SurPass v2.0 was rolled out in six target countries (Austria, Belgium, Germany Italy, Lithuania, Spain) in a multi-country implementation study, with a main cohort and an observational cohort. In the main cohort, personalised SurPass v2.0 were delivered to consenting CCS (n = 410 in total) with details on how to retrieve their documentation from the local electronic medical record (EMR). CCS included were diagnosed with cancer before the age of 18 years, had completed the planned treatment protocol, were still in continuous remission, ≥ 5 years survivorship and in follow-up care at one of the participating clinics. Eligible CCS were treated with/after the introduction of the EMR at the respective clinic, so that complete treatment data was expected to be available (electronically). CCS were excluded in case of current treatment for secondary malignancy and if they have already received a previous version of the SurPass. The study outcomes included patient activation as primary outcome (Patient Activation Measure, PAM), empowerment (Health Education Impact Questionnaire, heiQ) quality of life (5-level EQ-5D) and satisfaction with the digital SurPass tool (Technology Acceptance Model, TAM). Data on costs (for CCS and HCPs) were also collected for development of a Prediction Model and health economic analyses. The main cohort completed questionnaires at three timepoints: before receiving the SurPass (CCS: PAM, heiQ, EQ-5D), immediately after SurPass handover (HCPs: TAM, Operational Costs) and two to three months after receiving the SurPass (CCS: PAM, heiQ, EQ-5D, TAM, Costs). In the observational cohort, conducted in Austria and Italy, 376 participants were included with study outcomes comparing SurPass generated with actual medical data versus estimated doses for ITT SurPass.
