Effects of digital health on symptoms and health-related quality of life in children and adolescent cancer survivors: a meta-analysis and systematic review

OBJECTIVES: To assess the effectiveness of digital health on symptoms and health-related quality of life in children and adolescent cancer survivors. METHODS: We searched PubMed, Embase, Web of Science, Cochrane Library, and CINAHL databases on July 11, 2024, to identify randomized controlled trials of the impact of digital health on children and adolescent cancer survivors aged 0-19 years. The Cochrane Risk of Bias Tool version 1.0 was used to evaluate the quality of randomized controlled trials. It was registered in PROSPERO with the number CRD42024526347. RESULTS: A total of 23 randomized controlled trials were included, of which 18 were meta-analyzed. Compared with usual care, digital health interventions can significantly improve pain (SMD = -0.86, 95% CI: -1.21 to -0.51, P < 0.001), nausea and vomiting (SMD = -0.49, 95% CI: -0.97 to -0.02, P = 0.04), anxiety (SMD = -1.05, 95% CI: -1.60 to -0.50, P = 0.0002), distress (SMD = -0.74, 95% CI: -1.07 to -0.41, P < 0.001), fear (MD = -0.91, 95% CI: -1.40 to -0.42, P = 0.0003), and health-related quality of life (SMD = 1.41, 95% CI: 1.11 to 1.70, P < 0.001) in children and adolescent cancer survivors. However, improvements in fatigue and anger were not significant. CONCLUSIONS: Our systematic review provides evidence that digital health interventions have great potential to improve the symptoms and health-related quality of life of children and adolescent cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS: Digital technologies to improve symptoms and health-related quality of life in children and adolescent cancer survivors deserve wider application.