Poster & Mini-oral COSA 2015 ASM

Innovating multidisciplinary triage of head and neck cancer patients and their carers during (chemo)radiotherapy: the "ScreenIT" system (#165)

Laurelie Wall 1 , Bena Cartmill 2 , Liz Ward 1 , Anne Hill 3 , Elizabeth Isenring 4 , Joshua Byrne 5 , Suzanne Chambers 6 , Jeff Dunn 7 , Jodie Nixon 8 , Jane Whelan 9 , Sandro Porceddu 10
  1. Centre for Functioning & Health Research, Queensland Health, & School of Health and Rehabilitation Sciences, The Univerisity of Queensland, Brisbane , QLD, Australia
  2. Centre for Functioning & Health Research, Queensland Health; & Speech Pathology Department, Princess Alexandra Hospital, Brisbane, Australia
  3. School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
  4. Nutrition & Dietetics Department, Bond University , Robina , Qld, Australia
  5. Centre for Applied Economics, Griffith University, Brisbane , Qld, Australia
  6. Area of Strategic Investment for Chronic Disease Prevention, Griffith University, Brisbane, Qld, Australia
  7. Cancer Council Queensland , Brisbane, Qld, Australia
  8. Occupational Therapy Department, Princess Alexandra Hospital , Brisbane, Qld, Australia
  9. Social Work Department, Princess Alexandra Hospital , Brisbane, Qld, Australia
  10. Radiation Oncology Department, Princess Alexandra Hospital, Brisbane , Qld, Australia

Purpose: Patients with head/neck cancer (HNC) undergoing (chemo)radiotherapy (CRT) experience many physical and psychological symptoms during treatment, requiring synergistic multidisciplinary care. With growing patient numbers and associated strain on health resources, routine screening using patient-reported outcome measures has been proposed to enhance triage processes for face-to-face intervention. “ScreenIT” is an innovative, telehealth system developed to screen swallowing/nutrition and distress status in HNC patients and their carers to enable timely referrals to joint speech pathology/dietetics (SP/DN), occupational therapy and social work services. This project aimed to evaluate the reliability and validity of the ScreenIT tools.
Methods: Cross-sectional cohorts of 100 HNC patients referred for speech pathology/dietetic (SP/DN) services during CRT, and 40 of their carers, were recruited. ScreenIT contained questions relating to side-effects, self-reported functional oral intake (FOIS), nutrition (PGSGA)  and distress (Distress Thermometer). Data from ScreenIT Patient/Carer tools were compared with subsequent blinded face-to-face assessment by SP/DN clinicians. Agreement between ScreenIT and clinician ratings was analysed using agreement statistics (Percent Exact/Close Agreement  [PEA/PCA].
Results: Analysis revealed overall acceptable (>80%) agreement between ScreenIT tools and clinician ratings. Highest agreement was observed for weight and FOIS measures. Completing the Distress Thermometer via ScreenIT tools enabled more sensitive detection of mild-moderate distress in both patients and carers, compared to clinician judgement, and was instrumental at initiating new social work referrals at our facility.
Conclusion: Findings suggest that the ScreenIT tools can be valid and reliable measures for detecting swallowing, nutritional and distress status in HNC patients and carers, with potential to optimise patient triage and provide a clinical adjunct for synergistic multidisciplinary management of HNC during CRT.