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Introduction: Functional outcome measures like the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire are key components in the evaluation of certain diseases and injuries, and the use of electronic methods for data capture are gaining popularity for such measures.  We investigate whether DASH scores obtained via portable touch-screen tablet computer correlate with paper scores, and whether there are differences in time to completion, missed question rates, and patient preferences between modes.  

Materials and Methods: An electronic version of the DASH survey (DigiDASH) was developed for use on a touch-screen tablet computer (iPad, Apple, Inc., Cupertino, CA). Forty-eight patients (age range, 18 to 87 years) in a hand specialist’s clinic consented to completing both the paper DASH and DigiDASH, with the order of administration randomized. Correlations were assessed using linear regressions with Pearson’s R reported. Subject preferences were recorded in open-ended format and qualitatively analyzed for themes. 

Results: There was a significant correlation between the DASH scores obtained for each patient via the two different modes of administration (R=0.957, p<0.0001). No significant differences between the two sets of scores were detected by two-tailed t-test (p=0.864), with no significant correlation between age and disparity between scores (R= -0.029, p=0.423). Mean time to finish the DigiDASH (4.8 minutes) and paper DASH (3.8 minutes) did not differ significantly (p=0.073), and there was no significant correlation between age and increased time necessary to complete the DigiDASH (R=0.002, p=0.496). Missed response rates for the electronic (0.6%) and paper questionnaire (0.8%) did not vary significantly, even when stratified by age (p=0.660). There were no significant order effects found (mean 31.5 on first mode versus 32.5 on the second, p=0.811). Only 11 of 48 subjects (22.9%) reported preferring the paper version. In those subjects who preferred the DigiDASH, predominant reasons were perceptions that it was easier to use, more fun/modern, and reduced the need for writing (Figure 1). 

Conclusions: The data collected using the electronic and paper versions of the DASH questionnaire were equivalent, and most patients either preferred the DigiDASH or reported no preference. Our results also suggest that electronic data collection via portable touch screen tablet computer may be used in a hand clinic’s elderly population without sacrificing accuracy or time efficiency. Electronic data collection for use in patients with upper extremity pathology is a viable alternative to traditional paper-based data collection, with potential benefits in terms of ease of use and reduced writing.