Updated December 2024

Symptom Management > Introduction

The Symptom Management Reporting Database was developed to support the goals of the Ontario Cancer Symptom Management Collaborative, which are to: promote earlier identification, documentation and communication of patient’s symptoms, optimal symptom management and collaborative care planning for patients with cancer.

Data in the Symptom Management Reporting Database is comprised of two components: patient registration and symptom screening using patient reported outcome measures (PROMs) (e.g., Edmonton Symptom Assessment System Revised-+ [ESAS-r+]). PROM data serves as one standard for the screening and monitoring of symptoms for patients with cancer across the continuum of care. Only one PROM screen is stored in the database by the System for the same patient, site, and assessment date.

PROM information may be captured by participating sites using the Interactive Symptom Assessment and Collection (ISAAC) system - directly by the patient into an ISAAC kiosk, through a link to the ISAAC webpage for remote/home channel access on a patient’s personal device ahead of their appointment, or it may be collected on paper and subsequently uploaded to ISAAC. Sites may also collect PROMs through their Electronic Medical Record, and then transfer the data to ISAAC. Data also needs to be submitted to the Activity Level Reporting, which supplies data to the Symptom Management Reporting Database.

Questions specific to the Tobacco Use Survey can be directed to SmokingCessation@ontariohealth.ca

Patient Registration

The patient registration data is related to patient demographics and disease sites. This information is entered once by each care site but may be updated over time.

Edmonton Symptom Assessment Scale- Revised+ (ESAS-r+)

ESAS-r+ is a modified version of the validated ESAS-r symptom screening tool. Patients with cancer are asked to rate the severity of 12 common symptoms, specifically: pain, tiredness, nausea, depression, anxiety, drowsiness, lack of appetite, well-being, shortness of breath (dyspnea), sleep, diarrhea, and constipation.

Expanded Prostate Cancer Index Composite for Clinical Practice (EPIC-CP)

EPIC-CP is a validated symptom screening tool that is designed for patients with early-stage prostate cancer. EPIC-CP is composed of 17 questions to measure quality of life and symptom domains (e.g., urinary incontinence, urinary irritation/obstruction, and bowel, sexual and vitality/hormonal) for patients with early-stage prostate cancer.

MD Anderson Symptom Inventory - Head and Neck Cancer (MDASI-H&N )

MDASI-H&N is a validated symptom screening tool to assess symptoms associated with head and neck cancers. MDASI-H&N is composed of 28 questions related to common cancer symptoms, head and neck cancer-specific symptoms such as swallowing and speaking, and an interference scale, which assesses the interference of cancer to the daily activities of the patient.

Patient Reported Functional Status (PRFS)

PRFS is sourced from the activities/function domain of the Patient-Generated Subjective Global Assessment (PG-SGA) Scale, which is a widely used, well-validated measure used to screen and monitor overall nutritional status in patients with cancer. PRFS is a single question related to performance status/activity level of the patient, and is prompted after ESASr+, EPIC-CP and MDASI-H&N.

Patient Health Questionnaire-9 (PHQ-9)

The PHQ-9 is a validated symptom screening tool for assessing and monitoring depression criteria and severity. It is composed of 9 questions. If this PROM is enabled at the site, patients are prompted with PHQ-9 if they rate depression ≥ 2 on ESASr+.

MD Anderson Symptom Inventory - Head and Neck Cancer (MDASI - H&N)

MDASI - H&N is a screening tool to assess symptoms associated with head and neck cancers such as swallowing and speaking. It also includes an interference scale, which assesses the interference of cancer to the daily activities of the patient. The tool contains 28 questions.

Tobacco Use Survey

The Tobacco Use Survey is used to collect information about a patient's tobacco use, including current smoking status, amount smoked and quit methods attempted (if applicable).

Voluntary Self-Identification for Indigenous Patients (VSIP)

This is a voluntary question asking patients if they self-identify as Indigenous (First Nations, Inuit or Métis). Patients may choose not to respond by selecting "I do not want to answer".