An Electronic Diary Is Shown to Be More Reliable than a Paper Diary: Results from a Randomized Crossover Study in Patients with Persistent Asthma

Abstract

Acceptable reproducibility of the percentage of RFD (ICC = 0.78) was only observed for the e-diary using the FEV(1) stability criterion. The ICCs for SFD and RFD were acceptable, 0.84 and 0.70, respectively, suggesting better reliability for the e-diary.

Measurement properties of an asthma symptom and rescue medication use diary

“…The calculations of SFD (based on all three stability definitions) and RFD (based on the FEV 1 stability definition) for the ASRMU eDiary were shown to have acceptable test-retest reliability [32]. For the paper-and-pencil diary, only the calculation of SFD was shown to have acceptable test-retest reliability; calculations of RFD using all three definitions of stability were not shown to be reproducible [32].…”

“…The ICC for RFD for the eDiary in patients categorized as stable according to the FEV 1 definition demonstrated acceptable reproducibility (ICC ¼ 0.78). The ICC estimates for RFD produced using the other two stability definitions for the eDiary and all three stability definitions for the paper-and-pencil diary did not meet the threshold for acceptable test-retest reliability [32].…”

“…Participants were mostly female (66%) and white (62%) with a mean age of 36.5 ± 17.5 years and mean (standard deviation) baseline FEV 1 predicted was 2.8 (0.8) L. Participants' asthma was classified by a clinician mostly as moderate persistent (68%), according to National Asthma Education and Prevention Program Report guidelines [2], although the majority (80%) of participants reported their asthma as well controlled based on ACT scores ! 20, none were very poorly controlled based on ACT score 15; nearly 75% of participants were taking a combination inhaler containing an ICS and LABA [32].…”

“…Twenty-four-hour SFD were estimated using patient ratings of daytime and night-time symptom items; individuals were classified as having an SFD if they reported ''no symptoms during the night'' and ''no symptoms during the day''. Similarly, participants were recorded as having an RFD if the total number of puffs of rescue medication over the past 24-h period equaled zero [32].…”

“…This study was also designed to evaluate the measurement equivalence between paper-andpencil and electronic modes of administration [32]. Patients meeting the following criteria were eligible: adolescent (aged 12-17 years) or adult (aged !…”