Equivalence of Electronic and Paper-and-Pencil Administration of Patient-Reported Outcome Measures: A Meta-Analytic Review
Version of Record online: 17 JUL 2007
© 2008, International Society for Pharmacoeconomics and Outcomes Research (ISPOR)
Value in Health
Volume 11, Issue 2, pages 322–333, March/April 2008
How to Cite
Gwaltney, C. J., Shields, A. L. and Shiffman, S. (2008), Equivalence of Electronic and Paper-and-Pencil Administration of Patient-Reported Outcome Measures: A Meta-Analytic Review. Value in Health, 11: 322–333. doi: 10.1111/j.1524-4733.2007.00231.x
- Issue online: 17 JUL 2007
- Version of Record online: 17 JUL 2007
- paper and pencil;
- patient-reported outcomes
Objectives: Patient-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.
Methods: Meta-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.
Results: Among 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).
Conclusions: Extensive evidence indicates that paper- and computer-administered PROs are equivalent.