{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T17:12:27Z","timestamp":1769188347823,"version":"3.49.0"},"reference-count":25,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"Queensland Children\u2019s Hospital Foundation, 2018 Fellowship and the National Health and Medical Research Council","doi-asserted-by":"publisher","award":["APP1173243"],"award-info":[{"award-number":["APP1173243"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background\/Objectives: Children undergoing cancer treatment experience multiple distressing symptoms that often go undetected in routine care. This study evaluated the potential impact of integrating the Symptom Screening in Pediatrics Tool (SSPedi) into clinical workflows, focusing on symptom detection and implications for service delivery. Methods: Seventy children (aged 4\u201318 years) receiving active treatment, and\/or their caregivers completed SSPedi weekly for eight weeks (n = 479 completions). Medical records were audited for documentation of symptom assessments and symptom prevalence. SSPedi completions were categorized using a clinical algorithm (low, moderate, immediate concerns) and compared with score-only threshold. Results: The most bothersome symptoms were appetite changes (12%), fatigue (11%), nausea\/vomiting (9%) and pain (9%). Severe bother detected by SSPedi was more frequent while hospitalized than at home (e.g., appetite changes 17% versus 9%). Documentation rates of severe symptoms in medical records were substantially lower than SSPedi reports\u201412% when SSPedi was completed at home and 49% when completed in hospital. Applying the clinical algorithm flagged 58% of SSPedi completions as an immediate concern in home and 63% in hospital, compared with score-only thresholds (31% at home and 17% in hospital). Algorithm-based alerts for immediate concerns would have triggered almost twice as many phone calls as score-based thresholds (168 vs. 91). Conclusions: Routine PROM integration could improve symptom detection and timely intervention. Clinical algorithms enhance sensitivity but increase alert burden, highlighting the need to review thresholds and redesign workflows.<\/jats:p>","DOI":"10.3390\/children13020164","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T14:58:40Z","timestamp":1769180320000},"page":"164","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Making Symptoms Visible: The Impact of Real-Time PROM Integration in Pediatric Oncology"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1602-4544","authenticated-orcid":false,"given":"Natalie","family":"Bradford","sequence":"first","affiliation":[{"name":"School of Nursing, Queensland University of Technology, Brisbane, QLD 4101, Australia"},{"name":"Cancer and Palliative Care Outcome Centre at Centre for Children\u2019s Health Research, Queensland University of Technology, Brisbane, QLD 4001, Australia"},{"name":"Cancer Council Queensland, Fortitude Valley, Brisbane, QLD 4006, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ethan","family":"Whalan","sequence":"additional","affiliation":[{"name":"School of Nursing, Queensland University of Technology, Brisbane, QLD 4101, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula","family":"Condon","sequence":"additional","affiliation":[{"name":"Nursing Research, Workforce Learning and Development, Centre for Children\u2019s Health Research, Queensland Children\u2019s Hospital and Health Service, Brisbane, QLD 4101, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1999-9179","authenticated-orcid":false,"given":"Remziye","family":"Semerci","sequence":"additional","affiliation":[{"name":"School of Nursing, Ko\u00e7 University, Istanbul 34450, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9870-0931","authenticated-orcid":false,"given":"Alison","family":"Bowers","sequence":"additional","affiliation":[{"name":"School of Nursing, Queensland University of Technology, Brisbane, QLD 4101, Australia"},{"name":"Cancer and Palliative Care Outcome Centre at Centre for Children\u2019s Health Research, Queensland University of Technology, Brisbane, QLD 4001, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6748-3260","authenticated-orcid":false,"given":"Xiomara","family":"Skrabal Ross","sequence":"additional","affiliation":[{"name":"Cancer and Palliative Care Outcome Centre at Centre for Children\u2019s Health Research, Queensland University of Technology, Brisbane, QLD 4001, Australia"},{"name":"Canteen Australia, Sydney, NSW 2042, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,23]]},"reference":[{"key":"ref_1","first-page":"573","article-title":"Patient outcomes, patient experiences and process indicators associated with the routine use of patient-reported outcome measures (PROMs) in cancer care: A systematic review","volume":"29","author":"Graupner","year":"2021","journal-title":"Support. 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