Rapid Fire Best of the Best Oral 2025 Joint Meeting of the COSA ASM and IPOS Congress

Optimising paediatric cancer care with electronic patient-reported outcomes: Feasibility of the Ripple platform (125905)

Mikaela Doig 1 , Sophie Jessop 2 , Jordan R Hansford 2 3 4 , Hien Le 1 5 6 7 , Matthew O'Connor 2 , Peter Gorayski 1 5 6 , Andrew Cunningham 8 , Amanda Hutchinson 9 , Victoria Bedford 10 , Eva Bezak 1 , Nayana Parange 1 , Kelly Skelton 1 5 6 , Timothy Price 11 , Michala Short 1
  1. UniSA Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
  2. Michael Rice Centre for Haematology and Oncology, Women's and Children's Hospital, Adelaide, SA, Australia
  3. South Australia Health and Medical Research Institute, Adelaide, SA, Australia
  4. South Australian Immunogenomics Cancer Institute, University of Adelaide, Adelaide, SA, Australia
  5. Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide, SA, Australia
  6. Australian Bragg Centre for Proton Therapy and Research, Adelaide, SA, Australia
  7. College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
  8. UniSA STEM, University of South Australia, Adelaide, SA, Australia
  9. UniSA Justice and Society, University of South Australia, Adelaide, SA, Australia
  10. Cancer Voices South Australia, Adelaide, SA, Australia
  11. Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia

Objectives/purpose
Health-related quality of life (HRQoL) is not routinely assessed in South Australian paediatric oncology practice. We co-designed a child-friendly electronic patient-reported outcome measure (ePROM) platform ‘Ripple’ to assess HRQoL in children aged 5-12 years with cancer and support patient-centred care. This study evaluated the feasibility, acceptability and usability of Ripple in routine clinical practice.

Sample and setting
A mixed-methods feasibility study was conducted across paediatric oncology treatment sites in South Australia. The recruitment target was 20 families based on projected clinic attendance over six months.

Procedures
Participants completed PedsQL Generic Core PROMs via Ripple at key clinical milestones over 12 months. Clinicians accessed responses through the platform and were alerted when results exceeded predefined thresholds. An evaluation survey incorporating the System Usability Scale (SUS) was administered to parents and clinicians at six months.

Results
Thirty-seven children and 37 parents were enrolled alongside 17 clinicians. The median child age was 7.9 years, with a median time since diagnosis of 1.8 years (range 0.1-5.9). Diagnoses included leukaemia (61%), central nervous system tumours (13%), and extracranial solid tumours (26%). PROM completion was high, with 85.2% of all PROMs sent completed by at least one respondent (child or parent). Completion rates were 92.9% for children and 75.5% for parents. Nineteen children (51%) had one or more PROMs flagged for clinical follow-up. No statistically significant changes in child self-reported HRQoL were observed over time. Usability was rated ‘excellent’ (mean SUS score=88.6, SD=11.5). All parent evaluation survey respondents (n=17) agreed the platform captured important aspects of their child’s HRQoL, and 81% agreed HRQoL should be routinely assessed.

Conclusion and Clinical implications
Patient-reported HRQoL assessment using the Ripple platform was feasible and acceptable in paediatric oncology clinical practice. High usability and completion rates support further evaluation in implementation studies assessing the impact on clinical outcomes.