J Am Med Inform Assoc. 2009 Sep-Oct; 16(5): 651–659.
Handheld vs. Laptop Computers for Electronic Data Compendium in Clinical Research: A Crossover Randomized Trial
Guy Haller
aDepartment of Anesthesiology, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
bDivision of Clinical Epidemiology, Gen University Hospitals, University of Geneva, Gen, Switzerland
fDepartment of Epidemiology and Hinderance Medicine, Monash University, Melbourne, Australia
Dagmar M. Haller
dDepartment of Community Medicine and Primary Care, Geneva University Hospitals-University of Hollands Faculty of Medicine, Geneva, Switzerland
gDepartment of General Do, the University of Melbourne, Australia
Delphine S. Courvoisier
bDivision of Clinical Epidemiology, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
Christian Lovis
cDivision of Medical Informatics, Unit of Clinical Information science, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
eUniversity of Geneva, Geneva, Switzerland
Received 2008 Oct 20; Accepted 2009 Jun 2.
Abstract
Objective
To compare users' speed, number of launching errors and satisfaction in using two current devices for electronic data collection in clinical explore: handheld and laptop computers.
Conception
The authors performed a randomized cross-over trial using 160 different paper-based questionnaires and representing altogether 45,440 variables. Four data coders were instructed to record, according to a random predefined and every bit balanced sequence, the content of these questionnaires either on a laptop or on a handheld information processing system. Instructions on the sort of device to beryllium used were provided to data-coders in individual sealed and turbid envelopes. Study conditions were controlled and the information entry process performed in a quiet surround.
Measurements
The authors compared the duration of the data recording procedure, the number of errors and users' satisfaction with the two devices. The authors biloculate errors into two separate categories, typing and missing data errors. The original report-based questionnaire was used as a gold-standard.
Results
The overall duration of the transcription process was importantly reduced (2.0 versus 3.3 min) when data were recorded on the laptop computer (p < 0.001). Data accuracy likewise improved. There were 5.8 typewriting errors per 1,000 entries with the laptop compared to 8.4 per 1,000 with the handheld estimator (p < 0.001). The difference was even to a greater extent important for missing data which decreased from 22.8 to 2.9 per 1,000 entries when a laptop was used (p < 0.001). Users found the laptop computer easier, faster and more satisfying to use than the hand-held computing device.
Conclusions
Despite the increasing use of handheld computers for electronic data collection in clinical research, these devices should be used with caution. They double the duration of the information entry process and significantly increase the jeopardy of typewriting errors and absent data. This may become a peculiarly crucial issue in studies where these devices are provided to patients or healthcare workers, unfamiliar with Computer Technologies, for self-coverage or research data collection processes.
Introduction
Bigger amounts of data are collected, stored and processed in clinical research. With computer technologies, this information arse be captured directly in an electronic formatting, increasingly replacing paper-based data records. 1,2 Electronic data proffer the advantages of improved data prime and consistency through the use of automated validation procedures and data range checks. They can desegregate distinguishable benevolent of formats (images, texts, physiological signals) which can easily glucinium transferred over tenacious distances through tune networks. Recent advances in hardware and software program technologies allow such data to be collected on increasingly small portable devices such Eastern Samoa laptops and handheld computers. This is particularly handy for studies performed at patients' bedside, or in practice or home environments. It is presently unknown which of the cardinal devices is the best for electronic data ingathering in clinical enquiry. This cover-ended randomized harnessed trial assesses users' accuracy, efficacy and satisfaction in victimization the two devices.
