A review of randomized controlled trials comparing the effectiveness of hand held computers with paper methods for data collection

Shannon J Lane,1 Nancy M Heddle,1,2 Emmy Arnold,1 and Irwin Walker 1

Introduction: The use of hand held computers in the healthcare industry is on the rise. More and more clinicians today are trading in the traditional paper method for data collection, for the more advanced handheld computer. The purpose of this study was to summarize the results of randomized clinical trials which compared the handheld computer to paper and pencil.

Source: NLM Gateway, an interface that searches multiple retrieval systems

Study Selection: During May 1, 2003 – June 2005, the NLM Gateway was searched using various keywords that would return publications relating to the comparison of handheld computers vs. paper and pencil for data collection. The search was limited to only publications in English. The publications retrieved were then reviewed by two reviewers. Publications still fitting the criteria were then included in the study. Outcomes: 201 potentially relevant studies were identified through this reviewing process. After reviewing the titles and abstracts of these studies, the list dropped down to 141 potentially relevant studies. From these 141 studies, only 9 met the final criteria. The results of the randomized controlled trials (RCT) from these 9 studies were then gathered in order to compare against one another. Three of the studies used a parallel randomized controlled trial, while the other six used a randomized cross-over design. The studies were then summarized based on data accuracy, timeliness, adherence, and patient preference. It should be noted that not all studies collected information regarding all of the aforementioned attributes.

Findings: Data Accuracy – Six studies evaluated data accuracy of the handheld computer vs. the paper and pencil method. The handheld computer came out ahead in all scenarios except for when data accuracy was defined by comparing missing and problematic data. The paper and pencil method came out ahead in this area. Timeliness – Four out of the nine studies retrieved reported outcomes which compared the two methods. The handheld computer succeeded in this subject. Adherence – Three out of the nine studies touched on adherence, however, only one study reported data results. The handheld computer was preferred by a landslide. Patient Preference – Four out of the nine studies examined patient preference. It was reported that 59% preferred the PDA, 19% preferred the traditional paper and pencil method, and surprisingly, 22% reported no preference.

Conclusion: The use of the handheld computer for data collection has been found to be a successful alternative to the paper and pencil method. In the great majority of subject matters compared in this investigation, the PDA came out strongly above paper and pencil. When deciding between taking a PDA route vs. a paper and pencil route, the potential for improvement and advancement should be a consideration. The handheld computer has a promising future ahead. Paper and pencil is in a solid state, and will not continue to develop.

Angela Vacca