Measurement equivalence and feasibility of the EORTC QLQ-PR25: paper-and-pencil versus touch-screen administration

Abstract

ObjectiveWe assessed the measurement equivalence and feasibility of the paper-and-pencil and touch-screen modes of administration of the Taiwan Chinese version of the EORTC QLQ-PR25, a commonly used questionnaire to evaluate the health-related quality of life (HRQOL) in patients with prostate cancer in Taiwan.MethodsA cross-over design study was conducted in 99 prostate cancer patients at an urology outpatient clinic. Descriptive exact and global agreement percentages, intraclass correlation, and equivalence test based on minimal clinically important difference (MCID) approach were used to examine the equity of HRQOL scores between these two modes of administration. We also evaluated the feasibility of computerized assessment based on patients’ acceptability and preference. Additionally, we used Rasch rating scale model to assess differential item functioning (DIF) between the two modes of administration.ResultsThe percentages of global agreement in all domains were greater than 85% in the EORTC QLQ-PR25. All results from equivalence tests were significant, except for Sexual functioning, indicating good equivalence. Only one item exhibited DIF between the two modes. Although nearly 80% of the study patients had no prior computer-use experience, the overall proportion of acceptance and preference for the touch-screen mode were quite high and there was no significant difference across age groups or between computer-use experience groups.ConclusionsThe study results showed that the data obtained from the modes of administration were equivalent. The touch-screen mode of administration can be a feasible and suitable alternative to the paper-and-pencil mode for assessment of patient-reported outcomes in patients with prostate cancer.

Brief Communication: Patient Satisfaction with the Use of Tablet Computers: A Pilot Study in Two Outpatient Home Dialysis Clinics

“…Confirming our findings, Chang et al [ 15 ] also concluded that age and previous computer experience did not explain acceptance of an electronic platform. Pouwer et al [ 22 ] also found that e-PROs were very easy for research participants to use even if they had little computer experience.…”

“…Researchers cannot necessarily assume that translations of PROs from paper to electronic versions are equivalent [ 13 – 15 ]. The need to test measurement equivalence is determined by the level of modification required.…”

Strategies to use tablet computers for collection of electronic patient-reported outcomes

“… Immediate access to retrievable data [ 1 , 6 ] Potential to link ePRO data with electronic health records [ 6 , 12 , 13 ] Capacity to trigger automated alerts when patients identify problems [ 1 , 3 , 6 , 11 - 13 ] Immediate scoring and presentation of data [ 2 , 5 - 7 , 12 ] More economical in terms of resources and time [ 3 , 4 , 6 - 8 , 12 , 15 ] Greater likelihood of reporting sensitive information [ 1 , 2 , 5 ] Prevention of errors in data-entry [ 1 , 4 ] Observation of survey completion in real-time [ 1 , 5 , 6 , 11 ] Improved data quality [ 3 , 4 ] Less missing information [ 1 , 2 , 8 , 12 ] With minor modifications from paper to electronic formats, validation is not likely necessary [ 1 , 6 , 7 , 9 ] Patient satisfaction with electronic platform [ 1 , 2 , 5 , 7 , 11 , 14 ] Storage of longitudinal data [ 2 , 12 ] Web-based platforms allow reporting from multiple locations (ie home, clinic etc.) [ …”

“…With minor modifications from paper to electronic formats, validation is not likely necessary [ 1 , 6 , 7 , 9 ]…”

Analysis of the video motion tracking system “Kinovea” to assess surgical movements during robot‐assisted radical prostatectomy

“…Although patient selection was based on continence, a number of additional outcomes were compared to the video motion tracking data in order to assess whether there was a relation. These post‐operative outcomes included patient reported outcome measures (PROMs), lower urinary tract symptoms, measured using the International Prostate Symptom Score (IPSS), the lower urinary tract symptoms domain of the EORTC QLQ‐PR25 score (EORTC QLQ‐PR25 score), and post‐operative complications, which were registered in the patients' medical files as they occurred.…”