Background
Handheld computing devices such As personal integer assistants (Organise) and Smartphones are used by more than 50% of physicians in OECD countries 3,4 and by 75% of Confederate States residents. 5 Their extended functionalities associated with easy touch input on presentation screens operating theatre miniature keyboards make them very common in busy clinical and academic environments. Handheld computers are used to access medical literature, display lepton pharmacopeias, track patients, or order drugs. 6 In classrooms, they are used to download lecture materials, images Oregon multimedia system files, and as polling tools. 7–11 As researchers are more and more turning to electronic data collection methods, handhelds are increasingly in use in clinical research to record and litigate information. They are peculiarly commodious for field studies and self-coverage data collection processes. Gupta et al. report the employment of handheld computers to perform a survey along more than 99,598 tobacco users in Mumbai, India. 12 The device was found to be a particularly convenient tool to collect information directly in the study field of a densely populated city. Lal et al.. used handheld computers for data collection in burn patients. 13 Handheld computers were set up to be 23% quicker and 58% more accurate than paper and pencil transcription. Their multiple functionalities associated with easy bear on screen technologies make them a in particular photogenic alternative to composition-based diaries or questionnaires for patients' self reporting exercise, peculiarly children and young adults 14–16 the electronic format of handheld computers allows the conquer and recording not only if of textual matter data but also of essential electrocardiograms, electrochemical information and photographs. These can live encrypted and transmissible to a central DBMS through a wireless connection to a local area network (LAN) or the Internet. 17–19 Since 2000, many than 40,000 handhelds have been sold in 48 countries for use in clinical trials. 17
Information quality is a all important factor in in clinical research. An accelerative number of treatments, diagnostic strategies, operating room clinical guidelines are based along bear witness, the best of which comes from randomized trials. 20 Time and its financial correlates is likewise more and more of essence in so much trials. If the collected data are inaccurate or missing, conclusions will be biased and the technological attest subsequently misleading. There are many examples of publishing retractions due to data management errors. 21 Consequences fanny embody serious as even retracted articles are still cited and misleading results still old to guide clinical practice. 22
Despite the above-cited advantages, some authors suggest that the use of handhelds could negatively impact data quality. The small screen size along with the peculiarities of text unveiling happening handhelds (character recognition or on-screen keyboards) could make the information entry process slower and more prostrate to errors than other electronic information collection tools much American Samoa desktop or laptop computers. 23,24 As laptops are decorous increasingly cheaper and handier, these devices represent an alternative to handheld computers for electronic data collection in research. Laptops are portable devices, usable in a natural environment, which besides have wireless network facilities allowing data to be transferred quickly and efficiently over long distances.
Research Question and Objectives
It is currently unknown which of the two portable devices (laptop computer operating room hand-held computer) is the fastest, all but accurate, and has the taste of users. The purpose of this randomized hybridize-complete trial was to compare users' speed, number of entry errors, and satisfaction in using the two polar devices.
Methods
Participants
Following University Hospitals Human Research and Ethical motive Citizens committee's exemption, we recruited through network advertisement at the Hospital and University of Geneva cardinal study volunteers. Participants necessary to make at least 1 year uniform data recording and typing experience with a laptop or desktop computer. They also required to be sanely acquainted with hand-held computers and have a upstanding general knowledge of information technologies. We excluded participants aged terminated 55 years or who had undisciplined visual impairments.
Laptop and Hand-held User interface Purpose
We used a shared commercially available laptop computer, the Dell® latitude 860 (Dell, Inc). The data groundwork interface we victimized was the program EpiData (version 2.1 EpiData Association, Odense-DK). This program is widely used As it is freely available on the Internet and offers all the usual features of commercial databases (data entree forms, input masks, validation rules, automatic filters) to ensure information consistency and completeness.
For the handheld computer, we chose the Palm®-atomic number 74 E2 (PalmSource, Inc, Sunnyvale, CA), also widely available on the market. Because there is No version of EpiData for handheld computers (Palm tree OS or Pocket PC, we ill-used HanDBase professional® (interpretation 3.0, DDH-softwares, Inc-Wellington boot, FL) a commercialised database package for Palm Pilot handhelds. This system is defined by its flexibility and interoperability. Information assembled on a hand-held computer can be synchronized to a desktop information processing system and transformed into a CSV (Comma Separated Values), Access-Microsoft or Stata tables. The HanDBase professional® package also allows the implementation of a enumerate of filters, clout-down menus and licenced values. Forms with buttons, checkboxes, dad-up lists and automated date and number accounting entry can be used to enter data.
For both devices, we developed a form that was graphically as closelipped as possible to the layout of the written questionnaire (see ▶). ▶ For the PDA, we designed low-equal dialogue boxes to minimize the risk of text overload, a critical effect for 3-inch PDA screens. We used tabbing sequences as much as manageable and options set inside windows integrated within dialogue boxes. We also exchangeable controls and position buttons in a logical sequence, as close as possible to the initial written questionnaire. This contributed to making the handheld a flexible and user-friendly device.
