Using tablet computers to collect clinical and research data: Ease-of-use analysis

Abstract

20593 Background: Physicians struggle to accurately assess subjective data like quality-of-life (QOL). Validated paper instruments exist but must be completed by the patient and then manually scored. Touch screen computers could accomplish both tasks, making it possible for QOL measurement to support clinical care in real time. To be practical, computer applications must be easily usable by patients with little education, little computer familiarity, or disabilities. We designed such a system and here describe its patient-reported ease-of-use. Methods: A series of web pages are presented using a 9x12” tablet computer. Users answer questions from the EORTC QLQ-C30 (QLQ) using a pen to click on response buttons. Buttons and question text were rendered as large as possible (font sizes 24 to 48) to aid subjects with low vision or poor hand-eye coordination. Ease-of-use testing included 2 phases: 1) observing and interviewing 7 elderly cancer patients while they used the tablet computer application, and 2) surveying 60 subjects with solid tumors from medical oncology clinic who completed demographic information, the tablet computerized QLQ, and Davis’ validated 8 item ease of use questionnaire. Results: Observational testing yielded 3 methods to make tablet computers easier for novice users: 1) Provide a tilting lap table so the screen can be viewed at the most visible angle 2) Lock the display to prevent flipping between portrait and landscape modes 3) Disable the right- click function of the pen. 58 of 60 subjects participated in the survey. The mean age was 67 (SD = 10) and 43% were 65+. 22% did not have or use a computer at home, 22% had high school education or less and 47% had graduated from college. All 58 (100%) were able to complete the computerized questionnaire with no assistance. Most preferred the computer - only 10% preferred paper questionnaires. The QLQ-C30 data were 100% complete. Greater age and less education were associated with lower ease of use scores, although using a computer at home was not. Conclusions: By paying close attention to ease-of-use considerations, tablet computer applications can be made accessible to a general cancer population for research and clinical purposes. The ability of real time QLQ assessment in clinical practice to improve patient outcomes is under investigation. No significant financial relationships to disclose.