@Article{信息:doi 10.2196 / / jmir。7466，作者=“Gustafson, David H和DuBenske, Lori L和Atwood, Amy K和Chih, Ming-Yuan和Johnson, Roberta A和McTavish, Fiona和Quanbeck, Andrew和Brown, Roger L和Cleary, James F和Shah, Dhavan”，标题=“使用电子警报系统减少晚期癌症患者的症状痛苦:两项随机临床试验的综合分析”，期刊=“J医学互联网Res”，年=“2017”，月=“11”，日=“14”，量=“19”，数=“11”，页=“e354”，关键词=“互联网;健康的沟通;姑息治疗;沟通障碍;症状和体征;背景:濒死患者的症状痛苦可能迅速变化。如果家庭护理人员拥有适当的资源，他们有可能帮助患者控制这些症状，以及他们自己的压力。电子卫生(eHealth)系统可能能够提供这些资源。重病患者自己可能无法使用这种系统来报告他们的症状，但家庭护理人员可以。 Objective: The aim of this paper was to assess the effects on cancer patient symptom distress of an eHealth system that alerts clinicians to significant changes in the patient's symptoms, as reported by a family caregiver. Methods: A pooled analysis from two randomized clinical trials (NCT00214162 and NCT00365963) compared outcomes at 12 months for two unblinded groups: a control group (Comprehensive Health Enhancement Support System [CHESS]-Only) that gave caregivers access to CHESS, an online support system, and an experimental group (CHESS+CR [Clinician Report]), which also had CHESS but with a CR that automatically alerted clinicians if symptoms exceeded a predetermined threshold of severity. Participants were dyads (n=235) of patients with advanced lung, breast, or prostate cancer and their respective family caregivers from 5 oncology clinics in the United States of America. The proportion of improved patient threshold symptoms was compared between groups using area-under-the-curve analysis and binomial proportion tests. The proportion of threshold symptoms out of all reported symptoms was also examined. Results: When severe caregiver-reported symptoms were shared with clinicians, the symptoms were more likely to be subsequently reported as improved than when the symptoms were not shared with clinicians (P<.001). Fewer symptom reports were completed in the group of caregivers whose reports went to clinicians than in the CHESS-Only group (P<.001), perhaps because caregivers, knowing their reports might be sent to a doctor, feared they might be bothering the clinician. Conclusions: This study suggests that an eHealth system designed for caregivers that alerts clinicians to worrisome changes in patient health status may lead to reduced patient distress. Trial Registration: Clinicaltrials.gov NCT00214162; https://clinicaltrials.gov/ct2/show/NCT00214162 (Archived by WebCite at http://www.webcitation.org/6nmgdGfuD) and Clinicaltrials.gov NCT00365963; https://clinicaltrials.gov/ct2/show/NCT00365963 (Archived by WebCite at http://www.webcitation.org/6nmh0U8VP) ", issn="1438-8871", doi="10.2196/jmir.7466", url="//www.mybigtv.com/2017/11/e354/", url="https://doi.org/10.2196/jmir.7466", url="http://www.ncbi.nlm.nih.gov/pubmed/29138131" }