A Comparison of Psychometric Properties Between Internet and Paper Versions of Two Depression Instruments (BDI-II and MADRS-S) Administered to Clinic Patients Digital Education in Health Professions: The Need for Overarching Evidence Synthesis Internet Versus Mailed Questionnaires: A Randomized Comparison The Effectiveness of Technology-Based Strategies to Promote Engagement With Digital Interventions: A Systematic Review Protocol Reliability of short form-36 in an Internet- and a pen-and-paper version Faked depression: comparing malingering via the internet, pen-and-paper, and telephone administration modes. Development of a digital Childhood Health Assessment Questionnaire for systematic monitoring of disease activity in daily practice. Comparing Administration of Questionnaires via the Internet to Pen-and-Paper in Patients with Heart Failure: Randomized Controlled Trial Application of Information Technology: McMaster PLUS: A Cluster Randomized Clinical Trial of an Intervention to Accelerate Clinical Use of Evidence-based Information from Digital Libraries The use of research questionnaires with hearing impaired adults: online vs. paper-and-pencil administration Feasibility, reliability, and validity of adolescent health status measurement by the Child Health Questionnaire Child Form (CHQ-CF): internet administration compared with the standard paper version Validity, reliability, and responsiveness of a digital version of the visual analog scale. Psychometric Properties of the PTSD Checklist—Civilian Version Serial personal digital assistant data capture of health-related quality of life: A randomized controlled trial in a prostate cancer clinic Comparison of three problem-based learning conditions (real patients, digital and paper) with lecture-based learning in a dermatology course: A prospective randomized study from China Score equivalence of electronic and paper versions of the Social Difficulties Inventory (SDI-21): a randomised crossover trial in cancer patients Electronic pain questionnaires: A randomized, crossover comparison with paper questionnaires for chronic pain assessment Development of a brief measure to assess quality of life in obesity. Social desirability, anonymity, and internet-based questionnaires A Digital Test for Pelvic Muscle Strength in Women with Urinary Incontinence Development of the Treatment Adherence Survey-patient version (TAS-P) for OCD. Older Adults’ Use of Online and Offline Sources of Health Information and Constructs of Reliance and Self-Efficacy for Medical Decision Making Validation of self-reported weights and heights in the avoiding diabetes after pregnancy trial (ADAPT)
Background Self-report measures can guide clinical decisions and are useful when evaluating treatment outcomes . However , many clinicians do not use self-report measures systematic ally in their clinical practice . Internet-based question naires could facilitate administration , but the psychometric properties of the online version of an instrument should be explored before implementation . The recommendation from the International Test Commission is to test the psychometric properties of each question naire separately . Objective Our objective was to compare the psychometric properties of paper- and -pencil versions and Internet versions of two question naires measuring depressive symptoms . Methods The 87 participating patients were recruited from primary care and psychiatric care within the public health care system in Sweden . Participants completed the  Beck Depression Inventory ( BDI-II )  and the  Montgomery-Åsberg Depression Rating Scale — Self-rated ( MADRS-S )  , both on paper and on the Internet . The order was r and omized to control for order effects . Symptom severity in the sample ranged from mild to severe depressive symptoms . Results Psychometric properties of the two administration formats were mostly equivalent . The internal consistency was similar for the Internet and paper versions , and significant correlations were found between the formats for both MADRS-S ( r = .84 ) and the BDI-II ( r = .89 ) . Differences between paper and Internet total scores were not statistically significant for either question naire nor for the MADRS-S question dealing with suicidality ( item 9 ) when analyzed separately . The score on the BDI-II question about suicidality ( item 9 ) was significantly lower when administered via the Internet compared with the paper score , but the difference was small ( effect size , Cohen ’s [ d ] = 0.14 ) . There were significant main effects for order of administration on both question naires and significant interaction effects between format and order . This should not , however , pose a problem in clinical use as long as the administration format is not changed when repeated measurements are made . Conclusions The MADRS-S can be transferred to online use without affecting the psychometric properties in a clinical ly meaningful way . The full BDI-II also seems to retain its properties when transferred ; however , the item measuring suicidality in the Internet version needs further investigation since it was associated with a lower score in this study . The use of online question naires offers clinicians a more practical way of measuring depressive symptoms and has the potential to save re sources Synthesizing evidence from r and omized controlled trials of  digital health