Farr Jack, Verma Nikhil, Cole Brian J
Department of Orthopaedics, Indiana Orthopaedic Hospital, Indianapolis, Indiana.
J Knee Surg. 2013 Dec;26(6):445-51. doi: 10.1055/s-0033-1347361. Epub 2013 May 31.
Patient-reported outcomes (PRO) instruments are a vital source of data for evaluating the efficacy of medical treatments. Historically, outcomes instruments have been designed, validated, and implemented as paper-based questionnaires. The collection of paper-based outcomes information may result in patients becoming fatigued as they respond to redundant questions. This problem is exacerbated when multiple PRO measures are provided to a single patient. In addition, the management and analysis of data collected in paper format involves labor-intensive processes to score and render the data analyzable. Computer-based outcomes systems have the potential to mitigate these problems by reformatting multiple outcomes tools into a single, user-friendly tool.The study aimed to determine whether the electronic outcomes system presented produces results comparable with the test-retest correlations reported for the corresponding orthopedic paper-based outcomes instruments.The study is designed as a crossover study based on consecutive orthopaedic patients arriving at one of two designated orthopedic knee clinics.Patients were assigned to complete either a paper or a computer-administered questionnaire based on a similar set of questions (Knee injury and Osteoarthritis Outcome Score, International Knee Documentation Committee form, 36-Item Short Form survey, version 1, Lysholm Knee Scoring Scale). Each patient completed the same surveys using the other instrument, so that all patients had completed both paper and electronic versions. Correlations between the results from the two modes were studied and compared with test-retest data from the original validation studies.The original validation studies established test-retest reliability by computing correlation coefficients for two administrations of the paper instrument. Those correlation coefficients were all in the range of 0.7 to 0.9, which was deemed satisfactory. The present study computed correlation coefficients between the paper and electronic modes of administration. These correlation coefficients demonstrated similar results with an overall value of 0.86.On the basis of the correlation coefficients, the electronic application of commonly used knee outcome scores compare variably to the traditional paper variants with a high rate of test-retest correlation. This equivalence supports the use of the condensed electronic outcomes system and validates comparison of scores between electronic and paper modes.
患者报告结局(PRO)工具是评估医学治疗效果的重要数据来源。从历史上看,结局工具一直被设计、验证并作为纸质问卷实施。收集纸质结局信息可能会导致患者在回答重复问题时感到疲劳。当向单个患者提供多个PRO测量时,这个问题会更加严重。此外,以纸质形式收集的数据的管理和分析涉及到劳动密集型的评分和使数据可分析的过程。基于计算机的结局系统有可能通过将多个结局工具重新格式化为一个用户友好的单一工具来缓解这些问题。该研究旨在确定所呈现的电子结局系统产生的结果是否与相应的骨科纸质结局工具报告的重测相关性相当。该研究设计为一项交叉研究,基于连续到达两个指定骨科膝关节诊所之一的骨科患者。根据一组相似的问题(膝关节损伤和骨关节炎结局评分、国际膝关节文献委员会表格、36项简短调查第1版、Lysholm膝关节评分量表),患者被分配完成纸质或计算机管理的问卷。每个患者使用另一种工具完成相同的调查,以便所有患者都完成了纸质和电子版本。研究了两种方式结果之间的相关性,并与原始验证研究中的重测数据进行了比较。原始验证研究通过计算纸质工具两次施测的相关系数来确定重测信度。这些相关系数都在0.7至0.9的范围内,被认为是令人满意的。本研究计算了纸质和电子施测方式之间的相关系数。这些相关系数显示出相似的结果,总体值为0.86。基于相关系数,常用膝关节结局评分的电子应用与传统纸质变体相比,重测相关性较高,但存在差异。这种等效性支持使用精简的电子结局系统,并验证了电子和纸质模式之间评分的比较。