# Electronic patient-reported outcome (ePRO) symptom monitoring

Source: https://onco.cc/technologies/epro-symptom-monitoring/  
OnCo record `epro-symptom-monitoring` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Patients report symptoms weekly through an app or web form, and nurses respond to alerts. Randomised trials showed this simple system improved quality of life, cut emergency visits and, in one trial, extended survival by five months.

## Summary

Basch's MSK trial (JCO 2016; JAMA 2017) randomised 766 patients on chemotherapy to weekly web-based symptom reporting with nurse alerts versus usual care: better quality of life, fewer ER visits, more chemotherapy tolerated, and OS 31.2 vs 26.0 months. The French Moovcare trial (Denis, JNCI 2017) in lung cancer follow-up showed OS 22.5 vs 14.9 months with weekly symptom-based relapse detection. PRO-TECT (Basch, JAMA 2022) in 52 US community practices confirmed quality-of-life and physical-function benefits. ePRO is now a CMS Enhancing Oncology Model requirement and an FDA-endorsed trial endpoint (PRO-CTCAE). Implementation issues: alert fatigue, digital divide, integration with EHRs and reimbursement.

## Fields

- Kind: Technology
- Status: established
- Last checked: 2026-09-08
- Tags: gap-fill; supportive
- Principle: Systematic, frequent capture of patient-reported symptoms with threshold-triggered clinician alerts to detect deterioration earlier than scheduled visits allow, enabling prompt intervention.
- Since: 2016
- Strengths: Randomised evidence for quality of life, utilisation and survival; Low cost; scalable through existing portals; Standardised instruments (PRO-CTCAE, ESAS)
- Limitations: Requires responsive nursing capacity; Digital literacy and language barriers; Alert fatigue if thresholds poorly set

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Patient-reported_outcome
- Basch 2017 survival (JAMA): https://doi.org/10.1001/jama.2017.7156
- PRO-TECT (JAMA 2022): https://doi.org/10.1001/jama.2022.9265

## Connected records

- fronts: [AI & Computation](https://onco.cc/fronts/ai-computation/), [Supportive Care & Survivorship](https://onco.cc/fronts/supportive-care/)
- technologies: [Antiemetics for chemotherapy-induced nausea and vomiting](https://onco.cc/technologies/antiemetic-therapy/), [Asking people how they are, every week, as a treatment in its own right](https://onco.cc/technologies/rejuv-measure-epro-as-treatment/), [Early integrated palliative care](https://onco.cc/technologies/palliative-care/), [EORTC QLQ-C30: the questionnaire most cancer trials use](https://onco.cc/technologies/rejuv-measure-eortc-qlq-c30/), [G8 geriatric screening tool](https://onco.cc/technologies/g8-geriatric-screening/), [How recovery is measured: the questionnaires behind the numbers](https://onco.cc/technologies/rejuv-measure-patient-reported-outcomes/), [Oncology nursing and nurse-led care](https://onco.cc/technologies/oncology-nursing/), [Oncology nutrition assessment and medical nutrition therapy](https://onco.cc/technologies/nutrition-screening-mnt/), [PRO-CTCAE: side effects graded by the person having them](https://onco.cc/technologies/rejuv-measure-pro-ctcae/), [PROMIS: the item banks that let a short questionnaire be precise](https://onco.cc/technologies/rejuv-measure-promis/), [Prospective surveillance: looking for the problem before it becomes a disability](https://onco.cc/technologies/rejuv-rehab-prospective-surveillance/), [Psycho-oncology and distress screening](https://onco.cc/technologies/psycho-oncology/), [Telehealth and hospital-at-home in oncology](https://onco.cc/technologies/telehealth-oncology/), [Troponin and natriuretic peptide monitoring during cancer treatment](https://onco.cc/technologies/cardiac-biomarker-monitoring/), [What has actually been implemented since those trials, and what has not](https://onco.cc/technologies/rejuv-measure-epro-implementation/)
- companies: [Canopy](https://onco.cc/companies/canopy/), [Careology](https://onco.cc/companies/careology/), [Carevive Systems](https://onco.cc/companies/carevive-systems/), [Liyfe](https://onco.cc/companies/liyfe/), [REPROSENT](https://onco.cc/companies/reprosent/)
- institutions: [Memorial Sloan Kettering Cancer Center](https://onco.cc/institutions/mskcc/)
- key papers: [Basch: asking patients to report symptoms online during chemotherapy improved survival](https://onco.cc/key-papers/paper-basch-epro-survival-jama-2017/), [Effect of Electronic Symptom Monitoring on Patient-Reported Outcomes Among Patients With Metastatic Cancer: A Randomized Clinical Trial](https://onco.cc/key-papers/paper-basch-jama/), [Temel: early palliative care alongside chemotherapy improved quality of life, mood and survival in lung cancer](https://onco.cc/key-papers/paper-temel-early-palliative-care-nejm-2010/)
- terms: [Nutrition impact symptoms](https://onco.cc/terms/nutrition-impact-symptoms/), [Quality of life and patient-reported outcomes (QoL, PRO)](https://onco.cc/terms/qol-pro/)
- cancers: [Indolent and smouldering systemic mastocytosis](https://onco.cc/cancers/indolent-systemic-mastocytosis/)

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