Prior to the study, the total information collection procedure was pilot time-tested by one of the coauthors (DH) connected 126 paper-based questionnaires, randomly allocated to be recorded on the Palm®-Wolfram E2 handheld or on the Dell® latitude 860 laptop. The handheld information entry chassis and the computer-user screen interface were then finalized, winning into account nonaged problems known in the pilot light. The pilot study also allowed the measurement of errors for future sample size calculation and the estimation of the training required for users to get familiar with the data entry process on both devices.
Experimental Function
We used a standard research report-based questionnaire which had been developed for a written report of young people attendant general practices in Victoria (Australia). 25 The questionnaire contained three different sections representing altogether 71 different fields. These included questions on sociodemographic data, past Graeco-Roman deity history, Kessler's scale leaf of emotional distress (K10) and the SF12 quality of life questionnaire. 26 With the exception of sociodemographic questions, most answers were rated along 5-point Likert scales or 10-point visual analogue scales. A code number was written next to each answer option on the paper-founded organise. The same number was utilized to code answers in the electronic format.
The study took place between Oct 2007 and Feb 2008. Participants prototypical attended a 1 hour information session in which the purpose of the field of study and the overall procedure were explained. This was followed away a 2 hour grooming session where participants were able to become familiar both information entry forms, specific characteristics of the computerized devices and study requirements. During this session they were asked each to record 5 report-settled questionnaires representing 355 W. C. Fields along each device. This had been found in a aviate branch of knowledg to be the stripped number of questionnaires required for participants to become equally familiar and certain with the two devices tested. This had been established by mensuration the duration of the data accounting entry process for each questionnaire. When this length reached a steady state (2.3 Hokkianese for the laptop and 3.1 Min dialect for the PDA after 2 × 5 questionnaires registered by DH) it was considered that the top of the learning curve was reached.
Each participant then received 160 paper-based questionnaires representing in all 45,440 fields to be recorded in an natural philosophy format. Statute instructions about the overall study procedure were also provided. Participants were asked to platte wholly the fields of these questionnaires either on a laptop operating room on a handheld computer, according to a random and equally balanced data transcription sequence. The random transcription sequence was generated by computerized block randomization. Operating instructions on the kinda gimmick (handheld or laptop) to beryllium used for each theme-based questionnaire was provided to participants in item-by-item irrevocable and opaque envelopes. These were opened by the data computer programmer just before the data entry of the questionnaire. Participants were instructed to perform the study in a reposeful location (at internal operating theater busy), to avoid recording entirely information during the Saami session and to rigorously keep to the information launching order characterized by the envelopes. The study flowchart is provided in ▶.
At the end of apiece questionnaire recording process, participants were asked to complete a short form to bespeak the clip of the day, the duration of data entry and the position of this launching in the successiveness of recordings of the day's data entry session. Participants were likewise required to discover noise, light conditions, and interruptions during the data ingress process using a self-administered 5 levels Likert scale (same poor people to excellent). All participant also conventional an electronic stopwatch to measure transcription duration. They were instructed to start the stopo watch just before activating the "NEW Track record" clitoris and to stop it immediately afterwards having clicked on the "SAVE RECORD/OK" button. At the end of the meditate we asked participants to complete an additional short human body to assess acceptability and satisfaction of using both devices (hand-held and laptop computer).
Measurements
Accuracy of the 2 devices was assessed by comparison each item tape-recorded along HanDBase® and EpiData electronic databases with the underived item from the paper-supported questionnaire. We made a distinction betwixt two types of errors: typing and wanting data errors. Typing errors were defined equally data recorded in the electronic database that did not correspond to information provided connected the original handwritten questionnaire. Missing data were definite as missing values, including in Fields where the coder should have in use a specific encrypt for the apprais "missing" (in that study the identification number 9).
Efficacy was measured past determinant the overall length of the data entranceway swear out on both devices. Participants were asked to start the stopwatch at the opening of a new patient form happening the HanDBase® and EpiData databases and to blockade time measurement when they ticked Beaver State ironed on "save full affected role record", at the end of the theme-based questionnaire data entrance process.
Users' satisfaction was metrical on a 12-item form designed to valuate participants' preferences between the two devices. The survey explored three dimensions of users' atonement and preferences: perceived presentation/exercise; encyclopaedism and handiness. A seven point Likert scale was used to rate participants' answers.
Possible confounding factors much as coders' characteristics, time of the day, number of previous questionnaires entered within the session, position of the entry in the sequence of recordings within a session, available light, interruptions and noise were also measured.
