Remote symptom monitoring enters ovarian cancer follow-up testing
Persistent fatigue, pain, and other survivorship symptoms often sit outside the narrow frame of recurrence surveillance in ovarian cancer follow-up. This feasibility study protocol tests whether remote patient-reported outcome measures can move follow-up care away from routine hospital appointments and toward a model that captures daily symptom burden more directly. Instead of returning to clinic every three months for standard visits, patients will be asked to complete online surveys on symptoms and quality of life and to record weight and abdominal circumference at home.
The intervention, called Controle op Afstand or CopA, is built to be visible in two places at once: the electronic health record for clinicians and the patient portal for patients. That dual-access design is clinically important because remote monitoring only works when data do not disappear into a parallel system. By placing symptom tracking inside the workflow already used by healthcare professionals, the protocol is attempting to reduce the distance between patient-reported change and clinical response.
A follow-up model built around feasibility rather than efficacy claims
This is a single-centre longitudinal observational pilot, not a definitive outcomes trial. Its purpose is to determine whether the approach is usable, acceptable, and implementable in routine ovarian cancer follow-up care. The investigators will assess feasibility through several linked lenses: patient and healthcare professional experience, barriers and facilitators to implementation, and a process evaluation of how the intervention performs in practice.
For clinicians, the central question is whether remote monitoring can preserve safety while reducing the burden of repeated hospital attendance. For patients, the question is more immediate. Can symptom reporting from home feel manageable, trustworthy, and useful enough to sustain participation over time? In ovarian cancer survivorship, where symptoms may be chronic and ambiguous, that answer matters as much as the technology itself.
The protocol is intentionally pragmatic. It does not assume that digital follow-up will be automatically welcomed or that symptom capture alone will change care. Instead, it treats adoption as a behavioral and organizational problem as much as a technical one. That approach fits ovarian cancer follow-up, where anxiety about recurrence, symptom complexity, and the pressure of scheduled visits can all influence whether patients engage with monitoring tools.
PROMs, home measurements, and the clinical signal they may capture
The intervention asks patients to report patient-reported outcomes on symptoms and quality of life while also measuring weight and abdominal circumference at home. Those physical measures are not decorative additions. In ovarian cancer, changes in abdominal girth and body weight can reflect fluid accumulation, nutrition-related decline, treatment effects, or other clinically relevant shifts that deserve attention before a scheduled visit would normally occur.
Remote monitoring may therefore do more than replace a clinic appointment. It could create a more continuous view of the patient’s course, one that is better suited to chronic symptom management than to episodic surveillance alone. Ovarian cancer survivors often live with fatigue and pain that may not trigger urgent care but still erode function and quality of life. Capturing those symptoms regularly may help clinicians recognize patterns earlier and tailor follow-up to the person rather than to a fixed timetable.
The protocol also acknowledges a practical truth of survivorship care: recurrence detection is only one part of follow-up. A system designed solely around scanning for relapse can miss symptom burden, self-management difficulties, and the everyday costs of treatment. By embedding PROMs into routine follow-up, the study is testing whether symptom surveillance can become a legitimate clinical task rather than an optional extra.
How usability, satisfaction, and workflow burden will be measured
Feasibility will be measured from both sides of the encounter. Healthcare professionals will complete the Measurement Instrument for Determinants of Innovations questionnaire, which is intended to capture how staff perceive the innovation itself and the factors that may shape adoption. Patients will complete the Experienced Usability and Satisfaction with Self-monitoring in the Home Setting questionnaire, a tool aimed at understanding whether the experience feels practical and acceptable from the patient side.
The study will also use qualitative methods to examine barriers and facilitators to implementation. That qualitative component is essential because remote follow-up often fails for reasons that never appear in numerical feasibility scores. A system may be technically functional and still falter if patients find it burdensome, if clinicians do not trust the incoming data, or if responses are not integrated quickly enough to affect care.
Process evaluation adds another layer of realism. The protocol will assess reach, fidelity, compliance, time to response, and the number of (tele)consultations during the study period. Each of those elements speaks to a different operational pressure point. Reach shows who actually enrolls and participates. Fidelity shows whether the intervention is delivered as intended. Compliance reveals whether people keep using it. Time to response captures whether alerts and reports lead to timely clinical action. Consultation counts may show whether remote monitoring reduces, redistributes, or unintentionally adds workload.
A one-sentence truth sits at the center of this protocol: a remote follow-up system that cannot produce timely clinical responses will not relieve burden, no matter how elegant the software appears.
Ethics, oversight, and the limits of a feasibility design
The study received review by the Ethics Committee of the Amsterdam University Medical Centre and was exempted from further review because it was not subject to the Dutch Medical Research Involving Human Subject Act. The protocol will move forward as an observational pilot, which makes its scientific value distinct from that of a therapeutic trial. It is designed to answer whether this model can be used, tolerated, and operationalized, not whether it improves recurrence detection or long-term outcomes.
That distinction shapes how the results should be interpreted. A feasibility study can identify practical barriers, reveal workflow strain, and show whether patients are willing to submit regular symptom reports from home. It cannot establish whether remote PROMs monitoring improves survival, reduces anxiety, or lowers the rate of emergency care. Those questions would require a later effectiveness trial with a different design and a different evidentiary standard.
Still, the protocol addresses a real clinical gap. Ovarian cancer follow-up is often consumed by surveillance routines that may be poorly matched to the symptom realities of survivorship. If CopA proves usable and acceptable, it could support a more individualized model of post-treatment care, one in which symptom burden and home measurements feed into clinical decision-making between face-to-face visits rather than waiting for the next scheduled appointment.
Results will be disseminated through open-access publication, scientific conferences, and communication aimed at patient organizations, healthcare providers, and the wider public. The next clinical question will not be whether remote monitoring is possible in principle, but whether the system can be scaled without losing the responsiveness that makes it worthwhile.