title: A comparative trial of paper-and-pencil versus computer administration of the Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaire.
abstract: BACKGROUND
  Although most health-related quality of life questionnaires are self-administered by means of paper and pencil, new technologies for automated computer administration are becoming more readily available. Novel methods of instrument administration must be assessed for score equivalence in addition to consistency in reliability and validity.
  
  
  OBJECTIVE
  The present study compared the psychometric characteristics (score equivalence and structure, internal consistency, and reproducibility reliability and construct validity) of the Quality of Life in Reflux And Dyspepsia (QOLRAD) questionnaire when self-administered by means of paper and pencil versus touch-screen computer. The influence of age, education, and prior experience with computers on score equivalence was also examined.
  
  
  METHODS
  This crossover trial randomized 134 patients with gastroesophageal reflux disease to 1 of 2 groups: paper-and-pencil questionnaire administration followed by computer administration or computer administration followed by use of paper and pencil. To minimize learning effects and respondent fatigue, administrations were scheduled 3 days apart. A random sample of 32 patients participated in a 1-week reproducibility evaluation of the computer-administered QOLRAD.
  
  
  RESULTS
  QOLRAD scores were equivalent across the 2 methods of administration regardless of subject age, education, and prior computer use. Internal consistency levels were very high (alpha = 0.93-0.99). Interscale correlations were strong and generally consistent across methods (r = 0.7-0.87). Correlations between the QOLRAD and Short Form 36 (SF-36) were high, with no significant differences by method. Test-retest reliability of the computer-administered QOLRAD was also very high (ICC = 0.93-0.96).
  
  
  CONCLUSIONS
  Results of the present study suggest that the QOLRAD is reliable and valid when self-administered by means of computer touch-screen or paper and pencil.
authors.affiliation: Center for Health Outcomes Research, MEDTAP International Inc, Bethesda, Maryland, USA. Kleinman@Metap.com
authors.forename: L
authors.initials: L
authors.lastname: Kleinman
authors.forename: N K
authors.initials: NK
authors.lastname: Leidy
authors.forename: J
authors.initials: J
authors.lastname: Crawley
authors.forename: A
authors.initials: A
authors.lastname: Bonomi
authors.forename: P
authors.initials: P
authors.lastname: Schoenfeld
mesh_terms: D000367:Age Factors; D000368:Aged; D001294:Attitude to Health; D018592:Cross-Over Studies; D004415:Dyspepsia / Q000523:psychology*; D004522:Educational Status; D001330:Electronic Data Processing / Q000379:methods*; D005260:Female; D005764:Gastroesophageal Reflux / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D011788:Quality of Life; D012044:Regression Analysis; D015203:Reproducibility of Results; D020377:Self Efficacy; D011795:Surveys and Questionnaires / Q000592:standards*; D014584:User-Computer Interface