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Abstract：
BACKGROUND: Administering patient-reported outcome measures (PROMs) by text message may improve response rate in hard-to-reach populations. This study explored cultural acceptability of PROMs and compared measurement equivalence of the EQ-5D-3L administered on paper and by text message in a rural South African setting.
METHODS: Participants with upper or lower limb orthopaedic pathology were recruited. The EQ-5D was administered first on paper and then by text message after 24 h and 7 days. Differences in mean scores for paper and text message versions of the EQ-5D were evaluated. Test-retest reliability between text message versions was evaluated using Intraclass Correlation Coefficients (ICCs).
RESULTS: 147 participants completed a paper EQ-5D. Response rates were 67% at 24 h and 58% at 7 days. There were no differences in means between paper and text message responses for the EQ-5D Index (p = 0.95) or EQ-5D VAS (p = 0.26). There was acceptable agreement between the paper and 24-h text message EQ-5D Index (0.84; 95% Confidence Interval (CI) 0.78-0.89) and EQ-5D VAS (0.73; 95% CI 0.64-0.82) and acceptable agreement between the 24-h and 7-day text message EQ-Index (0.72; CI 0.62-0.82) and EQ-VAS (0.72; CI 0.62-0.82). Non-responder traits were increasing age, Xhosa as first language and lower educational levels.
CONCLUSIONS: Text messaging is equivalent to paper-based measurement of EQ-5D in this setting and is thus a viable tool for responders. Non-responders had similar socioeconomic characteristics and attrition rates to traditional modes of administration. The EQ-5D by text message offers potential clinical and research uses in hard-to-reach populations.
METHODS: Participants with upper or lower limb orthopaedic pathology were recruited. The EQ-5D was administered first on paper and then by text message after 24 h and 7 days. Differences in mean scores for paper and text message versions of the EQ-5D were evaluated. Test-retest reliability between text message versions was evaluated using Intraclass Correlation Coefficients (ICCs).
RESULTS: 147 participants completed a paper EQ-5D. Response rates were 67% at 24 h and 58% at 7 days. There were no differences in means between paper and text message responses for the EQ-5D Index (p = 0.95) or EQ-5D VAS (p = 0.26). There was acceptable agreement between the paper and 24-h text message EQ-5D Index (0.84; 95% Confidence Interval (CI) 0.78-0.89) and EQ-5D VAS (0.73; 95% CI 0.64-0.82) and acceptable agreement between the 24-h and 7-day text message EQ-Index (0.72; CI 0.62-0.82) and EQ-VAS (0.72; CI 0.62-0.82). Non-responder traits were increasing age, Xhosa as first language and lower educational levels.
CONCLUSIONS: Text messaging is equivalent to paper-based measurement of EQ-5D in this setting and is thus a viable tool for responders. Non-responders had similar socioeconomic characteristics and attrition rates to traditional modes of administration. The EQ-5D by text message offers potential clinical and research uses in hard-to-reach populations.
摘要：
背景：通过文本消息管理患者报告的结果指标（PROM）可能会提高难以到达人群的反应率。这项研究探讨了PROM的文化可接受性，并比较了在南非农村地区在纸上和通过短信施用的EQ-5D-3L的测量等效性。
方法：招募具有上肢或下肢骨科病理的参与者。EQ-5D首先在纸上给药，然后在24小时和7天后通过短信给药。评估了EQ-5D纸质和文本消息版本的平均得分差异。使用组内相关系数（ICC）评估文本消息版本之间的重测可靠性。
结果：147名参与者完成了EQ-5D论文。24小时反应率为67%，7天反应率为58%。对于EQ-5D指数（p=0.95）或EQ-5DVAS（p=0.26），纸质和文本消息响应之间的均值没有差异。论文和24小时文本消息EQ-5D指数（0.84;95％置信区间（CI）0.78-0.89）和EQ-5DVAS（0.73;95％CI0.64-0.82）之间存在可接受的一致性，并且24小时和7天文本消息EQ-Index（0.72;CI0.62-0.82）和EQ-VAS（0.72;CI0.62-0.82）之间存在可接受无反应者特征是年龄增加，科萨语为第一语言和较低的教育水平。
结论：在此设置中，文本消息等同于基于纸张的EQ-5D测量，因此对于响应者来说是可行的工具。无反应者的社会经济特征和流失率与传统的管理模式相似。EQ-5D通过短信为难以到达的人群提供了潜在的临床和研究用途。
方法：招募具有上肢或下肢骨科病理的参与者。EQ-5D首先在纸上给药，然后在24小时和7天后通过短信给药。评估了EQ-5D纸质和文本消息版本的平均得分差异。使用组内相关系数（ICC）评估文本消息版本之间的重测可靠性。
结果：147名参与者完成了EQ-5D论文。24小时反应率为67%，7天反应率为58%。对于EQ-5D指数（p=0.95）或EQ-5DVAS（p=0.26），纸质和文本消息响应之间的均值没有差异。论文和24小时文本消息EQ-5D指数（0.84;95％置信区间（CI）0.78-0.89）和EQ-5DVAS（0.73;95％CI0.64-0.82）之间存在可接受的一致性，并且24小时和7天文本消息EQ-Index（0.72;CI0.62-0.82）和EQ-VAS（0.72;CI0.62-0.82）之间存在可接受无反应者特征是年龄增加，科萨语为第一语言和较低的教育水平。
结论：在此设置中，文本消息等同于基于纸张的EQ-5D测量，因此对于响应者来说是可行的工具。无反应者的社会经济特征和流失率与传统的管理模式相似。EQ-5D通过短信为难以到达的人群提供了潜在的临床和研究用途。
