Methodological Issues in Internet-Mediated Research: A Randomized Comparison of Internet Versus Mailed Questionnaires

Background: The majority of Internet-mediated studies use measures developed as paper-and-pencil measures or face-to-face-delivered material. Previous research suggests that the equivalence between online and offline measures must be demonstrated rather than assumed. Objective: The objective of this study was to explore the equivalence 4 measures completed in an online or offline setting. Methods: A sample of students (n = 1969) was randomly assigned to complete 4 popular scales (the SF-12v2, the Hospital Anxiety and Depression Scale (HADS), the Fatigue Symptom Inventory, and a single-item fatigue measure) either online or by mail survey (pencil and paper). The response rate was 52.51% (n = 1034) and comparable between the online and offline groups. Results: Significant differences were noted in fatigue levels between the online and offline group (P = .01) as measured by the Fatigue Symptom Inventory, with the online sample demonstrating higher levels of fatigue. Equivalency was noted for the SF-12v2, the Hospital Anxiety and Depression Scale, and the single-item fatigue measure. Internal consistency was high except for the SF-12v2. The SF-12v2 may not be an ideal measure to use for remote administration. Conclusions: Equivalency of the Hospital Anxiety and Depression Scale (HADS) and the Physical Component Score and Mental Component Score of the SF-12v2 for online and offline data were demonstrated. Equivalency was not demonstrated for the Fatigue Symptom Inventory. Explanations for the difference in fatigue score between the online and offline samples are unclear. Research that seeks to match samples and control for extraneous online and offline variables is called for, along with exploration of factors that may mediate the completion of questionnaires or alter the respondents’ relationship with the same, to enhance progress in this area

Co-morbidade fadiga e depressão em pacientes com câncer colo-retal Enfermedad concomitante: fatiga y depresión en pacientes con cáncer colon-rectal Comorbidities between fatigue and depression in patients with colorectal cancer

O estudo teve como objetivos caracterizar e identificar a comorbidade entre fadiga e depressão em pacientes com câncer colorretal. A amostra não-probabilística foi de 154 pacientes ambulatoriais (53% homens; idade média 49,6&plusmn;11,7 anos; escolaridade média 8,9&plusmn;5,4 anos). A fadiga foi avaliada pela Escala de Fadiga de Piper Revisada e o humor pelo Inventário de Depressão de Beck. A Fadiga foi relatada por 76 (49,4%) pacientes e foi intensa (escore total > 6) para 19,7% deles. Escores que sugerem depressão (IDB>20) foram encontrados em 11 (7,1%) pacientes. Fadiga e depressão estavam correlacionadas (r=0,395; p 0,001). A co-morbidade fadiga moderada/intensa e disforia/depressão ocorreu em 12,3%. A Fadiga estava presente na totalidade dos doentes deprimidos (100%), e a depressão ocorreu em 18% dos doentes fatigados. Fadiga e depressão são fenômenos relacionados, a sua comorbidade pode ser muito deletéria ao doente; a depressão foi mais importante para a ocorrência de fadiga do que a fadiga para a depressão.<br>El estudio tuvo como objetivos caracterizar e identificar la relación entre la fatiga y la depresión en pacientes con cáncer colon-rectal. La muestra no probabilística fue de 154 pacientes de ambulatorio (53% hombres; edad promedio 49,6&plusmn;11,7 años; escolaridad promedio 8,9&plusmn;5,4 anos). La fatiga fue evaluada por la Escala de Fatiga de Piper Revisada y el humor por el Inventario de Depresión de Beck. La Fatiga fue relatada por 76 (49,4%) pacientes y fue intensa (puntaje total > 6) para 19,7% de ellos. Puntajes que sugieren depresión (IDB>20) fueron encontrados en 11 (7,1%) pacientes. La fatiga y la depresión estaban correlacionados (r= 0,395; p 0,001). La enfermedad concomitante fatiga moderada/intensa y disforia/depresión ocurrió en 12,3%. La Fatiga estaba presente en la totalidad de los enfermos deprimidos (100%), y la depresión ocurrió en 18% de los enfermos fatigados. Fatiga y depresión son fenómenos relacionados (concomitantes), y su acción puede ser muy deletérea para el enfermo; la depresión fue más importante para la ocurrencia de fatiga que la fatiga para la depresión.<br>The objective of this study was to identify and characterize the comorbidities of fatigue and depression in colorectal cancer patients. A non-probabilistic sample of 154 outpatients (53% men; mean age 49.6&plusmn;11.7 years; mean education 8.9&plusmn;5.4 years). Fatigue was evaluated using the Revised Piper Fatigue Scale (min:0; max:10) and depression was evaluated using the Beck Depression Inventory (BDI) (min:0; max: 63). Fatigue was identified by 76 (49.4%) patients, and was intense (total score > 6) for 19.7% . Scores compatible with depression (BDI> 20) were found in 11 (7.1%) patients. Fatigue and depression were correlated (r= 0.395, p<0.001). Comorbidities of moderate/severe fatigue and dysphoria/depression occurred in 12.3%. Fatigue was present in all patients with depression (100%) and depression occurred in 18% of patients with fatigue. Fatigue and depression are related phenomena. Comorbidities can be deleterious to the patient. Depression had a stronger effect on the occurrence of fatigue than the effect of fatigue on depression