Comparison of online and paper versions of the asthma control questionnaire and asthma quality of life questionnaire

Abstract

Background: Routine monitoring of asthma control and quality of life provides an opportunity to optimise patient-centred outcomes. For better patient feasibility, services like this will ideally be offered online or in-app, like in the Horizon2020 myAirCoach. To this end, we need to know if online questionnaires are interchangeable with validated paper versions. Aim: Assess the agreement between online and paper versions of the Asthma Control Questionnaire (ACQ) and Asthma Quality of Life Questionnaire (AQLQ). Methods: We included 35 patients (age 18–50 yrs, physician diagnosed persistent asthma, prescribed inhaled corticosteroids ≥3mos/previous year) from the SMASHING-project. Patients were randomized to complete either online or paper versions of the ACQ and AQLQ at baseline and the other version after two weeks. Agreement was assessed by paired t-tests, intra-class correlation coefficient (ICC) and a Bland-Altman plot. Results: No significant differences were found between online or paper versions. Only 5-10% of individual observations lie outside clinically relevant minimal important differences (0.5 points). Conclusions: Agreement between online and paper questionnaires was very good. Agreement may be underestimated in a relatively homogeneous population, like the current study, as the ICC is dependent on between-subjects variability. Online versions of the ACQ and AQLQ can be used in place of paper versions for the routine monitoring of asthma control and quality of life.