Validation and patient acceptance of a computer touch screen version of the WOMAC 3.1 osteoarthritis index

Abstract

Objectives: To validate the WOMAC 3.1 in a touch screen computer format, which applies each question as a cartoon in writing and in speech (QUALITOUCH method), and to assess patient acceptance of the computer touch screen version.

Methods: The paper and computer formats of WOMAC 3.1 were applied in random order to 53 subjects with hip or knee osteoarthritis. The mean age of the subjects was 64 years (range 45 to 83), 60% were male, 53% were 65 years or older, and 53% used computers at home or at work. Agreement between formats was assessed by intraclass correlation coefficients (ICCs). Preferences were assessed with a supplementary questionnaire.

Results: ICCs between formats were 0.92 (95% confidence interval, 0.87 to 0.96) for pain; 0.94 (0.90 to 0.97) for stiffness, and 0.96 (0.94 to 0.98) for function. ICCs were similar in men and women, in subjects with or without previous computer experience, and in subjects below or above age 65. The computer format was found easier to use by 26% of the subjects, the paper format by 8%, and 66% were undecided. Overall, 53% of subjects preferred the computer format, while 9% preferred the paper format, and 38% were undecided.

Conclusion: The computer format of the WOMAC 3.1 is a reliable assessment tool. Agreement between computer and paper formats was independent of computer experience, age, or sex. Thus the computer format may help improve patient follow up by meeting patients' preferences and providing immediate results.

Figure 2

Patients' preferences with regard to paper and computer format of the WOMAC (Western Ontario and McMaster Universities osteoarthritis index). Of persons who expressed a preference, there were significantly more who stated that the computer format was easier to use, and more preferred the computer over the paper format.

Figure 1

Differences between paper and computer format of the WOMAC osteoarthritis index version 3.1 by person and by subscale. The graphs show differences between formats using the paper format as the gold standard for each individual. Squares represent the individuals who had discrepant subscale scores, while identical scores are not shown. The horizontal line gives the mean difference between formats.