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BackgroundUnmanaged cancer symptoms and treatment-related side effects can compromise long-term clinical outcomes and health-related quality of life. Health information technologies such as web-based platforms offer the possibility to supplement existing care and optimize symptom management. ObjectiveThis paper describes the development and usability of a web-based symptom management platform for cancer patients and survivors that will be implemented within a large health system. MethodsA web-based symptom management platform was designed and evaluated via one-on-one usability testing sessions. The System Usability Scale (SUS), After Scenario Questionnaire (ASQ), and qualitative analysis of semistructured interviews were used to assess program usability. ResultsTen cancer survivors and five cancer center staff members participated in usability testing sessions. The mean score on the SUS was 86.6 (SD 14.0), indicating above average usability. The mean score on the ASQ was 2.5 (SD 2.1), indicating relatively high satisfaction with the usability of the program. Qualitative analyses identified valued features of the program and recommendations for further improvements. ConclusionsCancer survivors and oncology care providers reported high levels of acceptability and usability in the initial development of a web-based symptom management platform for cancer survivors. Future work will test the effectiveness of this web-based platform.

PURPOSE: The purpose of the present study was to describe the content and function of iBehavior, a smartphone-based caregiver-report electronic ecological momentary assessment (eEMA) tool developed to assess and track behavior change in people with intellectual and developmental disabilities (IDDs), and to examine its preliminary validity. METHODS: Ten parents of children (ages of 5-17 years) with IDDs (n = 7 with fragile X syndrome; n = 3 with Down syndrome) rated their childs behavior (aggression and irritability, avoidant and fearful behavior, restricted and repetitive behavior and interests, and social initiation) using iBehavior once daily for 14 days. At the conclusion of the 14-day observation period, parents completed traditional rating scales as validation measures, as well as a user feedback survey. RESULTS: Across the 140 possible observations, 8 were skipped, leading to a 94% response rate over 10 participants observation periods. Participants also completed 100% of items for each of their logged observations. Parent ratings using iBehavior showed emerging evidence of convergent validity among domains with traditional rating scales including the Behavior Rating Inventory of Executive Function 2 (BRIEF-2), and Aberrant Behavior Checklist-Community (ABC-C). iBehavior was feasible in the sample, and parent feedback indicated high overall satisfaction. CONCLUSION: Results of the present pilot study indicate successful implementation and preliminary feasibility and validity of an eEMA tool for use as a behavioral outcome measure in IDDs.

The standard error (SE) stopping rule, which terminates a computer adaptive test (CAT) when the "SE" is less than a threshold, is effective when there are informative questions for all trait levels. However, in domains such as patient-reported outcomes, the items in a bank might all target one end of the trait continuum (e.g., negative symptoms), and the bank may lack depth for many individuals. In such cases, the predicted standard error reduction (PSER) stopping rule will stop the CAT even if the "SE" threshold has not been reached and can avoid administering excessive questions that provide little additional information. By tuning the parameters of the PSER algorithm, a practitioner can specify a desired tradeoff between accuracy and efficiency. Using simulated data for the Patient-Reported Outcomes Measurement Information System Anxiety and Physical Function banks, we demonstrate that these parameters can substantially impact CAT performance. When the parameters were optimally tuned, the PSER stopping rule was found to outperform the "SE" stopping rule overall, particularly for individuals not targeted by the bank, and presented roughly the same number of items across the trait continuum. Therefore, the PSER stopping rule provides an effective method for balancing the precision and efficiency of a CAT.

