JMIR Publications

ABSTRACT

Background:

Remote patient-reported outcome measure (PROM) data capture can provide useful insights in research and clinical practice, and deeper insights can be gained by administering assessments more frequently. However, frequent data collection can be limited by the by the burden of multiple, lengthy questionnaires. This burden can be reduced with algorithms that select only the most relevant items from a PROM for an individual respondent. We developed "Ecological Momentary Computerized Adaptive Testing” (EMCAT), using algorithms to reduce PROM response burden and facilitate high frequency data capture via a smartphone application.

Objective:

To determine the feasibility of EMCAT as a system for remote PROM administration.

Methods:

We enrolled 40 patients with hand trauma or thumb-base arthritis, across 2 sites, between 13th July 2022 and 14th September 2022. We monitored their symptoms with a validated PROM (the Patient Evaluation Measure), via EMCAT, over a 12-week period. Patients were assessed either thrice weekly, once daily, or thrice daily. We additionally administered full-length PROM assessments at 0, 6, and 12 weeks, and the User Engagement Scale (UES) at 12 weeks.

Results:

The use of EMCAT significantly reduced the length of the PROM (median 2 vs 11 items) and the time taken to complete it (median 8.8 seconds vs 1 minute 14 seconds). Very similar scores were produced when EMCAT was administered concurrently with the full-length PROM, with a mean error of <0.01 on a logit (z-score) scale. The median response rate in the daily assessment group was 93%. The median Perceived Usability score of the UES was 4.0 (maximum possible score 5.0).

Conclusions:

EMCAT reduces the burden of PROM assessments, enabling acceptable high-frequency, remote PROM data capture. Clinical Trial: ISRCTN19841416