education  poses some challenges . These include a lack of clear categorization of digital health education in the literature ; constantly evolving concepts , pedagogies , or theories ; and a multitude of methods , features , technologies , or delivery setting s. The Digital Health Education Collaboration was established to evaluate the evidence on digital education in health professions ; inform policymakers , educators , and students ; and ultimately , change the way in which these professionals learn and are taught . The aim of this paper is to present the overarching methodology that we use to synthesize evidence across our digital health education review s and to discuss challenges related to the process . For our research , we followed Cochrane recommendations for the conduct of systematic review s ; all review s are reported according to the PRISMA ( Preferred Reporting Items for Systematic Review s and Meta-Analyses ) guidance . This included assembling experts in various digital health education fields ; identifying gaps in the evidence base ; formulating focused research questions , aims , and outcome measures ; choosing appropriate search terms and data bases ; defining inclusion and exclusion criteria ; running the search es jointly with librarians and information specialists ; managing abstract s ; retrieving full-text versions of papers ; extracting and storing large data sets , critically appraising the quality of studies ; analyzing data ; discussing findings ; drawing meaningful conclusions ; and drafting research papers . The approach used for synthesizing evidence from digital health education trials is commonly regarded as the most rigorous benchmark for conducting systematic review s. Although we acknowledge the presence of certain biases ingrained in the process , we have clearly highlighted and minimized those biases by strictly adhering to scientific rigor , method ological integrity , and st and ard operating procedures . This paper will be a valuable asset for research ers and method ologists undertaking systematic review s in digital health education Background The use of Internet-based question naires for collection of data to evaluate patient education and other interventions has increased in recent years . Many self-report instruments have been vali date d using paper- and -pencil versions , but we can not assume that the psychometric properties of an Internet-based version will be identical . Objectives To look at similarities and differences between the Internet versions and the paper- and -pencil versions of 16 existing self-report instruments useful in evaluation of patient interventions . Methods Participants were recruited via the Internet and volunteered to participate ( N=397 ) , after which they were r and omly assigned to fill out question naires online or via mailed paper- and -pencil versions . The self-report instruments measured were overall health , health distress , practice mental stress management , Health Assessment Question naire ( HAQ ) disability , illness intrusiveness , activity limitations , visual numeric for pain , visual numeric for shortness of breath , visual numeric for fatigue , self-efficacy for managing disease , aerobic exercise , stretching and strengthening exercise , visits to MD , hospitalizations , hospital days , and emergency room visits . Means , ranges , and confidence intervals are given for each instrument within each type of question naire . The results from the two question naires were compared using both parametric and non-parametric tests . Reliability tests were given for multi-item instruments . A separate sample ( N=30 ) filled out identical question naires over the Internet within a few days and correlations were used to assess test-retest reliability . Results Out of 16 instruments , none showed significant differences when the appropriate tests were used . Construct reliability was similar within each type of question naire , and Internet test-retest reliability was high . Internet question naires required less follow-up to achieve a slightly ( non-significant ) higher completion rate compared to mailed question naires . Conclusions Among a convenience sample recruited via the Internet , results from those r and omly assigned to Internet participation were at least as good as , if not better than , among those assigned mailed question naires , with less recruitment effort required . The instruments administered via the Internet appear to be reliable , and to be answered similarly to the way they are answered when they are administered via traditional mailed paper question naires Background Digital interventions provide effective and potentially cost-effective models for improving health outcomes as they deliver health information and services that are widely disseminated , confidential , and can be tailored to needs of the individual user . Digital interventions have been used successfully for health promotion , mental health , and for enabling self-management of long-term conditions . However , their effectiveness is limited by low usage rates , with non-engagement a major challenge . Hence , it is crucial to find effective strategies to increase user engagement with digital interventions . Objective This systematic review will aim to evaluate the effectiveness of technology-based strategies  to promote engagement with digital interventions . Methods We will follow Cochrane Collaboration guidelines on systematic review methodology . The search strategy will be executed across seven e- data bases ( including MEDLINE , EMBASE , PsycINFO , CINAHL ) using the concepts “ digital intervention ” and “ engagement ” , limited by study type ( r and omized controlled trial ) . Grey literature and reference lists of included studies will be search ed . Titles and abstract s will be independently screened by 2 authors . Then the full text of potentially eligible papers will be obtained and double screened . Data from eligible papers will be extracted by 1 author and checked for accuracy by another author . Bias will be assessed using the Cochrane bias assessment tool . Narrative synthesis will report on all included studies , and where appropriate , data will be pooled using meta- analysis . All findings will be reported according to the Preferred Reporting Items for Systematic Review s and Meta-Analyses guidelines . Sources of heterogeneity will be further investigated if required . Results Our research is in progress . The final draft of the systematic review is being written and will be su bmi tted before the end of 2015 . Conclusions The review findings will inform research ers and digital intervention providers about optimal use of technology-based strategies to promote engagement with digital interventions . Trial Registration PROSPERO International Prospect i ve Register of Systematic Review s : CRD42014010164 ; http://www.crd.york.ac.uk/ PROSPERO /display_record.asp?ID = CRD42014010164#.VTZmmiFViko ( Archived by WebCite at http://www.webcitation.org/6XxQC8fT8 ) Use of Internet versions of question naires may have several advantages in clinical and epidemiological research , but we know little about if Internet versions differ with respect to validity and reliability . We aim ed to compare Internet- and pen- and -paper versions of short form-36 ( SF-36 ) with respect to test – retest reliability and internal consistency . Women referred to mammography ( n = 782 ) were r and omised to receive either a paper version with a prepaid return envelope or a guideline on how to fill in the Internet version . A subgroup was asked to answer the question naire once again in the alternative version . Test – retest reliability was assessed by the intra-class correlation coefficient . Internal consistency was calculated as Cronbach 's alpha . The between-version test – retest reliability for the eight subscales were between 0.63 and 0.92 . Cronbach 's alpha for the two versions were all between 0.75 and 0.93 with minor differences between the Internet- and the pen- and -paper version . We found little or no evidence of a difference in test – retest reliability and internal consistency when we compared an Internet- and a pen- and -paper version of SF-36 BACKGROUND The Internet and telephone are valuable re sources for mental health practitioners when access to face-to-face assessment or therapy is difficult . However , despite the high stakes ( such as access to medication or financial compensation ) often involved in psychological testing , little is known about how test administration mode influences test scores when patients are malingering . The aim of this research was to examine for the first time the equivalence of a malingered measure of depression when administered over the Internet , over the telephone , and with pen and paper . SUBJECTS AND METHODS A mixed experimental design was used with participants ( n=91 ) r and omly allocated to Internet , telephone , or pen- and -paper groups .  Participants completed the Edinburgh Depression Scale , first under st and ard instructions and then under instructions to fake as if experiencing severe depression . A manipulation check was included to ensure participants had understood and followed instructions to fake . RESULTS As predicted , participants were able to significantly increase their depression scores when asked to fake depression . Participants reported significantly lower faked depression scores over the telephone than in pen- and -paper format . Faked depression scores in the online group did not differ significantly from those in the telephone and pen- and -paper groups . However , participants in all groups met criteria indicative of a provisional diagnosis of depression . CONCLUSIONS Overall , the results indicate that there may be no meaningful difference between malingering across administration modes . If an individual is malingering depression , administration mode has minimal influence . These findings provide preliminary support for the use of online/telephone technologies in the assessment of depression OBJECTIVE To develop a reliable and user-friendly digital Childhood HAQ ( CHAQ ) to facilitate systematic monitoring of disease activity at the outpatient clinic in juvenile idiopathic arthritis ( JIA ) patients . METHODS The digital CHAQ was tested with patients who visited the outpatient paediatric rheumatology clinic of the Erasmus MC Sophia Children 's Hospital . These patients completed in a r and omized order the paper form and digital CHAQ while being observed . Validity was tested by comparing outcomes with the paper form CHAQ .  