Delivery of Patient-Reported Outcome Instruments by Automated Mobile Phone Text Messaging

Abstract

Background: Patient-reported outcome (PRO) instruments allow patients to interpret their health and are integral in evaluating orthopedic treatments and outcomes. The purpose of this study was to define: (1) correlation between PROs collected by automated delivery of text messages on mobile phones compared with paper delivery; and (2) patient use characteristics of a technology platform utilizing automated delivery of text messages on mobile phones.

Methods: Paper versions of the 12-Item Short Form Health Survey (SF-12) and the short form of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) were completed by patients in orthopedic hand and upper extremity clinics. Over the next 48 hours, the same patients also completed the mobile phone portion of the study outside of the clinic which included text message delivery of the SF-12 and QuickDASH, assigned in a random order. Correlations between paper and text message delivery of the 2 PROs were assessed.

Results: Among 72 patients, the intraclass correlation coefficient (ICC) between the written and mobile phone delivery of QuickDASH was 0.91 (95% confidence interval [CI], 0.85-0.95). The ICC between the paper and mobile phone delivery of the SF-12 physical health composite score was 0.88 (95% CI, 0.79-0.93) and 0.86 (95% CI, 0.75-0.92) for the SF-12 mental health composite score.

Conclusions: We find that text message delivery using mobile phones permits valid assessment of SF-12 and QuickDASH scores. The findings suggest that software-driven automated delivery of text communication to patients via mobile phones may be a valid method to obtain other PRO scores in orthopedic patients.

Keywords: QuickDASH; SF-12; mobile phone; outcomes; text message.

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.

Screenshot from portion of SF-12 questionnaire as viewed on a mobile phone interface. Note. SF-12 = 12-Item Short Form Health Survey; PRO = patient-reported outcome.

Figure 2.

QuickDASH Bland-Altman plot showing differences between paper and mobile phone delivery versus their mean values. Note. Red lines represent upper and lower 95% agreement limits. QuickDASH = short form of the Disabilities of the Arm, Shoulder and Hand.

Figure 3.

SF-12 PCS Bland-Altman plot showing differences between paper and mobile phone delivery versus their mean values. Note. Upper and lower red lines represent upper and lower 95% agreement limits. SF-12 = 12-Item Short Form Health Survey; PCS = Physical Composite Score.

Figure 4.

SF-12 MCS Bland-Altman plot showing differences between paper and mobile phone delivery versus their mean values. Note. Upper and lower red lines represent upper and lower 95% agreement limits. SF-12 = 12-Item Short Form Health Survey; MCS = Mental Composite Score.