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Do web-based follow-up surveys have a better response rate than traditional paper-based questionnaires following outpatient arthroscopic rotator cuff repair? A randomized controlled trial - 22/03/23

Doi : 10.1016/j.otsr.2022.103479 
Jules Descamps a, , Malo Le Hanneur c, Pierre-Alban Bouché d, Baptiste Boukebous a, Louis-Denis Duranthon b, Jean Grimberg b
a Orthopedics Department, Beaujon-Bichat Hospital, Paris University, APHP, 46, rue Henri Huchard, 75018 Paris, France 
b Department of Orthopedic Surgery, Clinique Jouvenet-Ramsay-Générale de Santé, Paris, France, Institute of Research in Orthopedics and Sports Surgery (IRCOS), Paris, France 
c Centre main épaule Méditerranée, Clinique Bouchard, Elsan, Marseille, France 
d Orthopaedic Department, Lariboisiere hospital, APHP, Paris, France 

Corresponding author.

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Abstract

Introduction

Considering the extensive use of smartphones in current societies, web-based applications could be considered as a new option for patient follow-up in surgery. By means of such tool, automated and periodic questionnaires could improve the rigor, accuracy and the comprehensiveness of postoperative monitoring, as well as early detection of complications, especially in the current context of evolving ambulatory surgery.

Hypothesis

The web-based surveys would improve the quality of immediate postoperative monitoring.

Material and methods

For 7 months, we included all patients who underwent outpatient arthroscopic rotator cuff repair. After preoperative randomization, each patient was asked postoperatively to complete either paper-based forms or digital questionnaires via a website (Orthense.com®, Digikare Inc. Blagnac, France). Both media (i.e. paper and digital) followed the same postoperative agenda (i.e., D+3, D+14, D+28, D+45, D+90) and had the same content, including pain and discomfort assessments, functional scores (i.e. Shoulder subjective value, simple shoulder test and auto-constant scores). The main objective was to investigate the quality of postoperative follow-up after outpatient arthroscopic rotator cuff surgery, using either printed questionnaires or web-based surveys. The hypothesis was that using a web-based survey would result in greater response rates and increased patient satisfaction regarding follow-up. Primary outcomes were questionnaire response rates at D+45 and D+90, while secondary outcomes were overall response rates, patient recommendation for the monitoring medium and overall patient satisfaction regarding their follow-up using the net promoter score (NPS).

Results

Among the 59 consecutive patients who were included, there were 27 females and 26 males with a mean age of 57±10.2 years; 27 patients completed the web-based survey (Group A) and 26 patients answered paper-based questionnaires (Group B). Regarding the D+45 questionnaire, response rates were 85.2% (n=23) in group A and 42.3% (n=11) in group B (p=.005); a similar significant difference was observed regarding the D+90 questionnaire, with response rates of 70.4% and 34.6%, respectively (p=.027). The mean NPS for the survey was 10 in Group A and 8.29 in Group B (p=.016). Overall, satisfaction regarding postoperative care did not differ between the two groups.

Discussion

Compared to traditional paper-based forms, web-based surveys appear to increase patient adherence to short-term postoperative monitoring. If these findings were to be confirmed in long-term follow-up, such straightforward and cost-effective tool could be of great use in clinical care and research.

Level of evidence

I; Randomized controlled clinical trial.

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Keywords : Outpatient, Monitoring, Shoulder, Web-based survey


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Vol 109 - N° 2

Artículo 103479- avril 2023 Regresar al número
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