Complementary Medicine Research Unit, School of Medicine, University of Southampton, Southampton, UK.
BMC Musculoskelet Disord. 2010 Jun 8;11:113. doi: 10.1186/1471-2474-11-113.
Augmenting validated paper versions of existing outcome measures with an equivalent online version may offer substantial research advantages (cost, rapidity and reliability). However, equivalence of online and paper questionnaires cannot be assumed, nor can acceptability to respondents. The aim was to test whether online and written versions of the Roland Morris Disability Questionnaire (RMDQ), a standard measure of functional disability in back pain, are equivalent at both group and individual levels to establish whether they can be used interchangeably.
This is a within-participants equivalence study. 167 participants with back pain fully completed both the paper and online versions of the RMDQ in random order. Participants were recruited from a chiropractic clinic and patient support groups in Southern England. Limits of equivalence were pre-defined as 0.5 RMDQ points, the Bland-Altman range was calculated, and participants' comments were examined using content analysis.
The mean score difference was 0.03 (SD = 1.43), with the 95% Confidence Interval falling entirely within our limits of equivalence (-0.19 to 0.25). The Bland-Altman range was -2.77 to 2.83 RMDQ points. Participants identified unique advantages and disadvantages associated with each version of the RMDQ.
The group and individual level data suggest that online and paper versions of the RMDQ are equivalent and can be used interchangeably. The Bland-Altman range appears to reflect the known measurement properties of the RMDQ. Furthermore, participants' comments confirmed the potential value to be had from offering them the choice of completing the RMDQ online or on paper.
在已验证的纸质版现有结果测量工具的基础上，增加一个等效的在线版本可能会带来显著的研究优势（成本、速度和可靠性）。然而，不能假定在线和纸质问卷是等效的，也不能假定受访者会接受。目的是检验罗尔登·莫里斯残疾问卷（RMDQ）的在线和书面版本在群体和个体水平上是否等效，以确定它们是否可以互换使用。
这是一项参与者内等效性研究。167 名腰痛患者以随机顺序完整地完成了纸质版和在线版的 RMDQ。参与者是从英格兰南部的脊椎指压治疗诊所和患者支持团体招募的。等效性的界限预先定义为 0.5 RMDQ 点，计算了 Bland-Altman 范围，并使用内容分析法检查了参与者的意见。
平均得分差异为 0.03（SD = 1.43），95%置信区间完全在我们的等效性界限内（-0.19 至 0.25）。Bland-Altman 范围为-2.77 至 2.83 RMDQ 点。参与者确定了每个 RMDQ 版本的独特优缺点。
群体和个体水平的数据表明，RMDQ 的在线和纸质版本是等效的，可以互换使用。Bland-Altman 范围似乎反映了 RMDQ 的已知测量特性。此外，参与者的意见证实了为他们提供在线或纸质填写 RMDQ 的选择的潜在价值。
