Performance of health status measures with a pen based personal digital assistant

Abstract

Background: Increasing use of self reported health status in clinical practice and research, as well as patient appreciation of monitoring fluctuations of health over time, suggest a need for more frequent collection of data. Electronic use of health status measures in the follow up of patients is a possible way to achieve this. Objective: To compare self reported health status measures in a personal digital assistant (PDA) version and a paper/pencil version for test-retest reliability, agreement between scores, and feasibility. Methods: 30 patients with stable rheumatoid arthritis (mean age 61.6 years, range 49.8 to 70.0; mean disease duration, 16.7 years; 63% female; 67% rheumatoid factor positive; 46.6% on disease modifying antirheumatic drugs) completed self reported health status measures (pain, fatigue, and global health on visual analogue scales (VAS), rheumatoid arthritis disease activity index, modified health assessment questionnaire, SF-36) in a conventional paper based questionnaire version and on a PDA (HP iPAQ, model h5450). Completion was repeated after five to seven days. Results: Test-retest reliability was similar, as evaluated by the Bland-Altman approach, the coefficient of variation, and intraclass correlation coefficients. The scores showed acceptable agreement, but with a slight tendency to higher scores on VAS with the PDA than the paper/pencil version. No significant differences were seen for measures of feasibility (time to complete, satisfaction score), but 65.5% preferred PDA, 20.7% preferred paper, and 13.8% had no preference. Conclusions: The clinimetric performance of paper/pencil versions of self reported health status measures was similar to an electronic version, using an inexpensive PDA.

Association of Improvement in Pain With Therapeutic Response as Determined by Individual Improvement Criteria in Patients With Rheumatoid Arthritis

“…For pain measured on a 10‐point visual analog scale (VAS), MCIDs of 0.5 16 to 1.19 17 and a short‐term SDD of 1.63 18 have been reported. For fatigue measured on a 10‐point VAS, an MCID of 1.0 19 and an SDD of 3.23 18 have been reported.…”

“…For pain measured on a 10‐point visual analog scale (VAS), MCIDs of 0.5 16 to 1.19 17 and a short‐term SDD of 1.63 18 have been reported. For fatigue measured on a 10‐point VAS, an MCID of 1.0 19 and an SDD of 3.23 18 have been reported. Studies using statistically based measures to determine values that exceed random variation, such as SDD or reliable change index, consistently report higher values than those that report MCID.…”

Quantitative Clinical Rheumatology: “Keep It Simple, Stupid”: MDHAQ Function, Pain, Global, and RAPID3 Quantitative Scores to Improve and Document the Quality of Rheumatologic Care

“…However, patient self-report Core Data Set measures appear to be as reliable (reproducible) as joint count measures obtained by a physician 13 . Their effectiveness in clinical trials, prognosis, and documentation compared to traditional joint count and radiographic and laboratory data is extensively recognized 14 .…”

Revmatoid artritt

“…Spørreskjemaer har bred anvendelse for å vurdere helserelatert livskvalitet 59,60 , og har vist seg å vaere sensitive for endring 61,62 , og selvrapportert tap av fysisk funksjon predikerer mortalitet 63 . Selvrapportering av helse kan foregå ved hjelp av elektroniske hjelpemidler 64,65 og det er utviklet grenser for hva som er viktig bedring 66 og grenser for hva pasientene synes er et akseptabelt nivå på plagene 67 . Konvensjonelle røntgenbilder er fortsatt standardmetoden for å vurdere tilstedevaerelse og endring i skjelettskade, og van der Heijdes modifisering av Sharp 3 score synes i dag å vaere mer brukt enn skå-ringssystemet som ble utviklet av Arvi Larsen og Knut Dale 68 .…”