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Performance of health status measures with a pen based personal digital assistant
  1. T K Kvien1,
  2. P Mowinckel2,
  3. T Heiberg3,
  4. K L Dammann2,
  5. Ø Dale2,
  6. G J Aanerud2,
  7. T N Alme4,
  8. T Uhlig2
  1. 1Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
  2. 2National Resource Centre for Rehabilitation in Rheumatology, Diakonhjemmet Hospital
  3. 3Department of Administration, Ulleval University Hospital, Oslo
  4. 4Medicom, Oslo
  1. Correspondence to:
    Dr Tore K Kvien
    Department of Rheumatology, Diakonhjemmet Hospital, Box 23 Vinderen, N-0319 Oslo, Norway;


Background: Increasing use of self reported health status in clinical practice and research, as well as patient appreciation of monitoring fluctuations of health over time, suggest a need for more frequent collection of data. Electronic use of health status measures in the follow up of patients is a possible way to achieve this.

Objective: To compare self reported health status measures in a personal digital assistant (PDA) version and a paper/pencil version for test–retest reliability, agreement between scores, and feasibility.

Methods: 30 patients with stable rheumatoid arthritis (mean age 61.6 years, range 49.8 to 70.0; mean disease duration, 16.7 years; 63% female; 67% rheumatoid factor positive; 46.6% on disease modifying antirheumatic drugs) completed self reported health status measures (pain, fatigue, and global health on visual analogue scales (VAS), rheumatoid arthritis disease activity index, modified health assessment questionnaire, SF-36) in a conventional paper based questionnaire version and on a PDA (HP iPAQ, model h5450). Completion was repeated after five to seven days.

Results: Test–retest reliability was similar, as evaluated by the Bland–Altman approach, the coefficient of variation, and intraclass correlation coefficients. The scores showed acceptable agreement, but with a slight tendency to higher scores on VAS with the PDA than the paper/pencil version. No significant differences were seen for measures of feasibility (time to complete, satisfaction score), but 65.5% preferred PDA, 20.7% preferred paper, and 13.8% had no preference.

Conclusions: The clinimetric performance of paper/pencil versions of self reported health status measures was similar to an electronic version, using an inexpensive PDA.

  • ICC, intraclass correlation coefficient
  • MHAQ, modified health assessment questionnaire
  • OMERACT, outcome measures in arthritis clinical trials
  • PDA, personal digital assistant
  • RADAI, rheumatoid arthritis disease activity index
  • SDD, smallest detectable difference
  • SF-36, short form 36 item health assessment questionnaire
  • VAS, visual analogue scale
  • handheld computer
  • electronic data collection
  • rheumatoid arthritis
  • health status

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  • Published Online First 20 April 2005