EMCAT in hand surgery
Research type
Research Study
Full title
The feasibility of Ecological Momentary Computerised Adaptive Testing in hand surgery
IRAS ID
302403
Contact name
Conrad Harrison
Contact email
Sponsor organisation
University of Oxford / Research Governance, Ethics & Assurance
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Summary of Research
Patient-reported outcome measures (PROMs) are questionnaires that measure important elements of health. In hand surgery, PROMs are used to measure health constructs such as pain and hand function. This can be important in clinical practice, to tell whether an intervention (e.g. an operation or hand therapy) has made somebody feel better, or in research to compare how effective different interventions are. A problem with PROMs is that we usually only ask patients to complete them at infrequent and arbitrary time points (e.g. before surgery, at 6 weeks and again at 3 months). This means that day-to-day changes in symptoms are often missed. This is particularly important in arthritis and hand injuries, where symptoms can be brought on by certain activities, and even affected by the weather.
We plan to test a new technique to collect PROM responses more frequently. It is called Ecological Momentary Computerised Adaptive Testing (EMCAT). EMCAT works by using “artificial intelligence” to make PROM questionnaires much shorter and tailored to an individual, based on their previous responses. By making PROMs shorter, we think that people could complete them at frequent time points (e.g. every day) by using a smartphone app. This will help us capture day-to-day changes in symptom severity.
We are going to test a smartphone application that uses EMCAT in a group of 20 people who have had a hand injury, and 20 people who have hand arthritis. To see if people like using the app, we will check how frequently they used it and interview them about their experience. This information will help us to make the app better so that we can test it in a large scale study at a later date.Summary of Results
In this study, we have demonstrated that our smartphone application (Ecological Momentary Computerised Adaptive Testing, EMCAT) can remotely collect low burden, and highly granular patient-reported outcome measure (PROM) questionnaire data for both research and clinical care. We show that computer algorithms allow the platform to produce precise PROM scores from fewer questions and significantly shorter assessment times, supporting previous findings. Accurate pre-scheduling was possible, with most assessments returned within an hour of their prespecified time. The perceived usability of the platform was high, and this was reflected in high response rates for participants administered daily or thrice weekly assessments. While response rates for those administered thrice daily assessments were lower, the absolute number of assessments completed was still high, with most participants in this group completing over 100 assessments during the 12-week period. These sampling frequencies exceed those typically reported by studies aiming to monitor patients with traditional PROMs of similar lengths. We believe the EMCAT platform will allow clinicians and researchers to administer EMA assessments more frequently (or with more PROM scales) than they otherwise could, with similar accuracy, and this is likely to lead to deeper insights in clinical research and more responsive clinical monitoring.REC name
East of England - Cambridge East Research Ethics Committee
REC reference
21/EE/0261
Date of REC Opinion
24 Dec 2021
REC opinion
Further Information Favourable Opinion