Is Electronic Measurement of Quality of Life of Chronic Back/Knee Paint Patients Feasible and Useful in Clinical Practice?

Abstract

Health-related quality of life (HRQOL) is an important outcome of chronic joint problems but it is rarely measured in large scale in clinical practice because of logistic barriers. Electronic measurement and scoring may facilitate the capture of big data on HRQOL in normal clinical practice. Objectives: To evaluate the feasibility, perceived ease of use and usefulness, reliability and validity of electronic measurement of HRQOL by the EQ-5D-5L. Study Design and setting: Cross-sectional questionnaire survey in public outpatient clinics. Population: A convenient sample of 151 adult patients (mean age 65 years (±9.27), 53% male) with chronic knee and/or back pain who attended the study clinics, gave consent and were fit to complete the survey. Study Instruments: All subjects completed the electronic EQ-5D-5L that consists of five items and a Visual Analogue Scale, the paper Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and the Perceived Ease of Use and Usefulness Questionnaire. 32 subjects repeated the electronic EQ-5D-5L after 2 weeks. The doctors also rated the usefulness of the EQ-5D-5L HRQOL report on the first 101 subjects. Outcome Measures: Completion rate and time, proportion of subjects/doctors perceiving the electronic EQ-5D-5L measurement useful/easy to use, test-retest reliability and correlations between EQ-5D-5L and WOMAC scores. Results: All subjects completed the electronic EQ-5D-5L with no missing data, mean completion time was 130 seconds (±59). 95% and 69% subjects agreed the electronic EQ-5D-5L measurement was useful and easy to use, respectively. 99% doctors agreed the EQ-5D-5L report on HRQOL was useful for patient management. Test-retest intra-class correlation (ICC) was 0.76, indicating good reliability. Significant correlations (r=0.20-0.67) between relevant EQ-5D-5L and WOMAC scores supported construct validity. Conclusion: The electronic EQ-5D-5L was a feasible, reliable and valid measure of HRQOL in normal clinical practice, which were perceived by patients and doctors as useful. It can be implemented to capture big data on HRQOL in clinical practice to enhance patient-centered care of chronic musculoskeletal problems. Upon completion of this session, participants should be able to: 1. apply the EQ-5D-5L to measure health-related quality of life in clinical practice 2. include health-related quality of life as an outcome measure of the impact of musculoskeletal problems in clinical practice 3. include health-related