Replacing paper data collection forms with electronic data entry in the field: findings from a study of community-acquired bloodstream infections in Pemba, Zanzibar

Abstract

BackgroundEntering data on case report forms and subsequently digitizing them in electronic media is the traditional way to maintain a record keeping system in field studies. Direct data entry using an electronic device avoids this two-step process. It is gaining in popularity and has replaced the paper-based data entry system in many studies. We report our experiences with paper- and PDA-based data collection during a fever surveillance study in Pemba Island, Zanzibar, Tanzania.MethodsData were collected on a 14-page case report paper form in the first period of the study. The case report paper forms were then replaced with handheld computers (personal digital assistants or PDAs). The PDAs were used for screening and clinical data collection, including a rapid assessment of patient eligibility, real time errors, and inconsistency checking.ResultsA comparison of paper-based data collection with PDA data collection showed that direct data entry via PDA was faster and 25% cheaper. Data was more accurate (7% versus 1% erroneous data) and omission did not occur with electronic data collection. Delayed data turnaround times and late error detections in the paper-based system which made error corrections difficult were avoided using electronic data collection.ConclusionsElectronic data collection offers direct data entry at the initial point of contact. It has numerous advantages and has the potential to replace paper-based data collection in the field. The availability of information and communication technologies for direct data transfer has the potential to improve the conduct of public health research in resource-poor settings.

Implementing electronic data capture at a well-established health and demographic surveillance site in rural northern Malawi

“…Using EDC reduced the time needed before and after data collection, as printing and data entry were largely eliminated; the latter reflected in the reduction in the average number of days from data collection to availability to scientists. Other evaluations have found that the overall time required was always shorter with EDC [3,6,7,13,19], despite additional time needed at the beginning for making tablet forms [5,15], which is consistent with our findings.…”

“…Our quantitative results on data quality are consistent with findings from other evaluations [3,6,7,10,11,15–19]. On paper forms, the level of missing data increased with the complexity of skip patterns, while almost the opposite pattern was seen in EDC, showing the usefulness of programmed automatic skip patterns in guiding interviewers to the correct questions.…”

“…With a study size above a certain threshold (as start-up costs can be high), costs tend to be lower with EDC [6,7,10,13]. We were able to reduce costs in some areas, for example by buying devices in the UK, as they were expensive to buy locally.…”

“…Inconsistent electricity also causes problems with keeping devices charged in rural locations [2,5]. Several data collection software programmes now exist. Technical expertise required : In rural low-resource settings, finding local staff with the higher level of technical skills required maybe challenging. Cost : While economic analyses have found that, assuming a study beyond a certain size, the costs tend to be lower with EDC [6,7], a long-running site with existing infrastructure may incur different costs and savings. Acceptance of staff : It has been found that lack of previous experience with computers has not been a hindrance to fieldworkers learning to use the devices [2,8], and users tend to prefer EDC over paper [8–13]. However, fieldworkers are not the only people affected by a change to established procedures.…”

“…Cost : While economic analyses have found that, assuming a study beyond a certain size, the costs tend to be lower with EDC [6,7], a long-running site with existing infrastructure may incur different costs and savings.…”