R01CA271145

Improving Pro Interpretation at the Individual Level for Patients with Cancer Using Conversational Agents and Data Visualization

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, remain 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.

Tufts Medical Center Parent

TO IDENTIFY CANCER RISKS AND RISK REDUCTION STRATEGIES, TO IDENTIFY FACTORS THAT CAUSE CANCER IN HUMANS, AND TO DISCOVER AND DEVELOP MECHANISMS FOR CANCER PREVENTION AND PREVENTIVE INTERVENTIONS IN HUMANS. RESEARCH PROGRAMS INCLUDE: (1) CHEMICAL, PHYSICAL AND MOLECULAR CARCINOGENESIS; (2) SCREENING, EARLY DETECTION AND RISK ASSESSMENT, INCLUDING BIOMARKER DISCOVERY, DEVELOPMENT AND VALIDATION; (3) EPIDEMIOLOGY; (4) NUTRITION AND BIOACTIVE FOOD COMPONENTS; (5) IMMUNOLOGY AND VACCINES; (6) FIELD STUDIES AND STATISTICS; (7) CANCER CHEMOPREVENTION AND INTERCEPTION; (8) PRE-CLINICAL AND CLINICAL AGENT DEVELOPMENT; (9) ORGAN SITE STUDIES AND CLINICAL TRIALS; (10) HEALTH-RELATED QUALITY OF LIFE AND PATIENT-CENTERED OUTCOMES; AND (11) SUPPORTIVE CARE AND MANAGEMENT OF SYMPTOMS AND TOXICITIES. SMALL BUSINESS INNOVATION RESEARCH (SBIR) PROGRAM: TO EXPAND AND IMPROVE THE SBIR PROGRAM; TO STIMULATE TECHNICAL INNOVATION; TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT FUNDING; TO INCREASE SMALL BUSINESS PARTICIPATION IN FEDERAL RESEARCH AND DEVELOPMENT; AND TO FOSTER AND ENCOURAGE PARTICIPATION IN INNOVATION AND ENTREPRENEURSHIP BY WOMEN AND SOCIALLY/ECONOMICALLY DISADVANTAGED PERSONS.SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM: TO STIMULATE AND FOSTER SCIENTIFIC AND TECHNOLOGICAL INNOVATION THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT CARRIED OUT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS; TO FOSTER TECHNOLOGY TRANSFER THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS; TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT FUNDING, AND FOSTER PARTICIPATION IN INNOVATION AND ENTREPRENEURSHIP BY WOMEN AND SOCIALLY/ECONOMICALLY DISADVANTAGED PERSONS.

93.393 - Cancer Cause and Prevention Research

National Cancer Institute (NCI) [HHS - NIH]

Boston, Massachusetts 021111552 United States

Single Zip Code

NIH Research Project Grant (Parent R01 Clinical Trial Not Allowed) (PA-20-185)

Amendment Since initial award the total obligations have increased 385% from $713,039 to $3,457,863.