The effect of digital health technologies on managing symptoms across pediatric cancer continuum: A systematic review.

Only 11 studies were included, and they mixed randomized trials, quasi-experiments, pre-post tests and an interrupted time series, so they cannot be pooled into one clear estimate. Five studies had no control group, and several had small samples, so improvement may reflect time, attention or usual care. Blinding and assignment concealment were not feasible or not achieved in the included studies, which can bias symptom reports. Power analysis was done in only 2 studies, so some null results may be due to small samples. No included study reported adverse events, so harms of digital health tools are unknown. The review searched major databases but not grey literature, so some studies may be missing. Most studies were from the United States, with one from Canada, one from Germany and one from China, so results may not transfer to other health systems. Symptoms studied were mostly anxiety, depression and pain, and few studies examined symptom clusters or cost.

The review was funded by the China National Natural Science Foundation of China Youth Science Foundation (71904030) and the Shanghai Pujiang Talent Program (2019PJC006). The authors declared no conflicts of interest.

Do not conclude that digital health technologies are proven to manage pediatric cancer symptoms. The review found mixed results, many studies were small one-group pre-post tests without controls, and no study reported adverse events.