## 2 Materials and Methods  
### PersSIST Project  
This study was conducted as part of a European project titled PERSIST [24], which aims to enhance health outcomes and quality of life while simultaneously reducing stress among cancer survivors through a patient-centered care plan that leverages big data and artificial intelligence. The PERSIST consortium seeks to develop an open, interconnected system to optimize the care provided to cancer survivors. The primary objective of the PERSIST project was to evaluate whether and how self-efficacy and patient activation can be addressed as a collaborative effort between patients and clinical professionals. The secondary objective focused on assessing patient engagement, willingness to use the mHealth application, and gathering feedback from both patients and clinicians regarding their experiences with the PERSIST solution (see study protocol [25]). An overview of the PERSIST platform is depicted in Figure 1. Following the collection of real-world data from patients through mobile applications and smart bracelets, cutting-edge technologies were employed to extract multimodal features using the Multimodal Risk Assessment and Symptom Tracking (MRAST) framework. In addition to physical markers, subjective data were collected through questionnaires. All objective markers (vital signs) and subjective markers (Patient-Reported Experience Measures [PREMs], Patient-Reported Outcome Measures [PROMs], and linguistic/vocal/face cues) were gathered via the mHealth application. The fused data were processed using various tools (Cohort and Trajectory Analysis, Information Retrieval Tool, Alerts, and Motivation Mechanisms) and subsequently integrated into the Clinical Decision Support System (CDSS) (version 1.0) and the mClinician application (version 1.0). Digital Interventions  
To facilitate data collection and analysis, the study utilized several digital interventions. The mHealth application (version 1.0) enabled patients to self-report health parameters and vital signs, while the mClinician application (version 1.0) allowed healthcare providers to input and manage patient data. The MRAST platform (version 1.0) employed advanced artificial intelligence (AI) techniques, including automatic speech recognition and natural language processing, to extract valuable insights from patient interactions. These digital tools collectively contributed to the efficient and accurate collection of patient data, enabling the platform to deliver personalized care recommendations and support through the CDSS (version 1.0). The mHealth application (version 1.0) served as the central component for populating the Big Data Platform (version 1.0) with diverse types of patient data, thereby enabling other services to process and analyze this information. The mHealth application (version 1.0) allows individuals to track their health parameters and vital signs (Figure 2). Furthermore, the application facilitates the flow of data between users and healthcare providers. The mobile applications were developed using the Flutter framework (version 2.0) and the Dart programming language. Interoperability of patient data was ensured using Fast Healthcare Interoperability Resources (FHIR) standards, which enabled data sharing among project partners. Figure 1: The main data flow through PERSIST platform. Figure 2: mHealth App screenshots: (**a**) Summary of vital parameters; (**b**) Login screen. The mClinician application (version 1.0) served as a data ingestion tool within the PERSIST project (Figure 3). It was primarily developed for clinicians to assist in collecting patient data and providing an overview of the acquired information. The mClinician application (version 1.0) displays concepts from Symptoma's (Symptoma GmbH, Wien, Austria) API to generate structured data for patients in FHIR format. Clinicians determined the most relevant data to be collected from patients' electronic health records. The MRAST platform (version 1.0) incorporates multimodal analysis of patient video recordings [26] (Figure 4).