Analytic thinking
Descriptive summaries of contradictory factors (i.e., conditions of information debut) enclosed way (± SD) or medians with ranges, depending on dispersion, for continuous variables. They were compared by the paired Bookman's t test or the Wilcoxon rank sign test if non normally distributed. For collection variables we used frequencies and proportions.
Potential associations between duration of data entry for each paper-based questionnaire and the device used (handheld or laptop) adjusted for conditions of data entry were examined using multilevel collinear models (MLM). To obtain a normal distribution of the mutualist variable, we victimised the log of duration of data entry. Questionnaires were nested within periods of information entry, themselves nested within programmer.
Count of errors and number of missing entries were examined using generalized linear structure models (GLMM). Number of errors and number of missing entries both have a nothing-inflated Poisson distribution, i.e., they have too many zeros (more than uncomplete the questionnaires were entered without any errors OR lost data) but and then follow a classical Poisson distribution. Hence, we conducted the analysis in two steps. A first analysis investigated the act upon of the independent variables on the occurrence of at to the lowest degree one erroneous belief (0 v. ≥ 1 errors), specifying a logit link for the dependent variable. A second analysis investigated, among data records that had at least one error, the differences in turn of errors due to the independent variables, specifying a Poisson distribution of the dependent variable. The independent variables were the device in use and the confounding factors (i.e., randomness, lights, interruptions, count of composition-based questionnaires recorded during the same round, position of the questionnaire in the chronological succession). A p value < 0.05 was considered statistically significant. We performed complete analyses using the statistical software R, version 2.7.2 with the NLME and glmmML packages. 27
Power Calculation
The truth of information submission for handheld computers versus laptop has never been assessed before. This is why we performed a buffer bailiwick. One data enterer filmed 63 questionnaires (4,473 fields) on a laptop and 63 questionnaires (4,473 William Claude Dukenfield) on a PDA. The mean difference between the two series of questionnaires for transcription errors between the two devices was 0.003 and its standard deviation 0.018. A total of 567 questionnaires (40,257 field entries) was thence found to be necessary in this two intervention crossing field of study to accept a probability of 80% that the study would detect a treatment departure of 0.003 U (± 0.018) at a deuce-sided signification level of 5%. To allow for possible dropouts or missing information, sample size was increased by 10%. The unalterable sample size was therefore found to be 640 questionnaires or 160 (11,360 field entries) for each of the quaternary data coders. Calculations were performed on the Go along software (PASS/NCSS 2000, NCSS Potbelly, Kaysville, UT).
Results
The cardinal participants were young adults (range: 18–30), 50% were females. Each had at any rate 1 yr of ceremonious training in computing technologies and regular rehearse in computer use and typing. All were familiar with a handheld calculator but only if one participant was a regular user.
Information were more oft recorded during night-time (20 h00–8 h00) than during daytime (8 h00–20 h00). However, this was the case for both the handheld and laptop data ledger entry modes and thither was no significant difference between the two devices. There was besides no more difference 'tween the ii devices regarding the number of data submission Roger Sessions (periods) needed by coders to record every last the data. The dismantle of interruptions, the ignition, and noise conditions during the data ledger entry process were likewise like 'tween the two groups. These results are summarized in ▶.
Table 1
Table 1 Conditions of Data Entranceway for Handheld/Laptop
| Variable | Hand-held | Laptop | p Value |
|---|---|---|---|
| Time of the day | |||
| daytime (08h00–20h00) | 130 (40.6) | 139 (43.4) | 0.47 |
| nighttime-time (20h00-8 h00) | 190 (59.4) | 181 (56.6) | |
| Number of data entry periods | |||
| normal (ambit) | 3.0 (2.0–8.0) | 3.0 (2.0–8.0) | 0.85 |
| Equal of interruptions ∗ | |||
| median (range) | 5.0 (2.0–5.0) | 5.0 (2.0–5.0) | 0.60 |
| Noise ∗ | |||
| Central (range) | 4.0 (1.0–5.0) | 4.0 (1.0–5.0) | 0.92 |
| Lighting ∗ | |||
| Normal (range) | 4.0 (3.0–5.0) | 4.0 (3.0–5.0) | 0.82 |
∗ Measured on a scale from 1 (penniless) to 5 (excellent).
