Patient-reported outcome measures collected via a web application versus a touchscreen in patients with Systemic Lupus Erythematosus

Abstract

Introduktion: Siden 2006 har det i Danmark været muligt for patienter med reumatologiske sygdomme at besvare spørgeskema, såkaldte patient-reported outcome measures (PROMs), omhandlende helbredsrelateret livskvalitet og funktionsevne. Aktuelt foregår indsamlingen af PROMs via en touchskærm i ambulatoriet. I takt med at teknologien har udviklet sig, er der opstået interesse for nye måder at indsamle PROMs på. En relativ ny måde at indrapportere på er via egen elektronisk enhed. Dette studie undersøger sammenligneligheden mellem indrapportering af PROMs hjemmefra via webappen fra den nationale Danske Reumatologiske Database (DANBIO) på tablet eller smartphone og indrapportering via den traditionelle ambulante touchskærm hos patienter med Systemisk Lupus Erythematosus (SLE). Formål: Formålet med studiet er at sammenligne touchskærmen i ambulatoriet med DANBIO webappen besvaret hjemmefra med Systemic Lupus Activity Questionnaire (SLAQ) global health som det primære resultat. Metode: Studiet er et randomiseret, overkrydsnings-, sammenlignelighedsstudie hos patienter med SLE. Deltagerne blev randomiseret i to grupper, der besvarede PROMs via webapp eller touchskærm i en randomiseret rækkefølge med en forudbestemt udvaskningsperiode. Forskelle i PROM-score med 95% konfidensintervaller (CI) blev evalueret for lighed i henhold til forudbestemte ækvivalensmargener, og et Bland-Altman-plot blev benyttet til at vurdere grænserne for sammenlignelighed. Resultater: Mellem touchskærmen og webappen var der for SLAQ global health en forskel på -0,21, 95% CI (-0,64 til 0,23); således er disse ækvivalente. Desuden var alle andre PROMs ækvivalente med undtagelse af Visual Analogue Scale (VAS) global, hvor 95% CI på -1,45 til 6,80 overskred ækvivalensmargenen på ± 5. Forskellen var dog indenfor minimal clinically important difference (MCID) på ± 10. Af de i alt 34 deltagere foretrak 31 (91,2%) DANBIO webappen. Konklusion: For første gang er sammenlignelighed af DANBIO webappen og den traditionelle touchskærm bekræftet hos patienter med SLE. Ækvivalens blev fundet for alle PROMs med undtagelse af VAS global, der dog var indenfor MCID. Deltagerne foretrak i høj grad DANBIO webappen, hvorfor den fremtidige implementering af DANBIO webappen forventes at være et nyttigt og værdifuldt værktøj for både patienter og sundhedssystemet til at monitorere patienter på et mere individualiseret niveau.

Introduction: In Denmark, patients with rheumatologic diseases have assessed patient-reported outcome measures (PROMs) via a touchscreen prior to each consultation in the outpatient clinic since 2006; however, as technology develops, interest in new ways of collecting PROMs is emerging. Bring your own device (BYOD) is a relatively new way of collecting PROMs through a personal electronic device. This study is evaluating the comparability between the national Danish Rheumatology Database (DANBIO) web app through a smartphone or a tablet and the traditional outpatient touchscreen regarding patients with Systemic Lupus Erythematosus (SLE). Objectives: the aim of the study is to compare the outpatient touchscreen to a from home web app with Systemic Lupus Activity Questionnaire (SLAQ) global health as primary outcome. Methods: This is a randomized, within-participants crossover, agreement study with enrolment of patients with SLE. Participants were randomized into two groups assessing PROMs through the two devices in a randomized order with a predefined wash out period. Differences in PROM scores with 95% confidence intervals (CI) were evaluated for similarity according to prespecified equivalence margins and a Bland-Altman plot was used to assess limits of agreement. Results: Equivalence was found for SLAQ global health with a difference between the two electronic devices of -0.21, 95% CI (-0.64 to 0.23); Furthermore, all other PROMs were equivalent except for Visual Analogue Scale (VAS) global as the 95% CI of -1.45 to 6.80 exceeded the equivalence margin of ± 5. However, the difference was well within the minimal clinically important difference (MCID) of ± 10. Thirty-one (91.2%) of the total 34 participants preferred the DANBIO web app. Conclusion: For the first time in patients with SLE, comparability between PROMs collected on a web app and an outpatient touchscreen was verified. Participants highly preferred the DANBIO web-app. Thus, the future implementation of the DANBIO web-app is expected to be a helpful and valuable tool for both patients and health care in order to monitor patients on a more individualized level.

A master thesis from Aalborg University

Patient-reported outcome measures collected via a web application versus a touchscreen in patients with Systemic Lupus Erythematosus