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Secondary outcomes were health related quality of life (Functional Assessment of Cancer Therapy\u2014General; FACT-G), Supportive Care Needs Survey Short-Form (SCNS-SF34), State-Trait Anxiety Inventory\u2014Revised (STAI-R), Communication and Attitudinal Self-Efficacy scale for cancer (CASE-Cancer), and work limitations questionnaire (WLQ).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>For the intervention group, symptom burden remained at pre-chemotherapy treatment levels, whereas controls reported an increase from cycle 1 onwards (least squares absolute mean difference \u22120.15, 95% confidence interval \u22120.19 to \u22120.12; P&lt;0.001; Cohen\u2019s D effect size=0.5). Analysis of MSAS sub-domains indicated significant reductions in favour of ASyMS for global distress index (\u22120.21, \u22120.27 to \u22120.16; P&lt;0.001), psychological symptoms (\u22120.16, \u22120.23 to \u22120.10; P&lt;0.001), and physical symptoms (\u22120.21, \u22120.26 to \u22120.17; P&lt;0.001). FACT-G scores were higher in the intervention group across all cycles (mean difference 4.06, 95% confidence interval 2.65 to 5.46; P&lt;0.001), whereas mean scores for STAI-R trait (\u22121.15, \u22121.90 to \u22120.41; P=0.003) and STAI-R state anxiety (\u22121.13, \u22122.06 to \u22120.20; P=0.02) were lower. CASE-Cancer scores were higher in the intervention group (mean difference 0.81, 0.19 to 1.43; P=0.01), and most SCNS-SF34 domains were lower, including sexuality needs (\u22121.56, \u22123.11 to \u22120.01; P&lt;0.05), patient care and support needs (\u22121.74, \u22123.31 to \u22120.16; P=0.03), and physical and daily living needs (\u22122.8, \u22125.0 to \u22120.6; P=0.01). Other SCNS-SF34 domains and WLQ were not significantly different. Safety of ASyMS was satisfactory. Neutropenic events were higher in the intervention group.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Significant reduction in symptom burden supports the use of ASyMS for remote symptom monitoring in cancer care. A \u201cmedium\u201d Cohen\u2019s effect size of 0.5 showed a sizable, positive clinical effect of ASyMS on patients\u2019 symptom experiences. Remote monitoring systems will be vital for future services, particularly with blended models of care delivery arising from the covid-19 pandemic.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Trial registration<\/jats:title>\n            <jats:p>\n              Clinicaltrials.gov\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"NCT02356081\" ext-link-type=\"clintrialgov\">NCT02356081<\/jats:ext-link>\n              .\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1136\/bmj.n1647","type":"journal-article","created":{"date-parts":[[2021,7,22]],"date-time":"2021-07-22T01:30:16Z","timestamp":1626917416000},"page":"n1647","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":210,"title":["Real time remote symptom monitoring during chemotherapy for cancer: European multicentre randomised controlled trial 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