The comparison of paper- and web-based questionnaires in patients with hand and upper extremity illness
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SURGERY ARTICLES
The comparison of paper- and web-based questionnaires in patients with hand and upper extremity illness Arjan G. J. Bot & Mariano E. Menendez & Valentin Neuhaus & Chaitanya S. Mudgal & David Ring
Published online: 23 February 2013 # American Association for Hand Surgery 2013
Abstract Background Questionnaires are often used to quantify the subjective aspects of illness such as disability, coping strategies, or symptoms of depression. Most questionnaires were validated in a paper-based format, but direct entry into a computer is becoming commonplace. The aim of this study was to assess differences in outcome of questionnaires pertinent to hand and upper extremity illness when they were administered in a computer or paper format. Methods Ninety-nine patients completed both paper and web versions of the short forms of the Disabilities of Arm, Shoulder, and Hand; the Pain Catastrophizing Scale; the Short Health Anxiety Index (SHAI-6); the Patient Health Questionnaire Depression Scale; and a pain scale and the Pain Self-Efficacy Questionnaire sequentially during a single visit. We alternated starting with the paper or the web version after every five patients. Results The cohort consisted of 46 females and 53 males with a mean age of 49 years. There were significant differences in SHAI-6 and the pain scale, but not in the other measures. The intraclass correlation was high. Conclusions The use of these questionnaires in electronic format is valid provided that the small differences we observed are not important to the primary study question. In our opinion, for most studies, the advantages of using an A. G. J. Bot : M. E. Menendez : V. Neuhaus Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Yawkey Center, Suite 2100, 55 Fruit Street, Boston, MA 02114, USA C. S. Mudgal : D. Ring (*) Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Yawkey Center, Suite 2100, 55 Fruit Street, Boston, MA 02114, USA e-mail: [email protected]
electronic format outweigh the small additional variation that might be introduced in the measures in an electronic format. Keywords Questionnaires . Validation . Paper . Web
Introduction Questionnaires are often used to quantify the subjective aspects of illness such as disability, coping strategies, or symptoms of depression [15, 21, 22]. Most questionnaires were validated in a paper-based format, but direct entry into a computer is becoming commonplace. Electronic questionnaires are more efficient and obviate the need for secondary data entry [19]. Previous studies comparing paper-based and computerbased completion of questionnaires document comparable results for the SF-36 and Consumer Quality Index Breast Care questionnaire [2, 10, 23]. Ritter and colleagues documented comparable results for 16 different instruments [16]. On the other hand, some studies have found that patients assigned to computer-based questionnaires tended to have higher scores [4, 5, 7]. In the realm of musculoskeletal illness
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