Childhood Cancer, Survivorship
Conditions
Keywords
Health Data
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.
Interventions
None listed
Sponsors
St. Jude Children's Research Hospital
National Cancer Institute (NCI)
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
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.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Symptom log | Baseline, 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 |
| Euro QoL 5D | Baseline, 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 |
| NIH PROMIS 45 | Baseline, 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 |
| QLACS | Baseline, 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 Survey | Baseline, 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 log | Baseline, week 60 and week 108 | Log of patient reported chronic health condition status |
| Physical performance-Cardiopulmonary fitness | Baseline , week 60 and week 108 | Cardiopulmonary fitness - six minute walk and cardiopulmonary exercise testing |
| Physical performance-Muscular strength and endurance | Baseline, week 60 and week 108 | Muscular strength and endurance - Isometric grip strength, isokinetic knee extension and ankle dorsiflexion (Biodex System 4) |
| Physical performance-Flexibility | Baseline, week 60 and week 108 | Flexibility - Sit and reach test (Flex-Tester), passive ankle range of motion |
| Physical performance-Mobility | Baseline, week 60 and week 108 | Mobility - Timed up and go test |
| Physical performance-Balance and sensory integrity | Baseline, week 60 and week 108 | Balance and sensory integrity - Computerized dynamic posturography (SMART Equi Test) |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORI-Chang Huang, PhD
St. Jude Children's Research Hospital
Outcome results
None listed