"ScreenIT": Computerized screening of swallowing, nutrition and distress in head and neck cancer patients during (chemo)radiotherapy

Abstract

Background: In light of growing service demands, the use of computerized screening processes have been proposed to optimize patient triage and enhance the efficiency and synergy of multidisciplinary care practices. This study evaluated the accuracy of a novel system, ScreenIT, to detect swallowing, nutrition and distress status in HNC patients receiving (chemo)radiotherapy ([C]RT), and facilitate appropriate referrals for MDT management.

Materials and methods: Patient-reported data obtained from ScreenIT was compared to blinded face-to-face assessment by speech pathology/dietetic clinicians across five domains: side-effects, swallowing/oral intake, nutrition, distress, and need for supportive care services. Agreement was analysed using percent exact and close agreement (PEA/PCA) and kappa statistics.

Results: Clinically acceptable agreement (PEA/PCA 80% or higher) was achieved for the majority of domains. In areas of discordance, ScreenIT demonstrated a higher sensitivity to patient-perceived concerns, particularly regarding distress. Management pathways generated by ScreenIT initiated clinically appropriate referrals for high and medium-risk patients for swallowing/nutrition and distress.

Conclusion: Findings suggest that ScreenIT may provide an effective and efficient means of monitoring swallowing, nutrition and distress status during (C)RT, and facilitate clinically appropriate prioritization of MDT supportive care intervention.

Keywords: Distress; Head and neck cancer; Nutrition; Screening; Supportive care intervention; Swallowing; Telehealth.