eCHO: Supporting Cancer Patients by recommending Complementary Methods based on Individual Complaints

Introduction: Complementary and alternative methods (CAM) are increasingly used by many cancer patients [1]. CAM enable them to actively participate in their healing process. Unfortunately, many patients hesitate to involve their oncologist, yet search CAM on their own [2]. This leads to the problem, that these methods are not adjusted to the individual tumor treatment of a patient. Hence, by influencing the impact of the therapy of conventional medicine (therapy), CAM might cause interactions and side effects [1], [3]. In this context, interactions are defined as a correlation between cancer types or therapies and complementary methods (CM).

Cancer patients can benefit from expert knowledge and the access to reliable cancer information [4]. For this reason, the PRIO working group of the German Cancer Society (DKG) collects evidence-based oncological health information (EBI) related to CAM.

This paper presents eCHO, a system that consists of an app for patients and a management portal for experts. It supports cancer patients by giving recommendations of CMs based on individual complaints and therapies.

Methods: The data, managed by the system, is divided into two types: the EBI and the patient data. Therefore, the system relies on two separate databases.

The system architecture of eCHO is composed of three main parts: (i) the app on a patient’s smartphone. It consists of the user interface and a database (ADB), which is fully encrypted, (ii) the Web management portal accessible through a browser and (iii) the server-side backend, which exposes the EBI via a RESTful webservice.

The EBI database is currently centralized on a server at Heilbronn University. This server contains only the expert knowledge. PRiO can edit the EBI via the Web management portal - implemented with Angular2 - to keep cancer-related knowledge up to date.

Results: The eCHO-App is designed as a diary with a recommendation feature. A user creates daily diary entries and records current complaints with their respective intensity, ranked by personal assessment. Based on this information the app recommends appropriate CMs.

Afterward, the first three complaints the patient chose are analyzed. Based on these complaints suitable CM are identified in the ADB. Next, existing relations between the CM and therapies and the cancer type are checked for to avoid unwanted interactions. If there are no interactions, the CM will be shown to the patient, however, potentially conflicting CMs will never be displayed.

The app illustrates all created diary entries in form of a chronological chart. Additionally, the chart can be shared with an oncologist via e-mail.

Discussion: The presented system, eCHO, is capable to (a) record the severity of complaints, (b) recommend suitable information and (c) take therapies and complaints into account, potentially caused by therapeutic side effects of conventional medicine.

Next, an evaluation of the app will be conducted. The questionnaire has already been designed and assessed by medical professionals in the field of oncology. However, several patient groups need to be recruited to evaluate the app in terms of usability, understandability, comprehensibility and helpfulness.