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Archives of Orthopaedic and Trauma Surgery

, Volume 135, Issue 7, pp 935–941 | Cite as

Patient-reported outcome assessment after total joint replacement: comparison of questionnaire completion times on paper and tablet computer

  • N. KesterkeEmail author
  • J. Egeter
  • J. B. Erhardt
  • B. Jost
  • K. Giesinger
Trauma Surgery

Abstract

Introduction

Patient-reported outcome (PRO) assessment is becoming increasingly important after joint replacement surgery. However, PRO data collection, questionnaire handling, and data processing are time consuming and costly process. The aim of our study was to evaluate the efficiency of PRO assessment using tablet computers compared with traditional paper questionnaires in a total hip or knee arthroplasty (THR or TKR) population.

Materials and methods

We recruited 100 patients from outpatient clinics attending for routine follow-up 2 months, 1 year, or 5 years after THR or TKR. Fifty patients completed the Western Ontario and McMaster Universities (WOMAC) osteoarthritis score and Forgotten Joint Score-12 (FJS-12) questionnaires on paper, and 50 patients completed these on a tablet computer. Questionnaire completion was timed for each PRO assessment and for manual data entry of the paper questionnaires into the database. The t test, Mann–Whitney U test, Fisher’s exact test, and Wilcoxon test were used for statistical analysis.

Results

The mean age of the patients was 67.0 years (standard deviation 10.3 years), with no significant difference between the two groups. Median time for WOMAC questionnaire completion (including data entry for the paper questionnaires) was 197 s for the paper version and 117 s for the tablet version (p < 0.001). Median times for completion of FJS-12 were comparable for paper and tablet versions (32 vs. 37 s). We did not find a significant correlation between age and time for questionnaire completion.

Conclusion

Electronic PRO data collection can substantially decrease time, logistics, and effort associated with questionnaire completion in daily clinical practice. It is also acceptable for use in an older arthroplasty population.

Keywords

Patient-reported outcome Electronic data capture WOMAC score Forgotten Joint Score-12 Time factors 

Notes

Acknowledgments

This study was funded by a research grant from ‘Swiss Orthopaedics’ (Schweizerische Gesellschaft für Orthopädie und Traumatologie-SGOT).