Introduction: Short message service (SMS) is a widely accepted telecommunications approach used to support health informatics, including behavioral interventions, data collection, and patient-provider communication. However, SMS delivery platforms are not standardized and platforms are typically commercial 'off-the-shelf or developed 'in-house.' As a consequence of platform variability, implementing SMS-based interventions may be challenging for both providers and patients. Off-the-shelf SMS delivery platforms may require minimal development or technical resources from providers, but users are often limited in their functionality. Conversely, platforms that are developed in-house are often specified for individual projects, requiring specialized development and technical expertise. Patients are on the receiving end of programming and technical specification challenges; message delays or lagged data affect quality of SMS communications. To date, little work has been done to develop a generalizable SMS platform that can be scaled across health initiatives. Objective: We propose the Configurable Assessment Messaging Platform for Interventions (CAMPI) to mitigate challenges associated with SMS intervention implementation (e.g., programming, data collection, message delivery). Method: CAMPI aims to optimize health data captured from a multitude of sources and enhance patient-provider communication through a technology that is simple and familiar to patients. Using representative examples from three behavioral intervention case studies implemented among diverse populations (pregnant women, young sexual minority men, and parents with young children), we describe CAMPI capabilities and feasibility. Conclusion: As a generalizable SMS platform, CAMPI can be scaled to meet the priorities of various health initiatives, while reducing unnecessary resource utilization and burden on providers and patients. Public Significance Statement Telecommunications tools that promote patient-provider communication such as behavioral interventions and compliance are increasingly being used in healthcare settings. We present a short message service (SMS) system that can enhance patient-provider communication while reducing some of the common implementation barriers associated with technology solutions. Keywords: informatics, text messaging, short message service, mHealth Supplemental materials: https://doi.org/10.1037/fsh0000592.supp, Mobile phone communication has revolutionized health care by enabling real-time data collection to inform health information dissemination and clinical decision making. One of the most versatile, highly utilized, and scalable [...]

BackgroundTo examine the angiopoietin pathway inhibitor trebananib IV plus the anti-VEGF agents bevacizumab or motesanib in advanced solid tumours.MethodsIn this open-label phase 1b study, patients received IV trebananib 3 mg kg-1 QW plus bevacizumab 15 mg kg-1 Q3W (cohort 1) or motesanib orally 75 mg (cohort 2); or trebananib 10 mg kg-1 plus bevacizumab 15 mg kg-1 (cohort 3) or motesanib 125 mg (cohort 4). If 6 months. Across the trebananib plus motesanib cohorts, one patient had a partial response; five patients had stable disease lasting >6 months.ConclusionTrebananib IV 3 mg kg-1 or 10 mg kg-1 plus bevacizumab or motesanib in advanced solid tumours may be associated with less severe toxicities relative to those emerging when combining two anti-VEGF agents.

BackgroundTrebananib, an investigational peptibody, binds to angiopoietin 1 and 2, thereby blocking their interaction with Tie2.Patients and methodsThis open-label phase I study examined trebananib 3 mg/kg or 10 mg/kg intravenous (I.V.) once weekly plus sorafenib 400 mg twice per day or sunitinib 50 mg once per day in advanced RCC. Primary end points were adverse event incidence and pharmacokinetics.ResultsThirty-seven patients were enrolled. During trebananib plus sorafenib administration (n = 17), the most common treatment-related adverse events (TRAEs) included rash (n = 12; 71%), diarrhea (n = 12; 71%), hypertension (n = 11; 65%), and fatigue (n = 11; 65%); grade ≥ 3 TRAEs (n = 7; 41%); and 2 patients (12%) had peripheral edema. During trebananib plus sunitinib administration (n = 19), the most common TRAEs included diarrhea (n = 14; 74%), fatigue (n = 13; 68%), hypertension (n = 11; 58%), and decreased appetite (n = 11; 58%); grade ≥ 3 TRAEs (n = 13; 68%); and 8 (42%) patients had peripheral edema. Trebananib did not appear to alter the pharmacokinetics of sorafenib or sunitinib. No patient developed anti-trebananib antibodies. Objective response rates were 29% (trebananib plus sorafenib) and 53% (trebananib plus sunitinib).ConclusionThe toxicities of trebananib 3 mg/kg or 10 mg/kg I.V. plus sorafenib or sunitinib in RCC were similar to those of sorafenib or sunitinib monotherapy, with peripheral edema being likely specific to the combinations. Antitumor activity was observed.

A further extension of the iteration method for beam propagation calculation is presented that can be applied for volume Bragg gratings (VBGs) with extremely large grating strength. A reformulation of the beam propagation formulation is presented for analyzing the reflection of a laser beam by a deformed VBG. These methods will be shown to be very accurate and efficient. A VBG with generic z-dependent distortion has been analyzed using these methods. OCIS codes: 050.7330, 050.1755, 230.1480, 090.7330.