title: A randomized trial of the disabilities of the arm, shoulder, and hand administration: tablet computer versus paper and pencil.
abstract: OBJECTIVE
  To compare the Disabilities of the Arm, Shoulder, and Hand (DASH) patient-reported outcome measure as administered by tablet computer to the traditional paper format.
  
  
  METHODS
  In a prospective, randomized study design, 223 consecutive adult patients who presented to the clinic of a single hand surgeon at a tertiary medical center were randomized by visit time to receive the DASH by either paper or tablet computer. Test completeness, time to completion, DASH score, and diagnostic and demographic data were collected and compared between the two cohorts. In total, 120 participants took the DASH using the tablet and 103 using paper.
  
  
  RESULTS
  43% of the paper surveys had at least one question that was omitted, compared with 13% in the tablet group; 14% of the paper surveys were not scoreable (< 27 questions answered) compared with 4% of the tablet surveys. The mean time to complete was 3.1 minutes for the paper version of the DASH and 4.3 minutes for the tablet version. Among our study population, there was no influence of age, sex, or diagnosis category on the time required to complete either version of the test. The mean DASH score was 45 for the paper version and 32 for the tablet version.
  
  
  CONCLUSIONS
  The use of digital data entry methods in the arena of health care outcomes research is increasing. Administration of the DASH via a tablet computer resulted in more complete data, slightly increased responder burden, and a lower DASH score. This finding may have important implications for the use of this metric in an electronic format in future research endeavors.
  
  
  METHODS
  Diagnostic II.
authors.affiliation: University of Utah Department of Orthopedic Surgery, Salt Lake City, UT. Electronic address: Andrew.Tyser@hsc.utah.edu.
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Tyser
authors.affiliation: University of Utah Department of Orthopedic Surgery, Salt Lake City, UT.
authors.forename: James
authors.initials: J
authors.lastname: Beckmann
authors.affiliation: University of Utah Department of Orthopedic Surgery, Salt Lake City, UT.
authors.forename: Cindy
authors.initials: C
authors.lastname: Weng
authors.affiliation: University of Utah Department of Orthopedic Surgery, Salt Lake City, UT.
authors.forename: Andrew
authors.initials: A
authors.lastname: O'Farrell
authors.affiliation: University of Utah Department of Orthopedic Surgery, Salt Lake City, UT.
authors.forename: Man
authors.initials: M
authors.lastname: Hung
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D034201:Computers, Handheld / Q000706:statistics & numerical data*; D004185:Disability Evaluation; D004282:Documentation / Q000379:methods; D005260:Female; D006225:Hand / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010209:Paper; D063868:Patient Outcome Assessment; D011446:Prospective Studies; D012720:Severity of Illness Index; D012782:Shoulder / Q000503:physiopathology; D013647:Task Performance and Analysis; D034941:Upper Extremity / Q000503:physiopathology*
keywords: DASH score; patient-reported outcomes; research methodology