Patient-reported digital symptom monitoring and actionable triage in oncology: A scoping systematic review.

Abstract

e23274 Background: Treatment-related symptoms substantially impair quality of life (QoL) and drive unplanned acute care use in oncology. Although patient-reported digital symptom monitoring is widely studied, outcomes remain inconsistent. We examined how intervention design influences clinical impact. Methods: We conducted a scoping systematic review of prospective randomized trials and pragmatic real-world studies evaluating patient-reported digital symptom monitoring or management interventions in adult oncology populations. Eligible studies reported symptom burden, QoL and/or acute care utilization. Data were abstracted on cancer type, digital modality, triage approach, and direction of outcomes. Protocols and qualitative studies were reviewed for context but excluded from outcome synthesis. Results: Across studies involving solid tumors and hematologic malignancies, interventions used web-based portals, mobile applications or interactive voice response systems. A consistent pattern emerged across the evidence base: interventions that paired real-time symptom reporting with structured, rule-based triage and proactive clinician response demonstrated improvements in symptom burden and QoL across multiple settings. In contrast, passive monitoring or self-management alone showed limited or no benefit despite similar reporting intensity. Effects on acute care utilization were heterogeneous, with reductions most often seen in pragmatic, workflow-integrated implementations. Conclusions: The clinical value of patient-reported digital symptom monitoring lies not in symptom collection itself, but in how reported data are reviewed and acted upon by clinicians. Monitoring alone is insufficient. Implementation-ready models that embed actionable triage and clinician response workflows are essential to improve patient outcomes and reduce avoidable utilization. Intervention approaches and clinical outcomes of digital symptom monitoring in oncology. Intervention Approach Digital Modality Actionable Triage / Clinician Response Symptom Burden Quality of Life Acute Care Use Monitoring with proactive clinician response Portal / App / IVR Yes (rule-based, clinician-reviewed) Improved Improved Reduced / Mixed Monitoring with automated alerts only Portal / App Partial Mixed Mixed NR Passive monitoring or self-management App / Portal No No benefit No benefit NR Pragmatic, workflow-integrated models Mixed Yes + staffing workflows Improved Improved Reduced Heterogeneous or non-integrated implementations Mixed Variable Mixed Mixed Mixed Abbreviations: IVR = Interactive Voice Response; QoL = Quality of Life; NR = Not Reported.