Improving PRO Interpretation at the Individual Level for Patients with Cancer using Conversational Agents and Data Visualization

使用对话代理和数据可视化改善癌症患者个体水平的 PRO 解释

• 批准号: 10807160
• 负责人: TIMOTHY W. BICKMORE
• 金额: $ 73.06万
• 依托单位: TUFTS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-01 至 2027-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10807160
• 关键词: Adherence; Adjuvant; Adverse event; Aftercare; Antineoplastic Agents; Anxiety; Aromatase Inhibitors; Behavior; Behavior Therapy; Behavioral Medicine; Breast Cancer therapy; Cellular Phone; Chemotherapy and/or radiation; Clinical; Clinical assessments; Common Terminology Criteria for Adverse Events; Communication; Communication Methods; Computers; Cues; Data; Data Collection; Discipline; Disease; Electronic Health Record; Empathy; Evolution; Fatigue; Foundations; Gestures; Hand; Head and Neck Cancer; Impaired cognition; Individual; Information Systems; Instruction; Interactive Communication; Internet; Malignant Neoplasms; Measurement; Measures; Medicine; Mental Depression; Monitor; Moods; Oral; Pain; Pain interference; Paper; Participant; Patient Agents; Patient Outcomes Assessments; Patients; Performance; Pharmaceutical Preparations; Physical Function; Population Intervention; Process; Psychometrics; Quality of life; Radiation therapy; Randomized; Research; Schedule; Scheme; Surveys; Symptoms; System; Tamoxifen; Testing; Time; Validity and Reliability; Visual; Visualization; Visualization software; Voice; Work; Writing; cancer therapy; chemotherapy; clinical decision-making; clinically relevant; computer science; cost; data visualization; design; field study; gastrointestinal; gaze; health assessment; health literacy; health related quality of life; hormone therapy; improved; individual patient; low health literacy; malignant breast neoplasm; medication compliance; non-verbal; novel; older patient; patient engagement; receptor; satisfaction; screening; substance use; time use; tool; user-friendly

There is increasing recognition of the importance of patient-reported outcomes (PROs) for assessment of health- related quality of life in both research and clinical settings. PROs are especially important for inherently subjective but crucial clinical phenomena such as pain, mood, and fatigue. Despite much research in PROs, concerns about reliability and validity persist, especially when used at the individual level, particularly among patients who may struggle to understand PRO questions, such as those with low health literacy or undetected cognitive impairment. Over the past decade, we have developed and tested a tool with the potential to enhance PROs at the individual level – embodied conversational agents (ECA), which are computer characters that simulate face- to-face conversation using voice, hand gestures, gaze cues and other nonverbal behavior. We have successfully used them in behavioral interventions for populations with limited health literacy, elderly patients, and patients with cancer. Face-to-face encounters, in conjunction with written instructions supported by pictures, remains one of the best methods for communicating information in general, but is particularly effective for individuals with limited health literacy. We have also demonstrated that ECAs can be used as valid alternatives to standard paper-based surveys for substance use screening, and that the display of empathy for patients and other relational behavior by ECAs leads to increased engagement by patients over time. We will adapt our prior work on ECAs to produce ECA-PRO, a framework for administering PROs over time using an ECA on patients’ smartphones in English and Spanish. The ECA-PRO system will include novel user interfaces to optimally communicate the results to patients and clinicians using clear visualizations. To demonstrate the generalizability of ECA-PRO, we will focus on two clinical scenarios: 1) longitudinal monitoring of symptoms and quality of life in patients undergoing cancer treatment, and 2) monitoring of medication adherence in patients taking long-term oral anti-cancer drugs. We hypothesize that the ECA-PRO system, designed for individual-patient-level interactions and data collection, will improve the reliability, validity, and overall clinical relevance of PROs collected during cancer treatment. We will develop and evaluate a PRO system that engages patients with interactive communication and empathy, while delivering standard PROs in a way that minimizes missing data and enables user-friendly visual sharing of results. The ECA-PRO system will create a strong foundation for PRO-based clinical decision-making. If successful, these tools can be rapidly and broadly disseminated.

人们对患者报告结果的重要性（PRO）的认识越来越多，以评估健康 研究和临床环境中的相关生活质量。优点对于天生的主观尤其重要 但是关键的临床现象，例如疼痛，情绪和疲劳。尽管专业人士进行了很多研究，但担心 关于可靠性和有效性持续存在，尤其是在个人级别使用时，尤其是在患者中 可能难以理解专业问题，例如健康素养低或未发现认知的问题 损害。在过去的十年中，我们开发并测试了一种工具，有可能提高专业人士 单个级别 - 体现的对话剂（ECA），它们是模拟面部的计算机字符 使用语音，手势，凝视提示和其他非语言行为的访问对话。我们已经成功 在健康素养，老年患者和患者的人群中使用它们的行为干预措施 癌症。与图片支持的书面说明结合在一起，面对面的相遇仍然是一个 一般传达信息的最佳方法，但对于患有 健康素养有限。我们还证明，ECA可以用作标准的有效替代品 基于纸张的物质使用筛查的调查，以及对患者和其他的移情显示 ECA的关系行为会导致患者的参与度增加。我们将改编我们的先前工作 在ECA上生产ECA-PRO，这是一种随着时间的时间使用ECA的框架 英语和西班牙语的智能手机。 ECA-Pro系统将包括新颖的用户界面以最佳 使用明确的可视化将结果传达给患者和临床医生。证明普遍性 在ECA-Pro中，我们将重点介绍两种临床情况：1）纵向监测症状和生活质量 接受癌症治疗的患者，2）监测长期服用的患者药物依从性 口服抗癌药。我们假设ECA-PRO系统是为个人患者级设计的 相互作用和数据收集将提高专业人士的可靠性，有效性和整体临床相关性 在癌症治疗期间收集。我们将开发和评估一个专业系统，以吸引患者 交互式沟通和同理心，同时以最小化数据的方式提供标准优点 并启用结果的视觉分享结果。 ECA-Pro系统将为 基于专业的临床决策。如果成功，这些工具可以迅速而广泛地传播。