User-friendliness was evaluated through a short question naire . RESULTS A digital CHAQ was developed and revised several times according to our observations . Outcome is automatically calculated and can be printed . Fifty-one patients completed both the digital and paper form CHAQ . Correlation coefficient between both outcomes of the CHAQ Disability Index was 0.974 . No statistically significantly differences in median outcome were found in visual analogue scale ( VAS ) pain ( 25.6 vs 25.9 mm ) and VAS well-being ( 20.1 vs 19.5 mm ) . Although the mean time ( 5.06 min ) to complete the digital CHAQ was significantly longer than the mean time ( 3.75 min ) to complete the paper form , the majority of patients ( 75 % ) preferred the digital version . User-friendliness received maximum positive score . CONCLUSION We developed a reliable and user-friendly digital CHAQ , which can be easily and systematic ally completed during routine clinic visits . Such digitalization of question naires can be applied in any field to make systematic monitoring of disease activity in daily practice possible Background The use of the Internet to administer question naires has many potential advantages over the use of pen- and -paper administration . Yet it is important to vali date Internet administration , as most question naires were initially developed and vali date d for pen- and -paper delivery . While some have been vali date d for use over the Internet , these question naires have predominately been used amongst the healthy general population . To date , information is lacking on the validity of question naires administered over the Internet in patients with chronic diseases such as heart failure . Objectives To determine the validity of three heart failure question naires administered over the Internet compared to pen- and -paper administration in patients with heart failure . Methods We conducted a prospect i ve r and omized study using test-retest design comparing administration via the Internet to pen- and -paper administration for three heart failure question naires provided to patients recruited from a heart failure clinic in Toronto , Ontario , Canada : the Kansas City Cardiomyopathy Question naire ( KCCQ )  , the  Minnesota Living with Heart Failure Question naire ( MLHFQ ) , and the Self-Care Heart Failure Index ( SCHFI ) . Results Of the 58 subjects enrolled , 34 completed all three question naires . The mean difference and confidence intervals for the summary scores of the KCCQ , MLHFQ , and SCHFI were 1.2 ( CI -1.5 to 4.0 , scale from 0 to 100 ) , 4.0 ( CI -1.98 to 10.04 , scale from 0 to 105 ) , and 10.1 ( CI 1.18 to 19.07 , scale from 66.7 to 300 ) , respectively . Conclusions Internet administration of the KCCQ appears to be equivalent to pen- and -paper administration . For the MLHFQ and SCHFI , we were unable to demonstrate equivalence . Further research is necessary to determine if the administration methods are equivalent for these instruments BACKGROUND Physicians have difficulty keeping up with new evidence from medical research . METHODS We developed the McMaster Premium LiteratUre Service ( PLUS ) , an internet-based addition to an existing digital library , which delivered quality - and relevance -rated medical literature to physicians , matched to their clinical disciplines . We evaluated PLUS in a cluster-r and omized trial of 203 participating physicians in Northern Ontario , comparing a Full-Serve version ( that included alerts to new articles and a cumulative data base of alerts ) with a Self-Serve version ( that included a passive guide to evidence -based literature ) . Utilization of the service was the primary trial end-point . RESULTS Mean logins to the library rose by 0.77 logins/month/user ( 95 % CI 0.43 , 1.11 ) in the Full-Serve group compared with the Self-Serve group . The proportion of Full-Serve participants who utilized the service during each month of the study period showed a sustained increase during the intervention period , with a relative increase of 57 % ( 95 % CI 12 , 123 ) compared with the Self-Serve group . There were no differences in these proportions during the baseline period , and following the crossover of the Self-Serve group to Full-Serve , the Self-Serve group 's usage became indistinguishable from that of the Full-Serve group ( relative difference 4.4 ( 95 % CI -23.7 , 43.0 ) . Also during the intervention and crossover periods , measures of self-reported usefulness did not show a difference between the 2 groups . CONCLUSION A quality - and relevance -rated online literature service increased the utilization of evidence -based information from a digital library by practicing physicians Background When evaluating hearing rehabilitation , it is reasonable to use self-report question naires as outcome measure . Question naires used in audiological research are developed and vali date d for the paper- and -pencil format . As computer and Internet use is increasing , st and ardized question naires used in the audiological context should be evaluated to determine the viability of the online administration format . The aim of this study was to compare administration of question naires online versus paper- and pencil of four st and ardised question naires used in hearing research and clinic . We included the Hearing H and icap Inventory for the Elderly ( HHIE ) , the International Outcome Inventory for Hearing Aids ( IOI-HA ) , Satisfaction with Amplification in Daily Life ( SADL ) , and the Hospital Anxiety and Depression Scale ( HADS ) . Methods A cross-over