Skip to main content

Advertisement

Log in

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

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Swedish Hip Arthroplasty Register (2014). http://www.shpr.se/. Accessed 02 July 2014

  2. National Joint Registry (2014). http://www.njrcentre.org.uk/. Accessed 02 July 2014

  3. Implantat-Register S (2014). http://www.siris-implant.ch. Accessed 02 July 2014

  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 7:51

    Article  PubMed Central  PubMed  Google Scholar 

  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):109–118

    Article  CAS  PubMed  Google Scholar 

  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):154–167

    Article  PubMed  Google Scholar 

  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):998–1007

    CAS  PubMed  Google Scholar 

  8. Taenzer PA et al (1997) Computerized quality-of-life screening in an oncology clinic. Cancer Pract 5(3):168–175

    CAS  PubMed  Google Scholar 

  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):912–916

    Article  CAS  Google Scholar 

  10. Giesinger JM et al (2013) Development of a computer-adaptive version of the forgotten joint score. J Arthroplasty 28(3):418–422

    Article  PubMed Central  PubMed  Google Scholar 

  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):229–237

    Article  PubMed  Google Scholar 

  12. Clayton JA et al (2013) Web-based versus paper administration of common ophthalmic questionnaires: comparison of subscale scores. Ophthalmology 120(10):2151–2159

    Article  PubMed  Google Scholar 

  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):217–227

    Article  PubMed Central  PubMed  Google Scholar 

  14. (2014) PROMIS-patient reported outcomes measurement information system. http://www.nihpromis.org/

  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):419–429

    Article  PubMed  Google Scholar 

  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 12:126

    Article  PubMed Central  PubMed  Google Scholar 

  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):1833–1840

    CAS  PubMed  Google Scholar 

  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):80–84

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  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 e1

  20. Thienpont E et al (2014) Joint awareness in different types of knee arthroplasty evaluated with the forgotten joint score. J Arthroplasty 29(1):48–51

    Article  PubMed  Google Scholar 

  21. Nagle S, Schmidt L (2012) Computer acceptance of older adults. Work 41(Suppl 1):3541–3548

    PubMed  Google Scholar 

  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):513–519

    Article  CAS  PubMed  Google Scholar 

  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):219–229

    Article  PubMed  Google Scholar 

  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):714–724

    Article  PubMed  Google Scholar 

  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):107–111

    Article  PubMed  Google Scholar 

  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):1029–1035

    Article  PubMed Central  PubMed  Google Scholar 

  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):628–637

    Article  PubMed  Google Scholar 

  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):348–351

    Article  CAS  PubMed  Google Scholar 

  29. Bellamy N et al (2011) Osteoarthritis Index delivered by mobile phone (m-WOMAC) is valid, reliable, and responsive. J Clin Epidemiol 64(2):182–190

    Article  PubMed  Google Scholar 

  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):273–277

    Article  PubMed Central  PubMed  Google Scholar 

  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):138–142

    Article  PubMed  Google Scholar 

  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):2425–2434

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

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

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to N. Kesterke.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kesterke, N., Egeter, J., Erhardt, J.B. et al. Patient-reported outcome assessment after total joint replacement: comparison of questionnaire completion times on paper and tablet computer. Arch Orthop Trauma Surg 135, 935–941 (2015). https://doi.org/10.1007/s00402-015-2222-x

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-015-2222-x

Keywords

Navigation