A prospective study of the feasibility and acceptability of a Web-based, electronic patient-reported outcome system in assessing patient recovery after major gynecologic cancer surgery

Gynecol Oncol. 2012 Nov;127(2):273-7. doi: 10.1016/j.ygyno.2012.07.124. Epub 2012 Aug 4.


Purpose: The purposes of this study are to evaluate the feasibility of capturing patient-reported outcomes (PROs) electronically and to identify the most common distressing symptoms in women recovering from major gynecologic cancer surgery.

Methods: This was a prospective, single-arm pilot study. Eligible participants included those scheduled for a laparotomy for presumed or known gynecologic malignancy. Patients completed a Web-based "STAR" (Symptom Tracking and Reporting for Patients) questionnaire once preoperatively and weekly during the 6-week postoperative period. The questionnaire consisted of the patient adaptation of the NCI CTCAE 3.0 and EORTC QLQ-C30 3.0. When a patient submitted a response that was concerning, an automated email alert was sent to the clinician. The patient's assessment of STAR's usefulness was measured via an exit survey.

Results: Forty-nine patients completed the study. The procedures included the following: hysterectomy┬▒staging (67%), resection of tumor (22%), salpingo-oophorectomy (6%), and other (4%). Most patients (82%) completed at least 4 sessions in STAR. The CTC generated 43 alerts. These alerts resulted in 25 telephone contacts with patients, 2 ER referrals, one new appointment, and one pharmaceutical prescription. The 3 most common patient-reported symptoms generating an alert were as follows: poor performance status (19%), nausea (18%), and fatigue (17%). Most patients found STAR useful (80%) and would recommend it to others (85%).

Conclusion: Application of a Web-based, electronic STAR system is feasible in the postoperative period, highly accepted by patients, and warrants further study. Poor performance status, nausea, and fatigue were the most common distressing patient-reported symptoms.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Feasibility Studies
  • Female
  • Genital Neoplasms, Female / surgery*
  • Gynecologic Surgical Procedures*
  • Humans
  • Internet*
  • Middle Aged
  • Patient Acceptance of Health Care
  • Pilot Projects
  • Postoperative Complications* / epidemiology
  • Postoperative Period
  • Prospective Studies
  • Quality of Life*
  • Self Report*
  • Surveys and Questionnaires
  • Treatment Outcome