Equivalence of Electronic and Paper-and-Pencil Administration of Patient-Reported Outcome Measures: A Meta-Analytic Review

AbstractObjectivesPatient-reported outcomes (PROs; self-report assessments) are increasingly important in evaluating medical care and treatment efficacy. Electronic administration of PROs via computer is becoming widespread. This article reviews the literature addressing whether computer-administered tests are equivalent to their paper-and-pencil forms.MethodsMeta-analysis was used to synthesize 65 studies that directly assessed the equivalence of computer versus paper versions of PROs used in clinical trials. A total of 46 unique studies, evaluating 278 scales, provided sufficient detail to allow quantitative analysis.ResultsAmong 233 direct comparisons, the average mean difference between modes averaged 0.2% of the scale range (e.g., 0.02 points on a 10-point scale), and 93% were within ±5% of the scale range. Among 207 correlation coefficients between paper and computer instruments (typically intraclass correlation coefficients), the average weighted correlation was 0.90; 94% of correlations were at least 0.75. Because the cross-mode correlation (paper vs. computer) is also a test–retest correlation, with potential variation because of retest, we compared it to the within-mode (paper vs. paper) test–retest correlation. In four comparisons that evaluated both, the average cross-mode paper-to-computer correlation was almost identical to the within-mode correlation for readministration of a paper measure (0.88 vs. 0.91).ConclusionsExtensive evidence indicates that paper- and computer-administered PROs are equivalent

Feel My Pain: Design and Evaluation of Painpad, a Tangible Device for Supporting Inpatient Self-Logging of Pain

Monitoring patients' pain is a critical issue for clinical caregivers, particularly among staff responsible for providing analgesic relief. However, collecting regularly scheduled pain readings from patients can be difficult and time-consuming for clinicians. In this paper we present Painpad, a tangible device that was developed to allow patients to engage in self-logging of their pain. We report findings from two hospital-based field studies in which Painpad was deployed to a total of 78 inpatients recovering from ambulatory surgery. We find that Painpad results in improved frequency and compliance with pain logging, and that self-logged scores may be more faithful to patients' experienced pain than corresponding scores reported to nurses. We also show that older adults may prefer tangible interfaces over tablet-based alternatives for reporting their pain, and we contribute design lessons for pain logging devices intended for use in hospital settings

Modelling the effects of partially observed covariates on Poisson process intensity

We propose an estimating function for parameters in a model for Poisson process intensity when time- or space-varying covariates are observed for both the events of the process and at sample times or locations selected from a probability-based sampling design. We investigate the large-sample properties of the proposed estimator under increasing domain asymptotics, demonstrating that it is consistent and asymptotically normally distributed. We illustrate our approach using data from an ecological momentary assessment of smoking. Copyright 2007, Oxford University Press.

Affect, Craving, And Cognition: An Ema Study Of Ad Libitum Adolescent Smoking

Reducing smoking among adolescents is a public health priority. Affect, craving, and cognitive processes have been identified as predictors of smoking in adolescents. The current study examined associations between implicit attitude for smoking (assessed via the positive-negative valence implicit association test) and affect, craving, and smoking assessed using ecological momentary assessment (EMA). Adolescent smokers (n = 154; Mage = 16.57, SD = 1.12) completed a laboratory assessment of implicit smoking attitudes and carried a palm-top computer for several days while smoking ad libitum. During EMA, they recorded affect, craving, and smoking behavior. Data were analyzed using a multilevel path analysis. At the between-subjects level, more positive implicit smoking attitude was indirectly associated with smoking rate via craving. This association was moderated by positive affect, such that it was stronger for those with greater traitlike positive affect. At the event (within-subject) level, implicit attitude potentiated associations between stress and craving and between positive affect and craving. Individuals with a more positive implicit attitude exhibited more robust indirect associations between momentary stress-positive affect and smoking. In sum, a more positive implicit attitude to smoking was associated with overall levels of craving and smoking and might have potentiated momentary affect - craving associations. Interventions that modify implicit attitude may be an approach for reducing adolescent smoking

Overcoming limitations in previous research on exercise as a smoking cessation treatment: Rationale and design of the "Quit for Health" trial

Aerobic exercise has been proposed as a stand-alone or adjunct smoking cessation treatment, but findings have been mixed. Laboratory studies have shown that individual exercise sessions lead to decreases in withdrawal symptoms and cigarette cravings, but findings are limited by lack of follow-up and artificial settings. On the other hand, smoking cessation treatment RCTs have generally failed to show positive effects of exercise on smoking cessation, but have been plagued by poor and/or unverified compliance with exercise programs. This paper describes the rationale and design for Quit for Health (QFH)-an RCT designed to determine the efficacy of aerobic exercise as an adjunct smoking cessation treatment among women. To overcome limitations of previous research, compliance with the exercise (and wellness contact control) program is incentivized and directly observed, and ecological momentary assessment is used to examine change over time in withdrawal symptoms and cigarette cravings in participants' natural environments