# Implementing the NYU Electronic Patient Visit Assessment (ePVA) for Head and Neck Cancer In Rural and Urban Populations

> **NIH NIH R01** · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · 2024 · $644,318

## Abstract

ABSTRACT
Approximately 66,000 individuals will be diagnosed with head and neck cancer (HNC) in the United States (US)
in 2022. Most patients with HNC are treated aggressively with multi-modal therapies that have improved survival
but at a human cost of substantial symptom burden, decreased health-related quality of life (HRQoL), and
extensive acute care use. Symptom management for patients with HNC is critical. However, up to 50% of
patients' symptoms go undetected and electronic health records (EHR) documentation of symptoms is
incomplete. Ground-breaking research shows patient-reported symptom (PRO) monitoring during cancer care
is associated with improved symptom control, decreased acute care use, and longer survival. Yet, a closer
investigation of the literature finds the effects of PROs on cancer outcomes vary depending on implementation.
Reasons for variations in PRO implementation include limited integration with electronic health records (EHR),
inequality in access, and lack of standardized approaches, creating barriers to widespread implementation of
PROs. We developed the NYU Electronic Patient Visit Assessment (ePVA) for HNC as a valid, reliable PRO
that has evolved into a clinical support tool for early detection of uncontrolled symptoms. The ePVA provides a
global picture of the patient's condition automated to clinicians at point-of-care, enabling real-time interventions.
We completed a pilot randomized clinical trial of the ePVA in 32 patients with HNC undergoing radiation therapy
(RT) with or without chemotherapy, and found those assigned to the ePVA+Usual Care Arm reported significantly
less severe HNC symptoms (p<.05) and acute care use (p<.001) than those assigned to the Usual Care Arm.
Our objective in this proposal is to identify implementation strategies optimizing the effectiveness of the ePVA to
improve HNC outcomes in real-world settings and explore integrating the ePVA with the EHR architecture for
scalability and equality in access. To achieve this objective, we will conduct a mixed methods hybrid type I study
at three National Cancer Institute-Designated Comprehensive Cancer Centers serving diverse populations in
rural and urban settings (New York University, University of Kansas Cancer Center, Fox Chase Cancer Center)
using the RE-AIM framework. For participants with HNC undergoing RT with or without chemotherapy, the
specific aims are: 1) (Quantitative) Determine the effect of the Electronic Patient Visit Assessment (ePVA) on
HNC symptoms (primary outcomes), pain, HRQoL, and acute care use (secondary outcomes) in a two-arm
(usual care vs. ePVA+usual care) multisite randomized clinical trial (n=270); 2) (Qualitative) Examine HNC
patients’ and clinicians’ perspectives on patient, clinician, and organization facilitators and barriers to the ePVA’s
reach, adoption, effectiveness, and maintenance; 3) (Integrated) Identify implementation strategies optimizing
ePVA’s reach, adoption, effectiveness, and maintenance; Explor...

## Key facts

- **NIH application ID:** 10931436
- **Project number:** 5R01CA282149-02
- **Recipient organization:** UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
- **Principal Investigator:** JANET H VAN CLEAVE
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $644,318
- **Award type:** 5
- **Project period:** 2023-09-19 → 2028-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10931436

## Citation

> US National Institutes of Health, RePORTER application 10931436, Implementing the NYU Electronic Patient Visit Assessment (ePVA) for Head and Neck Cancer In Rural and Urban Populations (5R01CA282149-02). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10931436. Licensed CC0.

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