Electronic and paper delivery of parent proxy and children's report of two scar-specific patient-reported outcome measures (Brisbane Burn Scar Impact Profile and Patient and Observer Scar Assessment Scale): An equivalence study.

Abstract

The Brisbane Burn Scar Impact Profile (BBSIP) and the Patient and Observer Scar Assessment Scale (POSAS) are used in burn scar assessment to quantify patient health-related quality of life (HR-QoL). These questionnaires were developed using pen-and-paper delivery methods; however, there is a push towards electronic delivery of these questionnaires in both clinical practice and research. Equivalence testing is required to ensure that validity of these paper questionnaires is maintained electronically. Participants were presented with a survey containing the BBSIP and POSAS, which was completed twice during a single outpatient appointment using either pen-and-paper or a tablet. Completion order was randomised to: 1) paper-paper; 2) paper-tablet; 3) tablet-paper; and 4) tablet-tablet. Comparison of intraclass correlation coefficients (ICCs), calculated for each BBSIP and POSAS subscale, was conducted with the ICC of the paper-paper group. Participants (n = 104) included 55 caregiver proxies of children aged 8 years or less, 26 caregiver proxies of children aged 8-18 years, and 23 children aged 8-18 years. The majority but not all BBSIP (61 %) and POSAS (81 %) subscales were equivalent. The acceptability of electronic delivery was supported. Findings generally support electronic delivery of the BBSIP and POSAS, likely supporting their use in outpatient clinics, telehealth clinics, and remote monitoring. Additional testing is required for subscales that did not demonstrate equivalence.