design was used by r and omly letting the participants complete the question naires either online or on paper . After 3 weeks the participants filled out the same question naires again but in the other format . A total of 65 hearing-aid users were recruited from a hearing clinic to participate on a voluntary basis and of these 53 completed both versions of the question naires . Results A significant main effect of format was found on the HHIE ( p < 0.001 ) , with participants reporting higher scores on the online format than in the paper format . There was no interaction effect . For the other question naires were no significant main or interaction effects of format . Significant correlations between the two ways of presenting the measures was found for all question naires ( p<0.05 ) . The results from reliability tests showed Cronbachs α ’s above .70 for all four question naires and differences in Cronbachs α between administration formats were negligible . Conclusions For three of the four included question naires the participants ’ scores remained consistent across administrations and formats . For the fourth included question naire ( HHIE ) a significant difference of format with a small effect size was found . The relevance of the difference in scores between the formats depends on which context the question naire is used in . On balance , it is recommended that the administration format remain stable across assessment points Aims In this study we evaluated indicators of the feasibility , reliability , and validity of the Child Health Question naire-Child Form ( CHQ-CF ) . We compared the results in a subgroup of adolescents who completed the st and ard paper version of the CHQ-CF  with the results in another subgroup of adolescents who completed an internet version , i.e. , an online , web-based CHQ-CF question naire . Methods Under supervision at school , 1,071 adolescents were r and omized to complete the CHQ-CF and items on chronic conditions by a paper question naire or by an internet administered question naire . Results The participation rate was 87 % ; age range 13–7 years . The internet administration result ed in fewer missing answers . All but one multi-item scale showed internal consistency reliability ( Cronbach ’s α > 0.70 ) . All scales clearly discriminated between adolescents with no , a few , or many self-reported chronic conditions . The paper administration result ed in statistically significant , higher scores on 4 of 10 CHQ-CF scales compared with the internet administration ( P < 0.05 ) , but Cohen ’s effect sizes d were ≤0.21 . Mode of administration interacted significantly with age ( P < 0.05 ) on four CHQ-CF scales , but Cohen ’s effect sizes for these differences were also ≤0.21 . Conclusion This study supports the feasibility , internal consistency reliability of the scales , and construct validity of the CHQ-CF administered by either a paper question naire or online question naire . Given Cohen ’s suggested guidelines for the interpretation of effect sizes , i.e. , 0.20–.50 indicates a small effect , differences in CHQ-CF scale scores between paper and internet administration can be considered as negligible or small UNLABELLED The design used in this study was a prospect i ve cohort . Pain intensity levels recorded by the digital version of the visual analog scale ( VAS-D ) are easy to both score and share with other health care professionals . The purpose of the study was to examine the test-retest reliability , concurrent validity , and responsiveness of the VAS-D.  Thirty-three people with upper extremity injuries reported pain intensity levels before and after performing four maximal grip contractions ( pre- and postgripping ) . Our version of the VAS-D had high test-retest reliability ( r=0.96 ) and good concurrent validity ( r=0.84 - 0.97 ) with both the paper version of the VAS ( VAS-P ) and the verbal numerical rating scale ( NRS-V ) . Responsiveness of the VAS-D was indicated by a significant increase in pain levels from pre- to postgripping . Similar responsiveness to that of the VAS-P and NRS-V was indicated by similar effect size coefficients and analysis of variance of pain change scores . In conclusion , the VAS-D is a reliable , valid , and responsive measure of pain intensity for people with upper extremity injuries . However , differences in accuracy ( resolution ) among the VAS-D , VAS-P , or NRS-V may render the three pain scales not fully compatible . LEVEL OF EVIDENCE Not applicable We examined the psychometric properties of the  PTSD Checklist ( PCL ) , a self-report instrument design ed to assess symptoms of posttraumatic stress disorder . Three hundred ninety-two participants recruited in a university setting completed the PCL in addition to several well-established self-report instruments design ed to assess various forms of psychopathology ( e.g. , depression , general anxiety , PTSD ) . Ninety participants returned for readministration of selected measures . Findings provided support for psychometric properties of the PCL  , including internal consistency , test – retest reliability , convergent validity , and discriminant validity . Additional strengths of the PCL are discussed Background In clinical and research practice linked to prostate cancer treatment , frequent monitoring of patient health-related quality of life ( HRQOL ) is essential . Practical and analytic