觸控式電腦問卷與手寫問卷之可行性與相等性評估-以EORTC QLQ-C30及EORTC QLQ-PR25測量攝護腺癌患者生活品質為例

Abstract

The EORTC QLQ-C30（a 30-item European Organization for Research and Treatment of Cancer Core Quality-of-Life Questionnaire） and the EORTC QLQ-PR25（a 25-item questionnaire designed for use among patients with localized and metastatic prostate cancer） are widely used instruments for evaluating the health related quality of life (HRQL) of prostate cancer patients. Over the past two decades, researchers have measured HRQL using paper-and-pencil questionnaires. With the emergence of computer technology, electronic questionnaires are increasingly being used for data collection, particularly in medical practice. Nevertheless, the equivalence and feasibility of touch-screen version and paper-and-pencil version of two questionnaires measuring prostate cancer patients have not been clearly established. Therefore, this study compared data obtained using touch-screen versions of two questionnaires with those obtained using the equivalent paper-and-pencil versions for assessing quality of life. A crossover design study was used to investigate the equivalence and acceptance of the questionnaires in 99 prostate cancer patients enrolled from China Medical University Hospital’s Department of Urology out-patient clinic. Equivalence test, and a cross-over model analysis were applied to examine the equity of health-related quality of life scores between the two modes, using Rasch analysis to assess differential item functioning (DIF) between touch-screen and paper versions. Results of this study showed the equivalence of the paper version and the touch-screen version of two quality of life questionnaires. Intraclass correlation coefficient (ICC) ranged from 0.48~0.83 of the two modes in the EORTC QLQ-C30 and EORTC QLQ-PR25, which indicated moderate to good reliability. There was no DIF of the EORTC QLQ-PR25 using Rasch analysis to assess for prostate cancer patients. About 92% of patients had indicated that they liked to use the touch-screen to complete the questionnaire. About 97% of patients thought the touch-screen interface was user-friendly. In conclusion, information collected using the touch-screen version of EORTC QLQ-C30 and EORTC QLQ-PR25 questionnaires is equivalent to that collected using the paper-and-pencil version. The touch-screen version is well accepted for assessing prostate cancer patients’ quality of life. Feasibility of touch-screen mode is acceptable for most patients, and preferred in younger prostate cancer patients. The e-data can be easily integrated with other clinical data to provide real time diagnostic information in clinic. It may not only improve medical care quality, but also promote the relationship between physician and patient.