Advancing Canine Treatment In Oncology (ACTION): development of a Canine Oncology Proxy-Reported Outcome Measure (CO-PROM) for routine remote symptom-monitoring
Poor management of severe adverse events (sAEs) during chemotherapy can impair dogs’ quality of life and be life-threatening. Owner-perceived quality of life (QoL) is one of the most important determinants of decision-making in veterinary oncology, and measuring this construct and its components in small animals has become the focus of several recently developed QoL questionnaires. However, to date, these instruments have primarily been designed as data collection tools for research purposes rather than for routine symptom-monitoring.
This study will adopt a mixed-methods approach to develop and test a CO-PROM. It will adhere to gold-standards for the development of outcome measures including a) a rapid review of the evidence to identify existing owner-reported instruments to monitor symptoms in dogs receiving chemotherapy. b) the development of the CO-PROM (including item generation and stakeholder consensus on content), followed by c) real world pilot testing (n=30 families) of the CO-PROM over 7-days combined with cognitive interviews (e.g., using ‘think aloud’ techniques) and qualitative feedback (n=15).
Psychometric performance of the tool will be evaluated alongside the data from cognitive interviews and qualitative feedback. These outcomes will inform further refinement of the CO-PROM. Findings will be shared with stakeholders to gain consensus on the prototype CO-PROM and the next steps for testing/implementation.
Practical implications/ conclusions
With further validation, this CO-PROM has the potential to improve the assessment of chemotherapy-related symptoms in dogs, thus enhancing veterinary care as well as canine oncological outcomes and QoL.
Aims and objectives
This project aims to develop a prototype Canine Oncology Proxy (i.e. by family/owner)-Reported Outcome Measure (CO-PROM) to help detect and alleviate dog discomfort, distress and altered behaviour, and determine the user-centred requirements (family, veterinary and research users) for a future digital platform and remote-monitoring package (in which the CO-PROM will be hosted).
- Rapid review of evidence and expert consensus to establish content and scope of a prototype CO-PROM
- Development and mixed methods testing of a prototype CO-PROM with high content validity and sensitive to measure change
- Preliminary specification of the user-centred requirements for digital platform and care package for future translation to digital (smartphone, web-based).
This is a collaborative project between the University of Surrey and AURA veterinary.
Dr Jenny Harris
Senior Lecturer in Cancer Care and Health Statistics
Jenny is a Senior Lecturer in Cancer Care and Health Statistics the School of Health Sciences at the University of Surrey. Her on-going programme of work focuses on optimising health care delivery and outcomes based on data-driven approaches often informed by psychological and behavioural insights.
Jenny has a particular interest in psychosocial care for people living with cancer and using data driven insights to improve multidisciplinary teamworking and quality of care, patient experience and clinical outcomes.
My recent work has been particularly focused on the intersection of cancer and maternity care, and exploring how insights from cancer health services research might be adapted and implemented for other conditions or areas of care, notably maternity and obstetric care (TEAM-QI) and peripheral artery disease.
Methodological interests include predictive risk modelling incorporating questionnaires, surveys and questionnaire design and validation, mixed-methods evaluations of complex interventions (quasi-experimental designs, feasibility studies, RCTs) and real-world implementation of electronic Patient Reported Outcome and Experience Measures.
Professor Emma Ream
Professor, Director of Health Sciences Research
Emma Ream is a Professor of Supportive Cancer Care and Director of Health Sciences Research. She is a Registered Nurse with a research career spanning 30 years. She qualified in 1990 having undertaken a BSc in Nursing with Economics at St Bartholomew's Hospital in conjunction with City University, London. She worked in general and oncology nursing before moving into academia at King's College London. She was awarded her MSc in Nursing from King's College London (1995) and later her doctorate (2002) for her work developing and evaluating an intervention for cancer-related fatigue.
Emma held various research and teaching posts at King's College London before being conferred the title Professor of Supportive Cancer Care in 2009. At King's College London she led the Supportive Cancer Care Research Group and provided strategic leadership in the Florence Nightingale Faculty of Nursing and Midwifery for cancer and palliative nursing education and research.
She moved to the University of Surrey in 2015 to take up position as Director of Health Sciences Research. Her research interests include symptom trajectories during and following cancer treatment, digital health, cancer in pregnancy, support needs of families when a parent has cancer that can't be cured, and cancer inequalities.
Professor Jo Armes
Professor of Cancer Care and Lead for Digital Health
Jo qualified as a Registered Nurse in 1985 at University College Hospital, London. She worked clinically in haematology and medical/clinical oncology before moving to St Bartholomew's & Homerton Hospitals to undertake psycho-oncology research. On completion of a BSc in Nursing Studies at The University of Hull she took up a research post at St Christopher's Hospice, London. In 2000 she was awarded a CRUK Nursing Fellowship to undertake a PhD at King's College London, during which she developed and tested a behavioural intervention for cancer-related fatigue. Subsequently she held a number of academic posts and led the Supportive Cancer Care Research Group in the Florence Nightingale Faculty of Nursing and Midwifery at King's College London. Jo joined the School of Health Sciences at the University of Surrey in 2017 as Reader and Lead for Digital Health. She also leads Digital Innovation theme for the NIHR Applied Research Collaboration for Kent Surrey & Sussex (ARC KSS). Jo has considerable expertise in clinical trials of complex interventions, including digital health interventions, mixed methods and experience based co-design methods.
Dr Quentin Fournier
Medical Oncology Specialist, AURA Veterinary
Research groups and centres
Our research is supported by research groups and centres of excellence.