The baseline questionnaire will include questions about health, daily function, quality of life, nutrition, cognition, social support, caregiver support, treatment preferences, and decision-making preferences. At UAB, some of these electronic patient-reported outcomes may already be collected as part of standard clinical care. If a patient has already completed overlapping questionnaires as part of standard care, the patient will not be asked to repeat those questions. Instead, the study team will abstract the relevant information from the electronic medical record or electronic patient-reported outcomes system for research purposes. If the patient has not completed the standard-of-care questionnaires, the patient will complete the study-specific REDCap questionnaire in English or Spanish.

For patients in the initial observational cohort, baseline questionnaire completion may occur within 2 weeks of enrollment. If patients do not complete more than 50% of the questionnaires within 2 weeks, they will be excluded from the study. For patients in the randomized intervention component, completion of the baseline questionnaire will be required before tumor board presentation. The study team will document patients who are unable to complete the questionnaire and the reason. Participants will also complete follow-up questionnaires at approximately 3 months and 6 months after enrollment. These follow-up questionnaires may be completed electronically, by phone, or on paper and will be entered into REDCap. If a patient does not complete a follow-up questionnaire, the research coordinator will make up to three attempts to contact the patient to encourage completion. These contacts may occur by phone, patient portal, or in person during clinic.

The baseline questionnaire is expected to take approximately 40 minutes if the full study questionnaire is completed. If the patient has already completed some electronic patient-reported outcomes as part of standard care, the abbreviated questionnaire is expected to take approximately 20 minutes. The 3-month and 6-month questionnaires are expected to take approximately 10 minutes each. Patients will not be asked to complete any additional clinic visits or study-specific medical procedures.

Use of Patient Questionnaire Information in Tumor Board