Abstract
BackgroundScrolling is a perceived barrier in the use of bring your own device (BYOD) to capture electronic patient reported outcomes (ePROs). This study explored the impact of scrolling on the measurement equivalence of electronic patient-reported outcome measures (ePROMs) in the presence and absence of scrolling.MethodsAdult participants with a chronic condition involving daily pain completed ePROMs on four devices with different scrolling properties: a large provisioned device not requiring scrolling; two provisioned devices requiring scrolling – one with a “smart-scrolling” feature that disabled the “next” button until all information was viewed, and a second without this feature; and BYOD with smart-scrolling. The ePROMs included were the SF-12, EQ-5D-5L, and three pain measures: a visual analogue scale, a numeric response scale and a Likert scale. Participants completed English or Spanish versions according to their first language. Associations between ePROM scores were assessed using intraclass correlation coefficients (ICCs), with lower bound of 95% confidence interval (CI) > 0.7 indicating comparability.ResultsOne hundred fifteen English- or Spanish-speaking participants (21-75y) completed all four administrations. High associations between scrolling and non-scrolling were observed (ICCs: 0.71–0.96). The equivalence threshold was met for all but one SF-12 domain score (bodily pain; lower 95% CI: 0.65) and two EQ-5D-5L item scores (pain/discomfort, usual activities; lower 95% CI: 0.64/0.67). Age, language, and device size produced insignificant differences in scores.ConclusionsThe measurement properties of PROMs are preserved even in the presence of scrolling on a handheld device. Further studies that assess scrolling impact over long-term, repeated use are recommended.
Highlights
Patient-Reported Outcome (PRO) measures have been increasingly gaining momentum in clinical outcome research because of recent movement toward patientcenteredness in both clinical practice and research [1, 2]
We aimed to evaluate the measurement equivalence of Electronic patient reported outcome measure (ePROM) in the presence and absence of scrolling on a set of provisioned smartphone devices as well as bring your own device (BYOD) smartphones
The Electronic patient reported outcome (ePRO) design good practice guidelines, such as those reported by the Critical Path Institute’s ePRO Consortium require the visibility of the full item stem text and its entire response options on the electric devices [24]. It follows that a principal concern in regard with migrating an existing pen and paper format Patient reported outcome measure (PROM) to an ePROM is that the participant may respond differently to items when the question and its response options are displayed fully compared to when items are partially displayed on a single screen
Summary
Patient-Reported Outcome (PRO) measures have been increasingly gaining momentum in clinical outcome research because of recent movement toward patientcenteredness in both clinical practice and research [1, 2]. An increasing number of clinical research studies employ electronic formats to collect PRO measures (PROMs) in field-based and in-clinic settings [7]. This has been driven by the availability, low cost, and reliability of modern mobile devices such as smartphones and tablets, along with the requirement to improve the integrity and quality of data collected while limiting missing data entries and ensuring the timeliness of PROM completion [8]. Due to smartphone screen size, ePRO solution providers typically aim to present a single PROM question per screen and to ensure all content is displayed without the requirement to scroll [10, 11]. This study explored the impact of scrolling on the measurement equivalence of electronic patient-reported outcome measures (ePROMs) in the presence and absence of scrolling
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