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  • Comparison between electronic and paper versions of patient-reported outcome measures in subjects with chronic obstructive pulmonary disease: an observational study with a cross-over administration

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Respiratory medicine
Original research
Comparison between electronic and paper versions of patient-reported outcome measures in subjects with chronic obstructive pulmonary disease: an observational study with a cross-over administration
  1. Koichi Nishimura1,
  2. Masaaki Kusunose1,
  3. Ryo Sanda1,
  4. Yousuke Tsuji2,
  5. Yoshinori Hasegawa3,
  6. Toru Oga4
  1. 1Department of Respiratory Medicine, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
  2. 2Hoshi Iryo-Sanki Co. Ltd, Tokyo, Japan
  3. 3National Hospital Organization, Nagoya Medical Center, Nagoya, Japan
  4. 4Department of Respiratory Medicine, Kawasaki Medical School, Kurashiki, Okayama, Japan
  1. Correspondence to Dr Koichi Nishimura; koichi-nishimura{at}nifty.com

Abstract

Objectives A wide range of electronic devices can be used for data collection of patient-reported outcome (PRO) measures in subjects with chronic obstructive pulmonary disease (COPD). Although comparisons between electronic and paper-based PRO measures have been undertaken in asthmatics, it is currently uncertain whether electronic questionnaires work equally as well as paper versions in elderly subjects with COPD. The aim of this study was to compare the responses to paper and electronic versions of the Evaluating Respiratory Symptoms in COPD (E-RS) and the COPD Assessment Test (CAT).

Design A randomised cross-over design was used to compare the responses to paper and electronic versions of the two tools. The interval between the two administrations was 1 week.

Setting Electronic versions were self-administered under supervision using a tablet computer at our outpatient clinic (secondary care hospital in Japan) while paper questionnaires completed at home were requested to be returned by mail. It was intended that half of the patients completed the electronic versions of both questionnaires first, followed by the paper versions while the other half completed the paper versions first.

Participants Eighty-one subjects with stable COPD were included.

Results The E-RS total scores (possible range 0–40) were 6.8±7.4 and 5.0±6.6 in the paper-based and electronic versions, respectively, and the CAT scores (possible range 0–40) were 10.0±7.4 and 8.6±7.8. In both questionnaires, higher scores indicate worse status. The relationship between electronic and paper versions showed significant reliability for both the E-RS total score and CAT score (intraclass correlation coefficient=0.82 and 0.89, respectively; both p<0.001). However, both the E-RS total and CAT scores were significantly higher in the paper versions (p<0.05).

Conclusions In both cases, the two versions of the same questionnaire cannot be used interchangeably even though they have both been validated.

  • chronic obstructive pulmonary disease (COPD)
  • patient-reported outcome (PRO)
  • the COPD assessment test (CAT)
  • the evaluating respiratory symptoms in COPD (E-RS)
  • health status

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2019-032767

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    Footnotes

    • Twitter @KoichiNishimura

    • Contributors KN contributed, as the principal investigator, to the study concept and design, analysis of the results, and writing of the manuscript. MK and RS contributed to performance of the study and acquisition of data. YT developed and maintained the electronic devices. YH contributed to the interpretation and editing of the manuscript. TO contributed to statistical analysis, the interpretation and editing of the manuscript.

    • Funding This study was partly supported by the Research Funding for Longevity Sciences (30-24) from the National Center for Geriatrics and Gerontology (NCGG), Japan.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval The present study was approved by the Institutional Ethics Committee of the National Center for Geriatrics and Gerontology (No. 887).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Anonymized participant data will be available upon reasonable request to the corresponding author.