Shortening the Time Interval for Soft Tissue Sarcoma Patient Referral to Expert Centers: Application of mHealth for Rare Tumors (Preprint)

BACKGROUND According to guidelines, all sarcoma patients must be managed from initial diagnosis at expert sarcoma centers. However, in everyday practice, the time interval to an expert center visit can be long, which delays presentation to an expert multidisciplinary tumor board (MTB) and increases the risk of inappropriate management, negatively affecting local tumor control and prognosis. The advent of mobile health (mHealth) offers an easy way to facilitate communication and cooperation between general health care providers (e.g., general practitioners and radiologists) and sarcomas experts. We developed a mobile application (Sar’Connect) based on the algorithm designed by radiologists from French Sarcoma Group. Through a small number of easy-to-answer questions, Sar’Connect provides personalized advice for management of patients and contact information on the closest expert center. OBJECTIVE This retrospective study is the first to assess this mobile application’s benefits in reducing the time interval for patient referral to an expert center according to the initial clinical characteristics of the soft tissue tumor. METHODS We extracted tumor mass data for 78 patients discussed by MTBs of three centers of French Sarcoma Group. We applied the Sar’Connect algorithm to these data and estimated the time interval to expert center referral; then, we compared this estimated time interval with the observed time interval. RESULTS We found that the use of Sar’Connect shortened the time interval to a referral center by approximately 7.5 months. Moreover, for half of patients with a malignant soft tissue tumor, Sar’Connect avoided inappropriate management outside of the reference center. We did not identify a significant determinant for shortening the time interval for referral. CONCLUSIONS Overall, promoting the use of a simple mobile application is an innovative and straightforward means to accelerating both the referral and management of soft tissue sarcoma patients in expert centers.