References

  1. 1.
    Swedish Hip Arthroplasty Register (2014). http://www.shpr.se/. Accessed 02 July 2014
  2. 2.
    National Joint Registry (2014). http://www.njrcentre.org.uk/. Accessed 02 July 2014
  3. 3.
    Implantat-Register S (2014). http://www.siris-implant.ch. Accessed 02 July 2014
  4. 4.
    Rogausch A et al (2009) Feasibility and acceptance of electronic quality of life assessment in general practice: an implementation study. Health Qual Life Outcomes 7:51PubMedCentralPubMedCrossRefGoogle Scholar
  5. 5.
    Crane HM et al (2007) Routine collection of patient-reported outcomes in an HIV clinic setting: the first 100 patients. Curr HIV Res 5(1):109–118PubMedCrossRefGoogle Scholar
  6. 6.
    Kinnaman JE, Farrell AD, Bisconer SW (2006) Evaluation of the computerized assessment system for psychotherapy evaluation and research (CASPER) as a measure of treatment effectiveness with psychiatric inpatients. Assessment 13(2):154–167PubMedCrossRefGoogle Scholar
  7. 7.
    Velikova G et al (1999) Automated collection of quality-of-life data: a comparison of paper and computer touch-screen questionnaires. J Clin Oncol 17(3):998–1007PubMedGoogle Scholar
  8. 8.
    Taenzer PA et al (1997) Computerized quality-of-life screening in an oncology clinic. Cancer Pract 5(3):168–175PubMedGoogle Scholar
  9. 9.
    Theiler R et al (2004) Responsiveness of the electronic touch screen WOMAC 3.1 OA Index in a short term clinical trial with rofecoxib. Osteoarthr Cartil OARS Osteoarthr Res Soc 12(11):912–916CrossRefGoogle Scholar
  10. 10.
    Giesinger JM et al (2013) Development of a computer-adaptive version of the forgotten joint score. J Arthroplasty 28(3):418–422PubMedCentralPubMedCrossRefGoogle Scholar
  11. 11.
    Lundy JJ, Coons SJ, Aaronson NK (2014) Testing the measurement equivalence of paper and interactive voice response system versions of the EORTC QLQ-C30. Qual Life Res 23(1):229–237PubMedCrossRefGoogle Scholar
  12. 12.
    Clayton JA et al (2013) Web-based versus paper administration of common ophthalmic questionnaires: comparison of subscale scores. Ophthalmology 120(10):2151–2159PubMedCrossRefGoogle Scholar
  13. 13.
    Bjorner JB et al (2014) Difference in method of administration did not significantly impact item response: an IRT-based analysis from the patient-reported outcomes measurement information system (PROMIS) initiative. Qual Life Res 23(1):217–227PubMedCentralPubMedCrossRefGoogle Scholar
  14. 14.
    (2014) PROMIS-patient reported outcomes measurement information system. http://www.nihpromis.org/
  15. 15.
    Coons SJ et al (2009) Recommendations on evidence needed to support measurement equivalence between electronic and paper-based patient-reported outcome (PRO) measures: ISPOR ePRO Good Research Practices Task Force report. Value Health 12(4):419–429PubMedCrossRefGoogle Scholar
  16. 16.
    Holzner B et al (2012) The Computer-based Health Evaluation Software (CHES): a software for electronic patient-reported outcome monitoring. BMC Med Inform Decis Mak 12:126PubMedCentralPubMedCrossRefGoogle Scholar
  17. 17.
    Bellamy N et al (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15(12):1833–1840PubMedGoogle Scholar
  18. 18.
    Bischoff-Ferrari HA et al (2005) Validation and patient acceptance of a computer touch screen version of the WOMAC 3.1 osteoarthritis index. Ann Rheum Dis 64(1):80–84PubMedCentralPubMedCrossRefGoogle Scholar
  19. 19.
    Behrend H et al (2012) The “forgotten joint” as the ultimate goal in joint arthroplasty: validation of a new patient-reported outcome measure. J Arthroplasty 27(3): 430–436 e1Google Scholar
  20. 20.
    Thienpont E et al (2014) Joint awareness in different types of knee arthroplasty evaluated with the forgotten joint score. J Arthroplasty 29(1):48–51PubMedCrossRefGoogle Scholar
  21. 21.
    Nagle S, Schmidt L (2012) Computer acceptance of older adults. Work 41(Suppl 1):3541–3548PubMedGoogle Scholar
  22. 22.
    Buxton J, White M, Osoba D (1998) Patients’ experiences using a computerized program with a touch-sensitive video monitor for the assessment of health-related quality of life. Qual Life Res 7(6):513–519PubMedCrossRefGoogle Scholar
  23. 23.
    Erharter A et al (2010) Implementation of computer-based quality-of-life monitoring in brain tumor outpatients in routine clinical practice. J Pain Symptom Manage 39(2):219–229PubMedCrossRefGoogle Scholar
  24. 24.
    Velikova G et al (2004) Measuring quality of life in routine oncology practice improves communication and patient well-being: a randomized controlled trial. J Clin Oncol 22(4):714–724PubMedCrossRefGoogle Scholar
  25. 25.
    Bellamy N et al (2010) Electronic data capture using the Womac NRS 3.1 Index (m-Womac): a pilot study of repeated independent remote data capture in OA. Inflammopharmacology 18(3):107–111PubMedCrossRefGoogle Scholar
  26. 26.
    Berry DL et al (2011) Enhancing patient-provider communication with the electronic self-report assessment for cancer: a randomized trial. J Clin Oncol 29(8):1029–1035PubMedCentralPubMedCrossRefGoogle Scholar
  27. 27.
    Hilarius DL et al (2008) Use of health-related quality-of-life assessments in daily clinical oncology nursing practice: a community hospital-based intervention study. Cancer 113(3):628–637PubMedCrossRefGoogle Scholar
  28. 28.
    Roberts N, Bradley B, Williams D (2014) Use of SMS and tablet computer improves the electronic collection of elective orthopaedic patient reported outcome measures. Ann R Coll Surg Engl 96(5):348–351PubMedCrossRefGoogle Scholar
  29. 29.
    Bellamy N et al (2011) Osteoarthritis Index delivered by mobile phone (m-WOMAC) is valid, reliable, and responsive. J Clin Epidemiol 64(2):182–190PubMedCrossRefGoogle Scholar
  30. 30.
    Andikyan V et al (2012) A prospective study of the feasibility and acceptability of a Web-based, electronic patient-reported outcome system in assessing patient recovery after major gynecologic cancer surgery. Gynecol Oncol 127(2):273–277PubMedCentralPubMedCrossRefGoogle Scholar
  31. 31.
    de Bree R et al (2008) Touch screen computer-assisted health-related quality of life and distress data collection in head and neck cancer patients. Clin Otolaryngol 33(2):138–142PubMedCrossRefGoogle Scholar
  32. 32.
    Blum D et al (2014) Feasibility and acceptance of electronic monitoring of symptoms and syndromes using a handheld computer in patients with advanced cancer in daily oncology practice. Support Care Cancer 22(9):2425–2434PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • N. Kesterke
    • 1
    Email author
  • J. Egeter
    • 2
  • J. B. Erhardt
    • 1
  • B. Jost
    • 1
  • K. Giesinger
    • 1
  1. 1.Department for Orthopedics and TraumatologyKantonsspital St.GallenSt.GallenSwitzerland
  2. 2.Medizinische Universität InnsbruckInnsbruckAustria

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