{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T05:31:59Z","timestamp":1792215119761,"version":"4.4.0"},"reference-count":21,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2011,3,10]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p> Patients receiving cancer-related thoracotomy are highly symptomatic in the first weeks after surgery. This study examined whether at-home symptom monitoring plus feedback to clinicians about severe symptoms contributes to more effective postoperative symptom control. <\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p> We enrolled 100 patients receiving thoracotomy for lung cancer or lung metastasis in a two-arm randomized controlled trial; 79 patients completed the study. After hospital discharge, patients rated symptoms twice weekly for 4 weeks via automated telephone calls. For intervention group patients, an e-mail alert was forwarded to the patient's clinical team for response if any of a subset of symptoms (pain, disturbed sleep, distress, shortness of breath, or constipation) reached a predetermined severity threshold. No alerts were generated for controls. Group differences in symptom threshold events were examined by generalized estimating equation modeling. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> The intervention group experienced greater reduction in symptom threshold events than did controls (19% v 8%, respectively) and a more rapid decline in symptom threshold events. The difference in average reduction in symptom interference between groups was \u22120.36 (SE, 0.078; P = .02). Clinicians responded to 84% of e-mail alerts. Both groups reported equally high satisfaction with the automated system and with postoperative symptom control. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> Frequent symptom monitoring with alerts to clinicians when symptoms became moderate or severe reduced symptom severity during the 4 weeks after thoracic surgery. Methods of automated symptom monitoring and triage may improve symptom control after major cancer surgery. These results should be confirmed in a larger study. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.2010.29.8315","type":"journal-article","created":{"date-parts":[[2011,2,1]],"date-time":"2011-02-01T03:51:34Z","timestamp":1296532294000},"page":"994-1000","source":"Crossref","is-referenced-by-count":321,"title":["Automated Symptom Alerts Reduce Postoperative Symptom Severity After Cancer Surgery: A Randomized Controlled Clinical Trial"],"prefix":"10.1200","volume":"29","author":[{"given":"Charles S.","family":"Cleeland","sequence":"first","affiliation":[{"name":"From The University of Texas MD Anderson Cancer Center, Houston, TX; and Vanderbilt University Medical Center, Nashville, TN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin Shelley","family":"Wang","sequence":"additional","affiliation":[{"name":"From The University of Texas MD Anderson Cancer Center, Houston, TX; and Vanderbilt University Medical Center, Nashville, TN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiuling","family":"Shi","sequence":"additional","affiliation":[{"name":"From The University of Texas MD Anderson Cancer Center, Houston, TX; and Vanderbilt University Medical Center, Nashville, TN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tito R.","family":"Mendoza","sequence":"additional","affiliation":[{"name":"From The University of Texas MD Anderson Cancer Center, Houston, TX; and Vanderbilt University Medical Center, Nashville, TN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherry L.","family":"Wright","sequence":"additional","affiliation":[{"name":"From The University of Texas MD Anderson Cancer Center, Houston, TX; and Vanderbilt University Medical Center, Nashville, TN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madonna D.","family":"Berry","sequence":"additional","affiliation":[{"name":"From The University of Texas MD Anderson Cancer Center, Houston, TX; and Vanderbilt University Medical Center, Nashville, TN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna","family":"Malveaux","sequence":"additional","affiliation":[{"name":"From The University of Texas MD Anderson Cancer Center, Houston, TX; and Vanderbilt University Medical Center, Nashville, TN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pankil K.","family":"Shah","sequence":"additional","affiliation":[{"name":"From The University of Texas MD Anderson Cancer Center, Houston, TX; and Vanderbilt University Medical Center, Nashville, TN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahima","family":"Gning","sequence":"additional","affiliation":[{"name":"From The University of Texas MD Anderson Cancer Center, Houston, TX; and Vanderbilt University Medical Center, Nashville, TN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wayne L.","family":"Hofstetter","sequence":"additional","affiliation":[{"name":"From The University of Texas MD Anderson Cancer Center, Houston, TX; and Vanderbilt University Medical Center, Nashville, TN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Joe B.","family":"Putnam","sequence":"additional","affiliation":[{"name":"From The University of Texas MD Anderson Cancer Center, Houston, TX; 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