limitations of paper question naire data capture may be overcome with the use of self-administered personal digital assistant ( PDA ) data collection . The objective of this study was to assess the reliability , validity , and feasibility of using PDA in place of paper versions of the International Prostate Symptom Score ( IPSS ) , the Patient Oriented Prostate Cancer Utility Survey ( PORPUS ) , and the International Index of Erectile Function-5 ( IIEF-5 ) in a prostate cancer clinic setting . Methods 152 participants were r and omly assigned to one of three conditions : 1 ) paper followed by PDA survey ; 2 ) PDA followed by paper survey ; or 3 ) PDA followed by PDA survey . Evaluation included an assessment of data quality ( internal consistency , test-retest reliability , response correlation , completeness of data ) , and feasibility ( participation rates , time to completion , preference and difficultly/ease of using PDA ) . Results Internal consistency was similar for both PDA and paper applications . Test-retest reliability was confirmed for PDA repeated administration . Data from paper and PDA question naires were strongly correlated . Lower missed item rates were found in PDA administration . 82.8 % of participants preferred using the PDA or had no preference . Mean difficulty/ease ratings indicated that participants found the PDA easy to use . Age did not significantly correlate with preference or difficulty . Conclusion The results confirm the adaptability of the IPSS , IIEF-5 , and the PORPUS to PDA administration . Similarly , the findings of this study support the feasibility of using PDA technology for HRQOL serial data capture in the prostate cancer patient population Background : The precise effect and the quality of different cases used in dermatology problem-based learning ( PBL ) curricula are yet unclear . Aim : To prospect ively compare the impact of real patients , digital , paper PBL ( PPBL ) and traditional lecture-based learning ( LBL ) on academic results and student perceptions . Methods : A total of 120 students were r and omly allocated into either  real- patients PBL ( RPBL ) group studied via real-patient cases , digital PBL ( DPBL ) group studied via digital-form cases , PPBL group studied via paper-form cases , or conventional group who received didactic lectures .  Academic results were assessed through review of written examination , objective structured clinical examination and student performance scores . A five-point Likert scale question naire was used to evaluate student perceptions . Results : Compared to those receiving lectures only , all PBL participants had better results for written examination , clinical examination and overall performance . Students in RPBL group exhibited better overall performance than those in the other two PBL groups . Real-patient cases were more effective in helping develop students ’ self-directed learning skills , improving their confidence in future patient encounters and encouraging them to learn more about the discussed condition , compared to digital and paper cases . Conclusion : Both real patient and digital triggers are helpful in improving students ’ clinical problem-h and ling skills . However , real patients provide greater benefits to students Purpose The  Social Difficulties Inventory  ( SDI-21 ) assesses everyday problems experienced by cancer patients , including difficulties with self-care , work and relationships . Early development and psychometric evaluation studies have vali date d the SDI-21 for computer administration . However , several recent studies have administered the SDI-21 on paper . We sought to test the score equivalence of electronic and paper versions of the SDI-21 . Methods A r and omised two-arm crossover trial in a sample of cancer patients with varied diagnoses . Patients completed  electronic ( via the internet ) and paper versions of the SDI-21 , with half r and omly assigned to complete the electronic version first ( n = 51 ) and half the paper version first ( n = 60 ) . Patients were asked to complete both versions at home , within 2 weeks . Analyses were performed for the SDI-21 summary score and three subscales . Results Score distributions and internal reliabilities for the paper and electronic versions were highly similar . There were no significant differences between mean summary or subscale scores for the two administration modes . All mean score differences ( all < 0.25 of a scale point ) were well below the SDI-21 ’s established minimally important differences , and all 95 % confidence intervals were narrow and included zero . Intraclass correlations between paper and electronic scores were uniformly high and significant ( all ≥0.85 ) and above the st and ard acceptable level of reliability . Conclusions Paper and electronic versions of the SDI-21 can be considered equivalent and used interchangeably . This is important because , despite the growth of electronic formats , paper versions are currently still necessary to ensure inclusive use of the SDI-21 with representative sample & NA ; Electronic question naires for pain assessment are becoming increasingly popular . There have been no published reports to establish the equivalence or psychometric properties of common pain question naires administered via desktop computers . This study compared responses to paper ( P ) and touch screen electronic ( E ) versions of the Short‐Form McGill Pain Question naire ( SF‐MPQ ) and Pain Disability Index ( PDI ) , while examining the role of computer anxiety and experience , and evaluating patient acceptance . In a r and omized , crossover design 189 chronic pain patients completed P and E versions of the SF‐MPQ and PDI , and self‐ratings of anxiety , experience , relative ease and preference . Psychometric properties were highly similar for P and E question naires . For the SF‐MPQ , 60 % or more of subjects gave equivalent responses on individual descriptors and PPI scale , with 80 % rating within ±1 point for an 11‐point VAS . Correlations for the SF‐MPQ scales ranged from 0.68 to 0.84 . For the PDI , 60 % or more of subjects responded within ±1 point on individual questions , and the total score correlation was 0.67 . Comparison of mean difference scores revealed no significant differences between modes for any of the question naire items or scores . Anxiety and experience scores showed no significant associations through correlations and high/low comparisons . Although nearly half of subjects reported no computer training , anxiety ratings were low , and considerably more subjects rated the E question naires as easier and preferred . Findings are consistent with test‐retest reliability data , and support the validity and acceptance of electronic versions of the SF‐MPQ and PDI OBJECTIVE Obesity research ers have a growing interest in measuring the impact of weight and weight reduction on quality of life . The Impact of Weight on  Quality of Life question naire ( IWQOL ) was the first self-report instrument specifically developed to assess the effect of obesity on quality of life . Although the IWQOL has demonstrated excellent psychometric properties , its length ( 74 items ) makes it somewhat cumbersome as an outcome measure in clinical research . This report describes the development of a 31-item version of the IWQOL ( IWQOL-Lite ) . RESEARCH METHODS AND PROCEDURES IWQOLs from 996 obese patients and controls were used to develop the IWQOL-Lite . Psychometric properties of the IWQOL-Lite were examined in a separate cross-validation sample of 991 patients and controls . RESULTS Confirmatory factor analysis provided strong support for the adequacy of the scale structure . The five identified scales of the IWQOL-Lite  ( Physical Function , Self-Esteem , Sexual Life , Public Distress , and Work ) and the total IWQOL-Lite score demonstrated excellent psychometric properties . The reliability of the IWQOL-Lite scales ranged from 0.90 to 0.94 and was 0.96 for the total score . Correlations between the IWQOL-Lite and collateral measures supported the construct validity of the IWQOL-Lite . Changes in  IWQOL-Lite scales over time correlated significantly with changes in weight , supporting its sensitivity to change . Significant differences in IWQOL-Lite scale and total scores were found among groups differing in body mass index , supporting the utility of the IWQOL-Lite across the body mass index spectrum . DISCUSSION The IWQOL-Lite appears to be a psychometrically sound and clinical ly sensitive brief measure of quality of life in obese persons It has been argued that behavior on the Internet differs from similar behavior in the “ real world ” ( Joinson , 1998a ) . In the present study , participants completed measures of self-consciousness , social anxiety , self-esteem , and social desirability  , using either the World-Wide Web ( WWW ) or pen and paper , and were assigned to either an anonymous or a nonanonymous condition . It was found that people reported lower social anxiety and social desirability and higher self-esteem when they were anonymous than when they were nonanonymous . Furthermore , participants also reported lower social anxiety and social desirability when they were using the Internet than when they were using paper-based methods . Contrast analyses supported the prediction that participants using the WWW anonymously would show the lowest levels of social desirability , whereas participants answering with pen and paper nonanonymously would score highest on the same measure . Implication s for the use of the Internet for the collection of psychological data are discussed This article reports further experience with a Version 2 digital test performed on 208 community-residing women , 25 to 87 years old . Test-retest ( n = 208 ) and interrater reliability ( n = 36 ) scores for pressure , displacement , and duration were r = .54 , .51 , and .53 and r = .67 , .73 , and .55 , respectively . Interrater reliability percentage agreement figures were exact for 94 % of the women on pressure and 67 % on displacement . With duration permitted to vary by 1 second , agreement was 75 % . Validity was tested using vaginal electromyography score with correlation coefficients ranging from .37 to .63 . A weak but significant correlation was found between the digital score and the st and -up test pad gain ( r = -.12 ) . No significant relationship was found between the digital test and a history of being able to stop the urine stream or other leakage measures . To address limitations in Version 2 , a third version of the digital scale is proposed This paper reports on the development and initial psychometric evaluation of the Treatment Adherence Survey-patient version ( TAS-P ) , a brief instrument design ed to assess patient adherence to