Accepted for/Published in: JMIR Formative Research
Date Submitted: Aug 8, 2019
Date Accepted: Mar 29, 2020
An Electronic Version of a Multidimensional Health Assessment Questionnaire (MDHAQ) for Routine Care Provides Similar Data to a Paper Version and is Preferred by Most Patients
ABSTRACT
Background:
A multidimensional health assessment questionnaire (MDHAQ) includes patient self-report scores for physical function, pain, patient global assessment, fatigue, painful joint count, and symptom checklist, as well as medical history information. MDHAQ scores can be assembled into indices to guide clinical decisions, including RAPID3 (routine assessment of patient index data) to assess changes in clinical status and FAST3 (fibromyalgia assessment screening tool) as a clue to fibromyalgia and distress.
Objective:
To compare a paper MDHAQ to an electronic eMDHAQ for reliability, feasibility, and patient preference.
Methods:
All patients with all diagnoses complete a paper MDHAQ upon registration for each encounter at one academic rheumatology setting. At the end of the same encounter, patients with different diagnoses were invited to complete an eMDHAQ on an iPad. Reliability was analyzed by comparing electronic vs paper scores arithmetically and using intraclass correlation coefficients (ICC). Feasibility was analyzed according to the time required to complete the eMDHAQ, and patient evaluation of MDHAQ to her/himself and the treating physician. Preference for the paper or iPad version (or neither) were queried, and analyzed for all patients and according to age and education level.
Results:
Among 98 patients, mean age was 53.7 (16.6) years, 89% were female, and 48% Caucasian. Scores were almost identical in the paper vs electronic versions - differences ranged from -0.4 to 0.7, all neither clinically nor statistically significant. ICCs ranged from 0.86 for the symptom checklist to 0.98 for RAPID3, indicating good to excellent reliability. The mean time for completion was 8.2 minutes. Preference for the electronic version was expressed by 72% of volunteers, versus 7% for the paper version, while 21% expressed no preference, similar according to age and educational level.
Conclusions:
Similar results are seen on an eMDHAQ to a paper MDHAQ. Most patients preferred the eMDHAQ. Results support implementation of eMDHAQ for routine rheumatology care.
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