Open Access Highly Accessed Technical advance

Collection of patient-reported outcomes; - text messages on mobile phones provide valid scores and high response rates

Anne Christie1*, Hanne Dagfinrud1, Øystein Dale2, Trenton Schulz2 and Kåre Birger Hagen1

Author Affiliations

1 National resource center for rehabilitation in rheumatology – NKRR, Department of Rheumatology, Diakonhjemmet Hospital, PO Box 23, Vinderen, 0319 Oslo, Norway

2 Norwegian Computing Centre, PO Box 114, Blindern, 0314 Oslo, Norway

For all author emails, please log on.

BMC Medical Research Methodology 2014, 14:52  doi:10.1186/1471-2288-14-52

Published: 16 April 2014

Abstract

Background

Patients with inflammatory rheumatic diseases have expressed a need for more frequent measurement of relevant outcomes, due to the variations in their symptoms during the day and from day to day. At present, patient-reported outcomes are extensively collected with questionnaires completed with pen and paper. However, as a measurement tool in frequent data collection the questionnaires are impractical. In contrast, text messages on mobile phones are suitable for frequent data collection.

The aim of this study was two-fold; to compare daily registrations of patient-reported outcomes assessed with text-messages on mobile phones (SMS) or with questionnaires completed with pen and paper (P&P), with regard to scores and variation of scores, and to examine feasibility of the SMS method in a multicentre clinical study.

Methods

To compare scores, 21 patients with an inflammatory, rheumatic disease performed daily assessments of pain, fatigue, stiffness and ability to carry out daily activities on a numeric rating scale (NRS). The patients were asked to assess the variables every other day with the SMS method and every other day with the P&P method for 28 consecutive days. In total each participant had to answer 14 P&P forms and 14 SMS messages. Mean scores and variation, expressed as the pooled standard deviation or as the average range between the maximum and minimum scores for the two methods, were compared using paired sample t-tests or Wilcoxon Signed Rank Test. To examine feasibility, 36 patients with an inflammatory, rheumatic disease assessed the same four variables with SMS twice a week for 35 weeks. Feasibility of the SMS method was expressed as mean response-rate (%) in the total group and per centre.

Results

Mean scores, standard deviation of mean scores and mean range scores did not differ significantly between the two methods (p > 0.05). Response-rate with the SMS method was 97.9% for the whole group and for the three centres 97.1%, 98.3% and 98.4%, respectively.

Conclusion

Outcomes assessed on numeric rating scales and reported with text-messages on mobile phones or with questionnaires completed with pen and paper provide comparable scores. Further, the SMS method provided high response rates (> 97%) in a multicentre setting. Our results encourage the use of text messages on mobile phones in studies requiring frequent data collection and real-time assessment, as in fluctuating diseases such inflammatory, rheumatic diseases.

Keywords:
Frequent data collection; Patient reported outcome; Rheumatic disease; Text-messages; Momentary assessment; Mobile phone; Paper questionnaires; Real-time assessment