Cognitive-Behavioral Therapy ( CBT ) and pharmacotherapy recommendations for OCD . Eighty individuals with Obsessive Compulsive Disorder ( OCD ) were administered the TAS-P as part of the intake interview of a prospect i ve , observational study of the course of OCD . Results demonstrated excellent test-retest reliability . Responses on the TAS-P were also significantly correlated with scores on a self-report measure of general treatment adherence and with data collected from a chart- review , demonstrating concurrent validity . Treatment adherence was not explained by demographic variables . However , participants who reported nonadherence to CBT recommendations had more severe OCD symptoms at the time of intake than those who did not endorse CBT nonadherence ( mean Y-BOCS = 23.27 + /- 7.5 versus 18.20 + /- 8.0 , respectively ) . Results suggest that the TAS-P is a promising instrument for assessing reasons for nonadherence to recommendations for CBT and pharmacotherapy interventions We know little about older adults ' use of online and offline health information sources for medical decision making despite increasing numbers of older adults who report using the Internet for health information to aid in patient – provider communication and medical decision making . Therefore we investigated older adult users and nonusers of online and offline sources of health information and factors related to medical decision making . Survey research was conducted using r and om digit dialing of Florida residents ' l and line telephones . The Decision Self-Efficacy Scale and the Reliance Scale were used to measure relationships between users and nonusers of online health information . Study respondents were 225 older adults ( age range = 50−92 years , M = 68.9 , SD = 10.4 ) , which included users ( n = 105 ) and nonusers ( n = 119 ) of online health information . Users and nonusers differed in frequency and types of health sources sought . Users of online health information preferred a self-reliant approach and nonusers of online health information preferred a physician-reliant approach to involvement in medical decisions on the Reliance Scale . This study found significant differences between older adult users and nonusers of online and offline sources of health information and examined factors related to online health information engagement for medical decision making Background R and omized controlled trials that test the effectiveness of mobile health-based weight loss programs are attractive to participants , funders , and research ers because of the low implementation cost , minimal participant burden , and the ability to recruit participants from longer distances . Collecting weight data from geographically dispersed participants is a challenge . Relying on participant self-report is one approach to data collection , but epidemiologic studies indicate that self-reported anthropometric data may be inaccurate . Methods We provided women enrolled in a r and omized controlled trial ( RCT ) of postpartum weight loss after gestational diabetes with a digital scale and training to collect and report weight via a web-based survey . To vali date self-reported weights and heights , we visited  30 r and omly selected women in their homes  , with a reference scale and stadiometer , a mean of 34 days after the self-report . We ran linear regression models to identify characteristics that were associated with underreporting or overreporting of anthropometric measures . Results Of the 30 women we visited , 11 women ( 37 % ) were assigned to the weight loss intervention group and 19 women ( 63 % ) were in the control group . Mean age was 38.5 years ( SD 4.5 ) . The overall mean difference between participants ’ self-reported weights and the weights obtained at their home visit was 0.70 kg ( + 1.92 ) . Women assigned to the intervention group underreported their weight in comparison with the control group by 1.29 kg ( 95 % CI −2.52 , −0.06 ) . The overall difference in collected to self-reported height was −0.56 cm ( ±1.91 ) . No characteristics were associated with underreporting or overreporting of height . Conclusions Our research suggests that by providing a digital scale and developing a weight collection protocol , research ers can train women to collect and record their own study weights with reasonable validity . To achieve the level of validity required for clinical trials , research ers should consider additional strategies to assure the validity of the data .Trial registration NCT01923350
When digital versions of self-report symptom scales are compared to pen and paper versions , most scales show high interformat reliability .
This supports the reliability of results obtained in psychotherapy research on the Internet and the comparability of the results to traditional psychotherapy research .
BACKGROUND Research on Internet-based interventions typically use digital versions of pen and paper self-report symptom scales .
However , adaptation into the digital format could affect the psychometric properties of established self-report scales .
Several studies have investigated differences between digital and pen and paper versions of instruments , but no systematic review of the results has yet been done .
OBJECTIVE This review aims to assess the interformat reliability of  self-report symptom  scales used in digital or online psychotherapy research .