E. Stalika*, M. Lavdaniti** and I. Chouvarda*
* Lab of Computing, Medical Informatics and Biomedical Imaging Technologies, School of
Medicine, AUTH, Thessaloniki, Greece
** Department of Nursing, International Hellenic University, Thessaloniki, Greece
E-mail address(es): evangelia.stalika@gmail.com, maria_lavdaniti@yahoo.gr, ioannach@auth.gr

The last decade, an increased amount of publications has
appeared in the field of Oncology, that were based on the
usage of large healthcare databases which include
clinical and biological records. These databases provided
researchers with the knowledges to answer questions in a
manner not feasible with prospective studies.(1)
Databases that include clinical data in addition with
psychometrics characteristics of cancer patients , further
highlight the need of a patient-centered clinical daily

The aim of this study is twofold: (i) note the advantages
and pitfalls of using clinical databases and Patient-
Reported Outcomes (PROs) in cancer research and (ii)
propose a unified framework that combines the clinicalbiological
records in addition with Patients-Reported
Outcomes (PROs).


Literature review was conducted across the Google
Scholar database from 2018 to 2021 using specific
keywords (clinical database, cancer, Patient-Reported
Outcomes), to offer evidence regarding the advantages
and obstacles of usage PROs in the clinical databases.


The advantages of using large databases concern (i) the
large sample size; (ii) the inclusion of more diverse
subsets of patients or completed outcomes; and (iii) the
study of practice patterns across a disease site with regard
to adherence to national guidelines (National
Comprehensive Cancer Network_NCCN, etc). (1)
The barriers of usage PROs in routine cancer care could
be categorized at the patient, healthcare professionals
(HP) and service level. (2)

The most frequent patient-level pitfalls concern: (i)
patients’ time limitation to complete PROs; and (ii)
patients’ incapacity to complete PROs due to disability
or difficulty with reading and recalling their symptoms or
being too unwell to report symptoms. (3)
On the HPs site, (i) lack of time and limited knowledge
to interpret and integrate meaningfully the PROs data
into their daily clinical routine; (ii) the fact that PROs
have not been adopted by many Oncology Institution
worldwide; and (iii) difficulty of PRO usage into existing
clinical workflows provide further obstacles for HP to
include them to their daily patients’ registries.

Design and implementation of a unified framework of
clinical-biological records and psychometric
characteristics of cancer patients focuses mainly on the
assessment of side effects, fatigue and the impact on their
quality of life, that will further allow the understanding
of the individual relationships of multiparametric
diseases and enhance our understanding of cancer
management. (Fig.1)

The modeling of the three data pilars will allow the
clinicians to further understand the underlying
pathogenetic mechanism of the disease and improve
patients’ quality-of-life.

Figure 1. Data modeling of multifactorial diseases such as malignancies.


An integrated patient monitoring model will further
improve care and human health, reduce suffering,
enhance patient-provider relationships, and develop
better information for addressing important problems in
medical care and population health management.


1. Jairam, V.,&Park,H.S.Strengths and limitations of
large databases in lung cancer radiation oncology
research. Translational lung cancer research,8,S172-183.
2. Nguyen, H., Butow, P., Dhillon, H., & Sundaresan, P.
A review of the barriers to using Patient‐Reported
Outcomes (PROs) and Patient‐Reported Outcome
Measures (PROMs) in routine cancer care. Journal of
Medical Radiation Sciences, 68(2), 186-195.
3. Wang, T. Q., Samuel, J. N., Brown, M. C., Vennettilli,
A., Solomon, H., Eng, L.,& Howell, D. Routine
surveillance of chemotherapy toxicities in cancer patients
using the patient-reported outcomes version of the
common terminology criteria for adverse events (PROCTCAE).
Oncology and therapy, 6(2), 189-201.


Clinical databases, Psychometric test, Patient-Reported
Outcomes (PROs), Cancer Research, Clinical-Biological



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