Influence of Device and Format: A Randomized Controlled Trial of an Electronic Health Record-Integrated Symptom...

The Symptom Screening in Pediatrics Tool (SSPedi) was integrated into the Epic electronic health records differently on the basis of completion using a computer or phone. Objectives were to determine whether completing SSPedi on a computer (multiple symptoms on a page) was easier or biased scores compared with completing SSPedi on a phone (one symptom per page).

We included patients with cancer who were age 8-18 years or guardians of patients with cancer who were age 2-18 years. Participants were randomly assigned to either complete SSPedi on a computer (multiple symptoms on a page) or a mobile phone (one symptom per page) first. After completion using the allocated device, participants completed SSPedi on the alternate device. Participants were then asked a series of questions focused on ease of use, preferences, and reasons behind discrepant scores between devices.

We enrolled 100 participants, 50 allocated to computer and 50 allocated to phone first. There was no significant difference in ease of completion between computer or phone first (P = .276). Overall, 54% (54/100) found the computer very easy to use, while 71% (71/100) found the phone very easy to use (P = .020). There was no significant difference in total SSPedi scores (median difference, 0, IQR, -1.00 to 1.25) reported using the computer versus phone. The phone was more commonly preferred (69% v 29%).

Completing SSPedi on a computer or phone, each of which presented SSPedi differently, did not affect ease of use or bias results. Although the phone was more commonly preferred, availability of SSPedi via both phone and computer will be important for implementation of routine symptom screening in pediatric patients with cancer to provide patients with flexibility that meets their preferences and needs.