title: The usefulness of a mobile device-based system for patient-reported outcomes in a spine outpatient clinic.
abstract: Patient-reported outcomes (PROs) are typically collected using a paper form, but this format is cumbersome to incorporate into outpatient clinic visits as well as in research. Therefore, we developed a mobile device-based system (mobile system) for spinal PRO. We hypothesized that this system may improve the quality of care in an outpatient clinic.
  
  
  
  This study aimed to analyze the patient-reported efficacy of a mobile system through a survey of patients' responses compared with a paper system.
  
  
  
  A prospective observational study was carried out.
  
  
  
  Surveys were conducted for 103 patients who had experience using both the paper and electronic systems in the outpatient clinic.
  
  
  
  Patient-reported positive response score (PRS) was the outcome measure.
  
  
  
  The survey included the characteristics of the patients (sex, age, use of smartphone, familiarity with smartphone applications, proficiency of typing with mobile device, site of pain, and education level) and eight questions in four domains: (1) efficacy in the waiting room, (2) efficacy during the clinic visit, (3) overall satisfaction, and (4) opinion about the use of this system. The response to each question was scored from 1 to 5 (1, negative; 5, positive response). The patient-reported PRS was calculated by adding the scores of the 8 questions and converting the total range to 0-100 (60, neutral).
  
  
  
  The mean PRS of the 8 questions was 79.8 (95% CI, 76.7-83.9). The mean PRS was 78.9 (75.6-82.2) at the waiting room and was 80.5 (77.1-83.9) during the clinic. The PRS for overall satisfaction and use of this system were 83.3 (79.6-87.0) and 77.1 (71.9-82.3), respectively. The use of smartphones and the proficiency of typing were independently significant predictors of PRS with an R(2) value of 0.325.
  
  
  
  The mobile device-based system improved the patient-reported efficacy in spine outpatient clinics. However, various factors such as the use of smartphones need to be considered when developing and applying mobile systems.
authors.affiliation: Department of Neurosurgery, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, 03080 Seoul, South Korea; Department of Neurosurgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 03080 Seoul, South Korea; Clinical Research Institute, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 03080 Seoul, South Korea.
authors.forename: Chi Heon
authors.initials: CH
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, 03080 Seoul, South Korea; Department of Neurosurgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 03080 Seoul, South Korea; Clinical Research Institute, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 03080 Seoul, South Korea; Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, 1 Gwanak-ro, Gwanak-gu, 08826 Seoul, South Korea. Electronic address: chungc@snu.ac.kr.
authors.forename: Chun Kee
authors.initials: CK
authors.lastname: Chung
authors.affiliation: Medical Research Collaborating Center, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 03080 Seoul, South Korea.
authors.forename: Yunhee
authors.initials: Y
authors.lastname: Choi
authors.affiliation: Medical Research Collaborating Center, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 03080 Seoul, South Korea.
authors.forename: HyunJeong
authors.initials: H
authors.lastname: Shin
authors.affiliation: Department of Neurosurgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 03080 Seoul, South Korea.
authors.forename: Ji Won
authors.initials: JW
authors.lastname: Woo
authors.affiliation: Department of Neurosurgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 03080 Seoul, South Korea.
authors.forename: Sung-Mi
authors.initials: SM
authors.lastname: Kim
authors.affiliation: Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, 03080 Seoul, South Korea.
authors.forename: Hyuk-Joon
authors.initials: HJ
authors.lastname: Lee
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D040421:Cell Phone; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000071066:Patient Reported Outcome Measures; D013122:Spinal Diseases / Q000534:rehabilitation / Q000628:therapy*; D017216:Telemedicine / Q000295:instrumentation / Q000379:methods*
keywords: Computer; Disability; Mobile applications; Mobile telephone; Outcome assessment; Pain; Spine