The Use of Electronic Diaries in Respiratory Studies

Abstract

Background—Electronic diary cards have advantages over paper diaries for daily collection of data on lung function and symptoms in patients with respiratory disorders. The suitability of a pen-based electronic diary (Apple MessagePad) for this purpose was assessed in a clinical trial setting.

Methods—Two studies were carried out in patients with chronic obstructive airways disease: 1. An open randomized two-period crossover study comparing electronic and paper diaries in 22 clinic outpatients aged 18–70. Data were collected for four weeks on each type of diary, and 2. An open study in 37 patients in general practice aged 13–80. Data were collected for four weeks on electronic diaries only.

Results—In Study 1, 59% of patients preferred the electronic diary and 18% preferred paper. Both paper and electronic diaries were found to be easy to use. There were fewer problematic data from the electronic diaries (0.24% of data points) compared with paper (5.6%), resulting in improved data reliability. There were more missing data, however, with electronic diaries (8.9% vs 0.2%; p = 0.0001) which probably relates to the fact that the electronic diary did not permit retrospective entry. Data handling procedures were greatly simplified for the electronic diaries. Problems occurred with battery life and power management. Study 2 confirmed the acceptability of electronic diaries in this patient group, and showed no battery problems using a later model of the hardware (MP 110).

Conclusions—Pen-based electronic diaries are acceptable to patients, and offer major benefits in terms of data reliability and simplification of data handling.