Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Dec 8, 2019
Date Accepted: Apr 15, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Development and Validation Study of a Mobile Technology for Collecting Patient-Reported Physical Activity and Distress Outcomes: A Case Study in Breast Cancer Survivors
ABSTRACT
Background:
Electronic Patient Reporting Results (PRO) provides a fast and reliable assessment of a patient's health-related quality of life. Nevertheless, using PRO in the traditional paper format is not practical for clinical practice due to the limitations associated with data analysis and management. A questionnaire app was developed to address the need for a practical way to group and utilize distress and physical activity assessment tools.
Objective:
The purpose of this study is to assess the level of agreement between electronic and paper-based questionnaire responses.
Methods:
To validate the app, we selected distress thermometer (DT), international physical activity questionnaire (IPAQ), and patient health questionnaire-9 (PHQ-9). A total of 102 participants answered to paper and app versions of DT and IPAQ, and 96 people completed PHQ-9. The study outcomes were the correlation of the data between the paper and app versions.
Results:
A total of 106 consecutive breast cancer patients were enrolled and analyzed for validation of paper and electronic versions. The paper and app survey correlation values for patients who responded to the DT app-based questionnaire within 7 days, within 3 days, and on the day, they responded to the paper-based questionnaire were 0.454 (p <0.001) and 0.479. (p <0.001) and 0.656. And similarly, the paper and app survey correlation values of IPAQ (Q2–6) were 0.668 (p <0.001), 0.756 (p <0.001), and 0.912 (p <0.001), respectively. The correlation of the PHQ9 value according to the time interval between the paper-based questionnaire and the app-based questionnaire was 0.526 for 14 days, 0.512 for 7 days, 0.615 for 3 days, and 0.856 for the same day. These were all statistically significant. In both cases, the shorter the interval between the paper-based questionnaire and the app-based questionnaire, the higher was the correlation value.
Conclusions:
The distress and physical activity questionnaire app has shown validity and high level of compliance with paper-based DT, IPAQ, and PHQ-9. The app-based questionnaires were not inferior to their respective paper versions and confirm the feasibility for their use in clinical practice. The high correlation between paper and mobile data collection apps allows the use of new mobile apps to benefit the overall healthcare system. Clinical Trial: NCT03072966
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