Tablet, Web-Based, or Paper Questionnaires for Measuring Anxiety in Patients Suspected of Breast Cancer: Patients' Preferences and Quality of Collected Data

Abstract

BackgroundElectronic applications are increasingly being used in hospitals for numerous purposes.ObjectiveOur aim was to assess differences in the characteristics of patients who choose paper versus electronic questionnaires and to evaluate the data quality of both approaches.MethodsBetween October 2012 and June 2013, 136 patients participated in a study on diagnosis-induced stress and anxiety. Patients were asked to fill out questionnaires at six different moments during the diagnostic phase. They were given the opportunity to fill out the questionnaires on paper or electronically (a combination of tablet and Web-based questionnaires). Demographic characteristics and completeness of returned data were compared between groups.ResultsNearly two-thirds of patients (88/136, 64.7%) chose to fill out the questionnaires on paper, and just over a third (48/136, 35.3%) preferred the electronic option. Patients choosing electronic questionnaires were significantly younger (mean 47.3 years vs mean 53.5 in the paper group, P=.01) and higher educated (P=.004). There was significantly more missing information (ie, at least one question not answered) in the paper group during the diagnostic day compared to the electronic group (using a tablet) (28/88 vs 1/48, P<.001). However, in the week after the diagnostic day, missing information was significantly higher in the electronic group (Web-based questionnaires) compared to the paper group (41/48 vs 38/88, P<.001).ConclusionsYounger patients and patients with a higher level of education have a preference towards filling out questionnaires electronically. In the hospital, a tablet is an excellent medium for patients to fill out questionnaires with very little missing information. However, for filling out questionnaires at home, paper questionnaires resulted in a better response than Web-based questionnaires.

Feasibility of the collection of patient-reported outcomes in an ambulatory neurology clinic

“…Our participation rate (49%) was similar to rates reported by other tablet-based PROM acquisition studies. [10][11][12][13][14] Tablet-based survey administration permitted both collection of large-scale PROMs data and verification of critical demographic information such as occupational status, education level, and living situation in the population studied. This study highlights the differences between participants and nonparticipants in the routine collection of PROMs.…”

Are web-based questionnaires accepted in patients attending rehabilitation?

“…Touvier et al (2010) showed high preference, equal or better quality of data and considerable cost savings when a web version of a selfadministered anthropometric questionnaire was compared to the paper version. [4] Barentsz et al (2014) showed higher preference web SAQs for younger and more educated patients suspected for breast cancer, [12] and Kongsved et al (2007) showed better completeness of data web SAQs as compared to paper SAQs in evaluation of four clinically validated questionnaires in a hospital setting in Denmark. [13] The success of introducing web SAQs is closely related to how well the population adopt and utilize the technology.…”

An Electronic Patient-Reported Outcome Tool for the FACT-B (Functional Assessment of Cancer Therapy-Breast) Questionnaire for Measuring the Health-Related Quality of Life in Patients With Breast Cancer: Reliability Study (Preprint)

“…Although paperbased surveys of PRO still predominate because there are only a few reliable and validated ePRO questionnaires, numerous projects have evaluated feasibility and acceptance of HRQoL in ePRO measurement in the last few years [29][30][31][32][33][34]. Nevertheless, knowledge regarding patient acceptance, feasibility, and barriers remains limited [35], especially since hurdles might exist in relation to health status, technical skills, and socioeconomic aspects, which could influence both patients´ willingness to use ePRO and their response behavior [10,36,37]. Although studies have already demonstrated a potential equivalence between some paper-based PRO and ePRO, reliability of ePRO questionnaires should be verified so as not to endanger the validity of ePRO surveys [10,[36][37][38][39][40].…”

“…Nevertheless, knowledge regarding patient acceptance, feasibility, and barriers remains limited [35], especially since hurdles might exist in relation to health status, technical skills, and socioeconomic aspects, which could influence both patients´ willingness to use ePRO and their response behavior [10,36,37]. Although studies have already demonstrated a potential equivalence between some paper-based PRO and ePRO, reliability of ePRO questionnaires should be verified so as not to endanger the validity of ePRO surveys [10,[36][37][38][39][40]. Indeed, ePRO tools of the FACT-B questionnaire with proven reliability are missing so far.…”

“…Thus, a corresponding analysis in relation to differences and correlations between the paper-based vision of FACT-B and newly developed online tools are of great importance. It can be assumed that many aspects (i.e., sociodemographic aspects, technical skills, health condition, and perhaps design specifics of the ePRO tool) may influence both patients' willingness to use the tool and their response behavior, which underlines the need for reliability analyses [10,24,[35][36][37]. However, almost no scientific studies have dealt with the reliability of ePRO questionnaires.…”