title: Comparing administration of questionnaires via the internet to pen-and-paper in patients with heart failure: randomized controlled trial.
abstract: BACKGROUND
  The use of the Internet to administer questionnaires has many potential advantages over the use of pen-and-paper administration. Yet it is important to validate Internet administration, as most questionnaires were initially developed and validated for pen-and-paper delivery. While some have been validated for use over the Internet, these questionnaires have predominately been used amongst the healthy general population. To date, information is lacking on the validity of questionnaires administered over the Internet in patients with chronic diseases such as heart failure.
  
  
  OBJECTIVE
  To determine the validity of three heart failure questionnaires administered over the Internet compared to pen-and-paper administration in patients with heart failure.
  
  
  METHODS
  We conducted a prospective randomized study using test-retest design comparing administration via the Internet to pen-and-paper administration for three heart failure questionnaires provided to patients recruited from a heart failure clinic in Toronto, Ontario, Canada: the Kansas City Cardiomyopathy Questionnaire (KCCQ), the Minnesota Living with Heart Failure Questionnaire (MLHFQ), and the Self-Care Heart Failure Index (SCHFI).
  
  
  RESULTS
  Of the 58 subjects enrolled, 34 completed all three questionnaires. 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.
authors.affiliation: Department of Medicine, University of Toronto, Toronto, ON, Canada. robert.wu@uhn.on.ca
authors.forename: Robert C
authors.initials: RC
authors.lastname: Wu
authors.forename: Kevin
authors.initials: K
authors.lastname: Thorpe
authors.forename: Heather
authors.initials: H
authors.lastname: Ross
authors.forename: Vaska
authors.initials: V
authors.lastname: Micevski
authors.forename: Christine
authors.initials: C
authors.lastname: Marquez
authors.forename: Sharon E
authors.initials: SE
authors.lastname: Straus
mesh_terms: D009202:Cardiomyopathies; D002908:Chronic Disease / Q000523:psychology; D003710:Demography; D006333:Heart Failure / Q000534:rehabilitation*; D006801:Humans; D020407:Internet; D008019:Life Style; D009864:Ontario; D011446:Prospective Studies; D011788:Quality of Life; D015203:Reproducibility of Results; D012648:Self Care; D011795:Surveys and Questionnaires; D014956:Writing