title: Tablet, web-based, or paper questionnaires for measuring anxiety in patients suspected of breast cancer: patients' preferences and quality of collected data.
abstract: BACKGROUND
  Electronic applications are increasingly being used in hospitals for numerous purposes.
  
  
  OBJECTIVE
  Our aim was to assess differences in the characteristics of patients who choose paper versus electronic questionnaires and to evaluate the data quality of both approaches.
  
  
  METHODS
  Between October 2012 and June 2013, 136 patients participated in a study on diagnosis-induced stress and anxiety. Patients were asked to fill out questionnaires at six different moments during the diagnostic phase. They were given the opportunity to fill out the questionnaires on paper or electronically (a combination of tablet and Web-based questionnaires). Demographic characteristics and completeness of returned data were compared between groups.
  
  
  RESULTS
  Nearly two-thirds of patients (88/136, 64.7%) chose to fill out the questionnaires on paper, and just over a third (48/136, 35.3%) preferred the electronic option. Patients choosing electronic questionnaires were significantly younger (mean 47.3 years vs mean 53.5 in the paper group, P=.01) and higher educated (P=.004). There was significantly more missing information (ie, at least one question not answered) in the paper group during the diagnostic day compared to the electronic group (using a tablet) (28/88 vs 1/48, P<.001). However, in the week after the diagnostic day, missing information was significantly higher in the electronic group (Web-based questionnaires) compared to the paper group (41/48 vs 38/88, P<.001).
  
  
  CONCLUSIONS
  Younger patients and patients with a higher level of education have a preference towards filling out questionnaires electronically. In the hospital, a tablet is an excellent medium for patients to fill out questionnaires with very little missing information. However, for filling out questionnaires at home, paper questionnaires resulted in a better response than Web-based questionnaires.
authors.affiliation: University Medical Center Utrecht, Utrecht, Netherlands. m.barentsz@umcutrecht.nl.
authors.forename: Maarten W
authors.identifier: http://orcid.org/0000-0003-2741-3457
authors.initials: MW
authors.lastname: Barentsz
authors.forename: Hester
authors.identifier: http://orcid.org/0000-0003-0721-7002
authors.initials: H
authors.lastname: Wessels
authors.forename: Paul J
authors.identifier: http://orcid.org/0000-0003-0658-2745
authors.initials: PJ
authors.lastname: van Diest
authors.forename: Ruud M
authors.identifier: http://orcid.org/0000-0002-6912-9414
authors.initials: RM
authors.lastname: Pijnappel
authors.forename: Cees
authors.identifier: http://orcid.org/0000-0002-7106-9115
authors.initials: C
authors.lastname: Haaring
authors.forename: Carmen C
authors.identifier: http://orcid.org/0000-0002-1045-2962
authors.initials: CC
authors.lastname: van der Pol
authors.forename: Arjen J
authors.identifier: http://orcid.org/0000-0002-0313-8844
authors.initials: AJ
authors.lastname: Witkamp
authors.forename: Maurice A
authors.identifier: http://orcid.org/0000-0002-8364-5626
authors.initials: MA
authors.lastname: van den Bosch
authors.forename: Helena M
authors.identifier: http://orcid.org/0000-0001-9480-1623
authors.initials: HM
authors.lastname: Verkooijen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000209:etiology*; D001943:Breast Neoplasms / Q000523:psychology*; D003625:Data Collection / Q000379:methods*; D005260:Female; D006801:Humans; D020407:Internet; D008838:Microcomputers; D008875:Middle Aged; D057240:Patient Preference; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: breast cancer; electronic questionnaires; paper questionnaires; quality of collected data