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Mobile Phone Administration of Hip-Specific Patient-Reported Outcome Instruments Correlates Highly With In-office Administration

Scott, Elizabeth J. MD; Anthony, Christopher A. MD; Rooney, Patrick BS; Lynch, T. Sean MD; Willey, Michael C. MD; Westermann, Robert W. MD

Journal of the American Academy of Orthopaedic Surgeons: April 24, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.5435/JAAOS-D-18-00708
Research Article: PDF Only

Introduction: Patient-reported outcome (PRO) instruments typically are delivered via paper or computer; we validated administration of hip-specific instruments over a mobile phone software communication platform outside a clinical encounter.

Methods: Consecutive patients (n = 69) presenting to a hip preservation clinic completed the Hip Disability and Osteoarthritis Outcome Score Short Form physical function and pain subscales (HOOS-PS and HOOS-PAIN) using standard collection techniques. The subsequent day, patients completed these instruments via a text messaging software program. Text reminders were sent to encourage completion of unanswered questions. Correlation between in-office and mobile phone delivery of PROs was assessed.

Results: The intraclass correlation coefficient between in-clinic and mobile phone delivery of HOOS-PS and HOOS-PAIN was 0.72 (95% confidence interval, 0.58 to 0.81) and 0.80 (95% confidence interval, 0.69 to 0.87), respectively. Completion rate of 93% (64 of the 69) was observed using mobile phone and software messaging. Nine patients completed their PRO after being sent a text message reminder. Fifty-one percent of patients completed all PRO questions within 5 minutes; 26% took between 5 and 10 minutes, and 16% took 10 to 30 minutes for completion.

Discussion: HOOS-PS and HOOS-PAIN PRO instruments administered via text messaging with automated reminders demonstrate good to excellent reproducibility, no minimal detectable change between communication methods, and a high completion rate in adolescents and young adults with hip pain. Mobile phone delivery via automated software may be a valid method for administration of other PROs, allowing for communication with patients anytime and anywhere.

Level of Evidence: Level IV, case series

From the Department of Orthopedics and Rehabilitation, University of Iowa Hospitals & Clinics, Iowa City, IA (Dr. Scott, Dr. Anthony, Mr. Rooney, Dr. Willey, and Dr. Westermann), and the Center for Shoulder, Elbow and Sports Medicine, Columbia University Medical Center, New York, NY (Dr. Lynch).

Correspondence to Dr. Scott:

This study was funded by a research grant from the Arthroscopy Association of North America.

Dr. Scott reports grants from Arthroscopy Association of North America, during the conduct of the study. Dr. Willey reports grants from AANA resident grant, grants from Orthopaedic Research and Education Foundation, grants from Department of Defense, during the conduct of the study. None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Anthony, Rooney, Dr. Lynch, and Dr. Westermann.

Natalie Glass, PhD, provided statistical analysis for this study. Shannon Ortiz provided organizational assistance with this study.

This study was approved by the Institutional Review Board and was deemed compliant with the Health Insurance Portability and Accountability Act.

© 2019 by American Academy of Orthopaedic Surgeons
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