Orthopedics Department, Beaujon-Bichat Hospital, Paris University, APHP, 46, rue Henri Huchard, 75018 Paris, France.
Centre main épaule Méditerranée, Clinique Bouchard, Elsan, Marseille, France.
Orthop Traumatol Surg Res. 2023 Apr;109(2):103479. doi: 10.1016/j.otsr.2022.103479. Epub 2022 Nov 17.
Considering the extensive use of smartphones in current societies, web-based applications could be considered as a new option for patient follow-up in surgery. By means of such tool, automated and periodic questionnaires could improve the rigor, accuracy and the comprehensiveness of postoperative monitoring, as well as early detection of complications, especially in the current context of evolving ambulatory surgery.
The web-based surveys would improve the quality of immediate postoperative monitoring.
For 7 months, we included all patients who underwent outpatient arthroscopic rotator cuff repair. After preoperative randomization, each patient was asked postoperatively to complete either paper-based forms or digital questionnaires via a website (Orthense.com®, Digikare Inc. Blagnac, France). Both media (i.e. paper and digital) followed the same postoperative agenda (i.e., D+3, D+14, D+28, D+45, D+90) and had the same content, including pain and discomfort assessments, functional scores (i.e. Shoulder subjective value, simple shoulder test and auto-constant scores). The main objective was to investigate the quality of postoperative follow-up after outpatient arthroscopic rotator cuff surgery, using either printed questionnaires or web-based surveys. The hypothesis was that using a web-based survey would result in greater response rates and increased patient satisfaction regarding follow-up. Primary outcomes were questionnaire response rates at D+45 and D+90, while secondary outcomes were overall response rates, patient recommendation for the monitoring medium and overall patient satisfaction regarding their follow-up using the net promoter score (NPS).
Among the 59 consecutive patients who were included, there were 27 females and 26 males with a mean age of 57±10.2 years; 27 patients completed the web-based survey (Group A) and 26 patients answered paper-based questionnaires (Group B). Regarding the D+45 questionnaire, response rates were 85.2% (n=23) in group A and 42.3% (n=11) in group B (p=.005); a similar significant difference was observed regarding the D+90 questionnaire, with response rates of 70.4% and 34.6%, respectively (p=.027). The mean NPS for the survey was 10 in Group A and 8.29 in Group B (p=.016). Overall, satisfaction regarding postoperative care did not differ between the two groups.
Compared to traditional paper-based forms, web-based surveys appear to increase patient adherence to short-term postoperative monitoring. If these findings were to be confirmed in long-term follow-up, such straightforward and cost-effective tool could be of great use in clinical care and research.
I; Randomized controlled clinical trial.
考虑到智能手机在当前社会中的广泛应用，基于网络的应用程序可以被视为手术患者随访的新选择。通过这种工具，自动化和定期的问卷调查可以提高术后监测的严谨性、准确性和全面性，并及早发现并发症，尤其是在当前不断发展的门诊手术背景下。
基于网络的调查将提高即时术后监测的质量。
在 7 个月的时间里，我们纳入了所有接受门诊关节镜肩袖修复的患者。在术前随机分组后，每位患者在术后被要求填写纸质表格或通过网站（Orthense.com®，Digikare Inc. Blagnac，法国）填写数字问卷。两种媒体（即纸质和数字）都遵循相同的术后日程安排（即 D+3、D+14、D+28、D+45、D+90），并且内容相同，包括疼痛和不适评估、功能评分（即肩主观价值、简单肩测试和自动常数评分）。主要目的是调查使用纸质问卷或基于网络的调查进行门诊关节镜肩袖手术后的术后随访质量。假设是使用基于网络的调查会导致更高的响应率，并提高患者对随访的满意度。主要结果是 D+45 和 D+90 时的问卷响应率，次要结果是总响应率、患者对监测媒介的推荐以及使用净推荐值（NPS）对随访的总体患者满意度。
在 59 例连续纳入的患者中，有 27 名女性和 26 名男性，平均年龄为 57±10.2 岁；27 名患者完成了基于网络的调查（A 组），26 名患者回答了纸质问卷（B 组）。在 D+45 问卷中，A 组的响应率为 85.2%（n=23），B 组为 42.3%（n=11）（p=.005）；在 D+90 问卷中也观察到类似的显著差异，响应率分别为 70.4%和 34.6%（p=.027）。A 组调查的平均 NPS 为 10，B 组为 8.29（p=.016）。总体而言，两组患者对术后护理的满意度没有差异。
与传统的纸质表格相比，基于网络的调查似乎增加了患者对短期术后监测的依从性。如果这些发现能够在长期随访中得到证实，那么这种简单且具有成本效益的工具可能对临床护理和研究非常有用。
I；随机对照临床试验。
