Article Text

THU0632 Validation of internet-based reporting of patient reported outcomes within the swedish rheumatology quality register
  1. OE Hofstedt1,
  2. D Di Giuseppe2,
  3. G-M Alenius1,
  4. N Stattin3,
  5. H Forsblad-d'Elia1,
  6. L Ljung1
  1. 1Department of Public Health and Clinical Medicine, Umeå University, Umeå
  2. 2Department of Medicine Solna, Karolinska Institutet, Stockholm
  3. 3Swedish Rheumatism Association, Sundsvall, Sweden


Background Previous studies have validated the use of clinic based touchscreens for registering patient reported outcome measures (PROMs) (1–3). The Swedish Rheumatology Quality (SRQ) register has implemented an internet-based method (PER (Patientens Egen Registrering, or Patients' sElf Registration)) for collecting PROMs.

Objectives The aim of this study was to investigate the feasibility of the internet-based method as well as the validity of reported outcomes and disease activity scores compared to the gold standard paper format.

Methods We recruited patients (n=44, mean age =51.0, standard deviation =13.2 years, 69.6% women) included in SRQ with a diagnosis of rheumatoid arthritis, psoriatic arthritis, juvenile arthritis, spondyloarthritis or ankylosing spondylitis. Before a planned visit at the rheumatology clinic the patients registered Visual Analog Scales (VAS) for global health, pain and fatigue, both electronically by PER and on paper. Patients with axial disease also registered BASDAI and BASFI related variables (n=6). For patients with peripheral arthritis (n=38), DAS28 was calculated using both methods. The differences between the methods were compared by T-test and Intra-class correlation (ICC). Agreement was visualized using Bland-Altman plots for all VAS registrations. The patients also answered a questionnaire regarding the used device and preferred method.

Results No differences between PER or paper based VAS scores were found for VAS Global, VAS Pain and VAS Fatigue (p=0.086, p=0.691 and p=0.197, respectively). ICC scores ranged from 0.930 to 0.971. Bland-Altman plots for VAS assessments showed good agreement and no proportional bias was detected (Fig 1). Mean difference for DAS28 was - 0.04 (p=0.177). Of the recruited patients, 78%, preferred the Internet based method. BASDAI and BASFI could not be evaluated due to a limited number of observations.

Conclusions Internet based reporting of PROMs supply valid VAS data. DAS28 scores from the internet-based method presents an acceptable alternative to the traditional paper formats.


  1. Greenwood MC, et al. Rheumatology (Oxford). 2006.

  2. Schefte DB, et al., Rheumatology (Oxford). 2010.

  3. Cunha-Miranda L, et al Rheumatol Int. 2015.


Disclosure of Interest None declared

Statistics from

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.