Session Type: Abstract Submissions (ACR)
Background/Purpose: The medical field is increasingly relying on electronic health records (EHR). Many children’s hospitals are converting from paper-pencil questionnaires to electronic versions. The purpose of this study was to compare correlation of results of paper-pencil versus electronically administered versions of two self-report questionnaires: 1) Rheumatology module of the Pediatric Quality of Life Inventory (RHE-PedsQL) and 2) Review of Systems (ROS) symptom checklist.
Methods: Patients (8-28 years old) with rheumatologic conditions, or their parents, completed the RHE-PedsQL (n=76) and ROS checklist (n=100) as a paper-pencil form and electronically through a tablet computer within the same office visit. Interclass correlations (ICC) and weighted-kappa statistics were computed using SAS 9.3 to compare questionnaire modes of administration. Repeated measures analysis of variance was used to determine between and within subject effects for the following covariates: age, gender, race, diagnosis, subtype, and ethnicity. Concurrently, a sample of patients/parents (n=22) was given a qualitative survey about the use of the tablet computer and preference for paper-pencil vs. electronic modes.
Results: Overall, no significant differences were found between the paper-pencil and tablet questionnaires in total score (RHE-PedsQL p=0.16; ROS p=0.56), as well as for any of the identified covariates considered.
Moderate agreement was found for each domain of the RHE-PedsQL (range: ICC= 0.46-0.61). Consistency, at the individual item level, between paper-pencil and electronic capture ranged from poor to moderate (range: kappa= 0.14-0.58), with the treatment domain having the highest correlations (kappa = 0.58) and the worry domain having the lowest (kappa= 0.14).
The ROS checklist yielded substantial agreement for “average pain” (ICC= 0.87) and “overall status” items (ICC= 0.76). Moderate to excellent agreement was found for each of the 60 individual items of the ROS questionnaire (kappa= 0.3 – 1.0), with questions regarding the nervous system (e.g., depression, tingling/numbness) showing the best consistency (all kappa > 0.70) and items regarding skin problems (e.g., tightening, discoloring) showing the most discrepancies (kappa= 0.32 – 0.95).
Qualitative analysis revealed many patients/parents found the tablet simpler, easier and faster than paper-pencil forms. Ten respondents preferred the tablet, eleven had no preference and only one patient preferred the paper-pencil.
Conclusion: There were no significant differences found, for both the ROS checklist and the RHE-PedsQL, in overall score and individual item values, when switching from paper-pencil application to electronic data capture. Furthermore, moderate to substantial agreement was found between modes of administration for the RHE-PedsQL and ROS checklist. The use of electronic questionnaires can increase efficiency of office visits, improve data collection, and patient monitoring, as well as satisfy patient preferences. The ability to integrate electronic patient-reported data into EHR has the potential to improve health care delivery.
J. M. Sage,
J. L. Huggins,
T. V. Ting,
E. M. Morgan DeWitt,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/moving-into-the-electronic-age-validation-of-rheumatology-self-assessment-questionnaires-on-tablet-computers/