Digital questionnaires to help determine a face-to-face review for ‘on treatment’ oncology clinics


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Mayuran Sivanandan1,Catherine Sharma1,Pippa Bullard1,Judith Christian1
1Nottingham University Hospitals NHS Trust



Oncology has increasing outpatient activity related to increased cancer incidence, better survival rates and more treatments. The use of digital forms to identify the need for a face-to-face appointment is one potential method that could deal with increasing demand. Our study’s aim was to assess the feasibility of digital questionnaires to detect the need for face-to-face review in clinics monitoring patients on treatment (‘on treatment clinics’).


This study was performed in a regional oncology centre. Target clinics covered both systemic therapy and radiotherapy cohorts. The Common Terminology Criteria for Adverse Events (CTCAE) was adapted into patient-friendly language to form the basis for acute toxicity questionnaires; any response of grade 2 or above would flag for face-to-face review. The study involved digital toxicity questionnaires being answered by patients and their clinicians alongside face-to-face appointments. Patients and clinicians did not see each other’s results, which were not used for clinical decisions. Agreement between patients and clinicians was assessed through statistical analysis. Patient and staff feedback was also obtained.  


90 patients took part in the study across 10 different treatment clinics. 96.7% of patients’ questionnaires flagged appropriately and no patients with severe toxicity would have been missed. 30% of participating patients could have been spared a face-to-face review and stratification by treatment revealed certain groups were more likely to suffer minimal toxicity, with 70% of single-agent immunotherapy patients and 40-50% of tyrosine kinase inhibitor patients having no significant physical or psychosocial issues. Patient and staff feedback showed high approval with the questionnaires and their potential for use in remote monitoring.


Digital side effect questionnaires can appropriately determine the need for face-to-face review in ‘on treatment’ clinics. Their use with specific treatment types could safely reduce the requirement for face-to-face review and we are now conducting an innovative remote pilot to investigate this further.