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Updated: Oct 9, 2025

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Clinical Decision Support for Symptom Management in Lung Cancer Patients: A Group RCT.

Mary E Cooley1, Emanuele Mazzola2, Niya Xiong2

  • 1Research in Nursing and Patient Care (M.E.C, B.H.), Dana-Farber Cancer Institute, Boston, Massachusetts, USA.

Journal of Pain and Symptom Management
|December 18, 2021
PubMed
Summary

Clinical decision support improved symptom management in lung cancer patients but did not significantly impact their quality of life. Further research is needed to confirm the effectiveness of this approach.

Keywords:
Symptom managementanxietyclinical decision supportdepressiondyspneafatigue health-related quality of lifenonsmall cell lung cancerpainpatient-reported outcomessymptom assessment

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Area of Science:

  • Oncology
  • Clinical Informatics
  • Health Services Research

Background:

  • Clinical guidelines for cancer symptom management exist but are underutilized in practice.
  • Clinical decision support (CDS) systems can improve guideline adherence and cancer care quality.
  • Integrating guideline-based symptom management into oncology care is crucial for patient well-being.

Purpose of the Study:

  • To evaluate the impact of CDS-based recommendations on symptom management and health-related quality of life (HR-QOL) in lung cancer outpatients.
  • To assess the effectiveness of the Symptom Assessment and Management Intervention (SAMI) compared to an attention control (AC) group.

Main Methods:

  • A randomized trial involving 20 providers and 179 lung cancer patients, allocated to either SAMI or AC.
  • SAMI involved patient symptom reporting and CDS-generated recommendations for pain, fatigue, dyspnea, depression, and anxiety.
  • Outcomes including clinical management and HR-QOL were assessed over six months; adherence was reviewed via chart analysis.

Main Results:

  • The SAMI group showed significant improvements in clinical management for all targeted symptoms compared to the AC group.
  • Patients in SAMI received more appropriate treatments for pain, dyspnea, fatigue, and anxiety.
  • No statistically significant differences in health-related quality of life were observed between the SAMI and AC groups at any time point.

Conclusions:

  • The Symptom Assessment and Management Intervention (SAMI) effectively improved clinical management of symptoms in lung cancer patients.
  • Despite improved symptom management, SAMI did not lead to significant improvements in patient-reported health-related quality of life.
  • A larger-scale study is recommended to further evaluate the overall effectiveness of CDS-based interventions in oncology care.