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
Lecturer in Cancer Care
I am a Lecturer in Cancer Care in the School of Health Sciences at the University of Surrey and oversee HSstats our statistical advice service for Health Science students and staff.
I have worked in Health Sciences research since 2003. Previously I worked as a Research Fellow for the EU funded eSMART project, an RCT using smartphone-based remote-monitoring to monitor chemotherapy-related toxicities for people with cancer across five European countries. I have worked in the independent research sector as a Senior Researcher at the National Centre for Social Research (2006-2011) and as a Research Associate at King's College London (2003-2006; 2011-2017).
My research interests include digital health services research, clinical trials and feasibility studies, statistical modelling and questionnaire design . I am particularly interested health-related anxiety, the use of predictive risk models in psychosocial oncology (the topic of my PhD at King's College London) and interventions aimed at supporting people live with and beyond cancer.
Professor Emma Ream
Professor, Director of Health Sciences Research
Emma 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 in recognition of her contribution to cancer and palliative care nursing and her outstanding research profile and academic leadership. 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.
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