Patients undergoing surgery for lumbar degenerative spinal disorders favor smartphone-based objective self-assessment over paper-based patient-reported outcome measures |
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| Authors: | Marketa Sosnova Anna Maria Zeitlberger Michal Ziga Oliver P Gautschi Luca Regli Astrid Weyerbrock Oliver Bozinov Martin N Stienen Nicolai Maldaner |
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| Institution: | 1. Department of Neurosurgery, Kantonsspital St.Gallen, St. Gallen, Switzerland;2. Neuro- and Spine Center, Hirslanden Clinic St. Anna, Lucerne, Switzerland;3. Department of Neurosurgery, University Hospital Zurich & Clinical Neuroscience Center, University of Zurich, Zurich, Switzerland;1. Department of Neurosurgery, Kantonsspital St.Gallen, St. Gallen, Switzerland;2. Neuro- and Spine Center, Hirslanden Clinic St. Anna, Lucerne, Switzerland;3. Department of Neurosurgery, University Hospital Zurich & Clinical Neuroscience Center, University of Zurich, Zurich, Switzerland;1. Hospital for Special Surgery, Department of Orthopedic Surgery, New York, NY, USA;2. Orthopedic Soft Tissue Research Program, Hospital for Special Surgery, 535 East 70th St., New York, NY, USA;3. Department of Biomechanics, Hospital for Special Surgery, New York, NY, USA;1. Department of Orthopaedic Surgery, Stanford University, 430 Broadway Street, MC: 6342, Pavilion C, 4th Floor, Redwood City, CA 94063-6342;2. Department of Biomedical Data Science, Stanford University, 1265 Welch Road, Stanford, CA 94305;1. Weill Cornell Medical College, New York, NY, USA;2. Department of Orthopedic Surgery, Hospital for Special Surgery, 535 E. 70th St, New York, NY 10021, USA;1. Department of Orthopaedic Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan;2. Department of Anatomy and Neuroscience, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan;1. Department of Ophthalmology, Stanford University, Palo Alto, CA;2. Department of Neurology & Neurological Sciences, Stanford University, Palo Alto, CA;3. Center for Population Health Sciences, Stanford University, Stanford, CA;4. Department of Anesthesiology, Walter Reed Military Medical Center, Bethesda, MD, USA;5. Center for Clinical and Translational Sciences, University of Illinois, Chicago, IL, USA;6. Department of Ophthalmology and Visual Sciences, University of Illinois, Chicago, IL, USA;7. Department of Anesthesiology, University of Illinois, Chicago, IL, USA;1. Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA;2. Department of Orthopaedic Surgery, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, Utrecht, the Netherlands, 3584 CX;3. Department of Surgery, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, Utrecht, the Netherlands, 3584 CX;4. Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA |
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| Abstract: | Background ContextSmartphone-based applications enable new prospects to monitor symptoms and assess functional outcome in patients with lumbar degenerative spinal disorders. However, little is known regarding patient acceptance and preference towards new modes of digital objective outcome assessment.PurposeTo assess patient preference of an objective smartphone-based outcome measure compared to conventional paper-based subjective methods of outcome assessment.Study designProspective observational cohort study.Patient sampleFourty-nine consecutive patients undergoing surgery for lumbar degenerative spinal disorder.Outcome measuresPatients completed a preference survey to assess different methods of outcome assessment. A 5-level Likert scale ranged from strong disagreement (2 points) over neutral (6 points) to strong agreement (10 points) was used.MethodsPatients self-determined their objective functional impairment using the 6-minute Walking Test application (6WT-app) and completed a set of paper-based patient-reported outcome measures (PROMs) before and 6 weeks after surgery. Patients were then asked to rate the methods of outcome assessment in terms of suitability, convenience, and responsiveness to their symptoms.ResultsThe majority of patients considered the 6WT-app a suitable instrument (median 8.0, interquartile range IQR] 4.0). Patients found the 6WT more convenient (median 10.0, IQR 2.0) than the Zurich Claudication Questionnaire (ZCQ; median 8.0, IQR 4.0, p=.019) and Core Outcome Measure Index (COMI; median 8.0, IQR 4.0, p=.007). There was good agreement that the 6WT-app detects change in physical performance (8.0, IQR 4.0). 78 % of patients considered the 6WT superior in detecting differences in symptoms (vs. 22% for PROMs). Seventy-six percent of patients would select the 6WT over the other, 18% the ZCQ and 6% the COMI. Eighty-two percent of patients indicated their preference to use a smartphone app for the assessment and monitoring of their spine-related symptoms in the future.ConclusionsPatients included in this study favored the smartphone-based evaluation of objective functional impairment over paper-based PROMs. Involving patients more actively by means of digital technology may increase patient compliance and satisfaction as well as diagnostic accuracy. |
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