Perhaps one of the world’s first AI-driven smartphone apps, ePAL, could help patients improve cancer pain management by using patient-generated information collaboratively with others.

A First?

Mihir Kamdar, MD, associate director of palliative care and director of the Cancer Center at Massachusetts General Hospital, Boston, reports that “To our knowledge, this is the first mobile app to use patient-reported outcomes and artificial intelligence to significantly decrease pain scores and pain-related hospitalizations in patients with cancer-related pain” reports ClinicalOncology.

ePAL Study

The smartphone app allows patients to monitor their pain and includes other features such as several interventions and an educational library. The AI component analyzes the data to send patients, tailoring educational coaching messages each day, for example.

Dr. Kamdar and team studied the impact of the app on cancer pain, health care utilization and attitudes toward cancer pain.  They randomly assigned 112 patients with metastatic solid tumor-related pain to receive 8 weeks of the usual palliative care with or without ePAL.

ePAL Study Findings

The Massachusetts-based team found that pain severity, as measured by the Brief Pain Inventory, decreased significantly over the eight-week period (P=0.042) among patients using ePAL.  Additionally, these participants averaged four pain-related hospital admissions during the study period, compared with 20 admissions among those not using the app.  This is a striking difference!

ePAL users also were 82% less likely to visit the emergency department for pain-related reason. Moreover Dr. Kamdar’s team reported that app helped reduce negative attitudes toward cancer treatment, as measured by Barriers Questionnaire II (BQ-II).

But of interest, those using the ePAL reported higher anxiety scores compared with the control group. The researchers failed to explain this but perhaps the knowledge they generated both helped but also raised awareness of their cancer and hence the anxiety levels?


The ePAL app evidences strong potential use cases for apps such as this—not just for oncology but many other therapeutic areas.  Moreover as industry sponsors seek to leverage digitization with their patient populations the ePAL story should trigger some immediate brainstorming sessions.

Source: Clinical Oncology

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