title: Effectiveness of a web-based application to monitor health-related quality of life.
abstract: OBJECTIVE
  Monitoring health-related quality of life (HRQoL) by using electronic patient-reported outcomes (ePROs) has been only minimally evaluated in pediatrics. Children with juvenile idiopathic arthritis (JIA) are at risk for HRQoL problems. The aim of this study was to investigate the effectiveness of ePROs in clinical pediatric rheumatology care.
  
  
  METHODS
  All children (aged 0-18 years) with JIA visiting any of the 4 pediatric rheumatology clinics in Amsterdam between February 2009 and February 2010 were eligible for this sequential cohort intervention study. Before an outpatient consultation, children (aged 8-18 years) or parents (of children aged 0-7 years) completed web-based questionnaires. The resulting ePROfile was provided to the pediatric rheumatologist (PR). The study was divided into a control period in which the ePROfile was not discussed during consultation, and an intervention period in which the ePROfile was provided and discussed during consultation. Effectiveness was evaluated in terms of communication about different HRQoL topics, referral to a psychologist, and satisfaction with the consultations.
  
  
  RESULTS
  Out of the eligible JIA patients, 176 (65%) participated in the study. Use of the ePROfile increased discussion of psychosocial topics (P < .01), as well as the PR's satisfaction with provided care during consultation (P < .01). The use of ePROfiles did not affect referrals to a psychologist or parental satisfaction. Parents and PRs evaluated the use of the ePROfile as positive in 80% to 100% of the consultations.
  
  
  CONCLUSIONS
  Our web-based application to systemically monitor HRQoL problems in pediatric rheumatology contributed significantly to communication about psychosocial issues in a positive way. We recommend implementation of ePROs in pediatric clinical practice.
authors.affiliation: Emma Children's Hospital AMC, Meibergdreef 9, Room A3-241, 1105 AZ Amsterdam, Netherlands. l.haverman@amc.nl
authors.forename: Lotte
authors.initials: L
authors.lastname: Haverman
authors.forename: Marion A J
authors.initials: MA
authors.lastname: van Rossum
authors.forename: Mira
authors.initials: M
authors.lastname: van Veenendaal
authors.forename: J Merlijn
authors.initials: JM
authors.lastname: van den Berg
authors.forename: Koert M
authors.initials: KM
authors.lastname: Dolman
authors.forename: Joost
authors.initials: J
authors.lastname: Swart
authors.forename: Taco W
authors.initials: TW
authors.lastname: Kuijpers
authors.forename: Martha A
authors.initials: MA
authors.lastname: Grootenhuis
mesh_terms: D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000293:Adolescent; D001171:Arthritis, Juvenile / Q000523:psychology* / Q000534:rehabilitation; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003142:Communication; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011788:Quality of Life / Q000523:psychology*; D012017:Referral and Consultation; D012803:Sick Role; D011795:Surveys and Questionnaires; D016896:Treatment Outcome