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A randomized trial of electronic versus paper pain diaries in children: impact on compliance, accuracy, and
Tonya M Palermo1, Duaré Valenzuela, Paul P Stork
1Department of Pediatrics, Division of Behavioral Pediatrics and Psychology, Rainbow Babies and Children's Hospital, 11100 Euclid Avenue, Cleveland, OH 44106, USA Weatherhead School of Management, Case Western Reserve University, Cleveland, OH 44106, USA.
Insights
Electronic diaries (e-diaries) significantly improved compliance and accuracy for children recording pain and disability compared to paper diaries (p-diaries). Boys showed higher compliance with e-diaries.
Area of Science:
- Pediatric Pain Management
- Digital Health Technologies
- Clinical Research Methodology
Background:
- Electronic diaries are common in adult pain research but underutilized in pediatric populations.
- Assessing pain and disability in children requires reliable and accurate data collection methods.
Purpose of the Study:
- To compare the compliance, accuracy, and acceptability of electronic diaries (e-diaries) versus paper diaries (p-diaries) in children.
- To evaluate the feasibility of e-diaries for pediatric chronic pain research.
Main Methods:
- Sixty children (ages 8-16) with headaches or juvenile idiopathic arthritis were randomized to e-diaries or p-diaries.
- Data collected on diary completion rates, accuracy, and user acceptability.
- Analysis included comparisons of mean differences and gender interactions.
Main Results:
- Children using e-diaries completed significantly more diary entries (6.6 days) than those using p-diaries (3.8 days).
- E-diaries showed no errors or omissions, while p-diaries had significant errors and omissions.
- Both formats were rated highly acceptable; boys showed greater compliance with e-diaries.
Conclusions:
- Electronic diaries are a feasible and superior method for collecting pain and disability data in children.
- E-diaries enhance data accuracy and compliance in pediatric chronic pain studies.
- The findings support the adoption of e-diaries in pediatric research.
Abstract:
Electronic diary assessment of pain and disability has become increasingly popular in adult chronic pain research but use of this methodology with children has received limited attention. The aim of this study was to compare two formats of a prospective daily diary (handheld computer=e-diary; paper diary=p-diary) on children's compliance, accuracy, and acceptability ratings. Sixty children, ages 8-16 (M=12.3) with headaches or juvenile idiopathic arthritis, were randomized to receive either e-diaries administered via home visits (n=30) or p-diaries (n=30) handed out during clinic visits for return by mail. Results demonstrated significant mean differences in diary entries completed between groups, with children with e-diaries completing more days (M=6.6) compared to children with p-diaries (M=3.8), P<0.001. Diaries returned by children in the p-diary group contained significantly more errors and omissions compared to diaries returned by children in the e-diary group (which contained none), P<0.001. Children rated both diary formats as highly acceptable and easy to use. A significant gender x diary format interaction (P<0.01) was found for compliance where boys demonstrated greater compliance with the e-diary format. Findings demonstrated that the e-diary was feasible to use with children and showed significantly greater compliance and accuracy in diary recording compared to traditional paper diaries in a population of children with recurrent pain.