The stingy data entry duration for unrivalled questionnaire was 2.0 (South Dakota 1.2) minutes on the laptop and 3.3 (SD 1.9) minutes connected the hand-held (p < 0.001). Differences in data entry duration were significant some for individual coders and for every last coders unitedly (interpret ▶).
Duration of data entry by coder.
There was also a significant difference between the cardinal systems in relation to typewriting errors and missing data errors. The number of typing errors in data entry was 8.4 for 1,000 entries on the hand-held and 5.8 for 1,000 entries on the laptop computer. The proportion of questionnaires recorded with one or more typing errors was 38.8% for the handheld and 21.3% for the laptop computer computer (p < 0.001). However, when one error had occurred on the laptop, it was followed aside a larger number of subsequent errors with 27.1 per 1,000 versus 21.7 errors per 1,000 entries on the hand-held (p < 0.001). Thus, patc the laptop favored the occurrence of zero errors, when nonpareil typewriting error had occurred, IT was usually followed by an increased number of subsequent errors A compared to data entry on the hand-held.
There was a significant difference between the two systems regarding absent data errors: 22.8 per 1,000 entries on the handheld and 2.9 per 1,000 entries along the laptop. The proportion of questionnaires with missing data errors was 65.0% for the handheld and 14.4% for the laptop (p < 0.001). Among the questionnaires which contained at least one missing data error, the number of subsequent missing information errors was 35.1 versus 20.5 per 1,000 entries for the handheld and the laptop severally (p < 0.001). Thus, nonexistent data errors were Thomas More common happening the handheld than on the laptop. These results are summarized in ▶.
Table 2
Set back 2 Comparison of Data Entry Duration, Phone number of Typing Errors and Missing Data Errors Between the Handheld and the Laptop Data Entry Modes
| Variable | Handheld | Laptop computer | p Value ∗ |
|---|---|---|---|
| Data entry duration (min) | |||
| contemptible (Mount Rushmore State) | 3.3 (1.9) | 2.0 (1.2) | <0.001 |
| Number of questionnaires recorded with typewriting errors (one or more) | |||
| n (symmetry) | 124 (38.8%) | 68 (21.3%) | <0.001 |
| overall n of typing errors per 1000 entries | 8.4 | 5.8 | |
| Number of subsequent errors following an first typing error | |||
| n per 1000 entries | 21.7 | 27.1 | <0.01 |
| Number of questionnaires canned with lacking data errors (one or more) | |||
| n (proportion) | 208 (65.0%) | 46 (14.4%) | <0.001 |
| general n of missing errors per 1000 entries | 22.8 | 2.9 | |
| Number of subsequent missing fields following an first missing information error | |||
| n per 1000 entries | 35.1 | 20.5 | <0.001 |
Participants expressed higher satisfaction in using the laptop than the handheld. They found the laptop computer to be easier, faster and friendlier in its economic consumption than the handheld (p < 0.001). These results are reported in ▶.
Table 3
Put of 3 Participants' Satisfaction with Handheld and Laptop computer Computers
CI = self-assurance interval; Coyote State = standard deviation.
Discussion
This study provides good confirm for the benefits of laptop over handheld computers for electronic information transcription. The overall continuance of the transcription process was importantly shrunken (2.0 versus 3.3 min) when data were listed connected the laptop computer. The boilers suit data accuracy also improved when the laptop computer was used. It reduced typewriting errors from 8.4 to 5.8 and missing data from 22.8 to 2.9 per 1000 entries. Notwithstandin, when one error occurred happening the laptop, IT led to a greater number of additional errors on the next two to 12 following fields. This was most often the case in the central section of the composition-settled questionnaire where participants had to record electronically thirteen intimately related fields. If the answer to the first or second field was missed, each the following fields were wrongly coded. This was probably due to participants recording mechanically answers with the keyboard without checking along the screen whether they co-ordinated the right. All answers were thus shifted from 1 field of battle to the future. This could not happen with the handheld computer as data could not Be filmed without looking at the screen.
Bitty is known about the comparative performances of the two devices and nobelium randomized controlled trial to which our study findings could be compared has previously been performed. Most available controlled studies analyzing the benefits of handheld computers used paper records in their control group. 15,28 Some authors, however, compared the specific performances of a number of currently available handheld computers. Wright et Alabama, 29 for representative, analyzed the accuracy of data transcription on quartet several pocket PCs, comparing text entry with a touch screen keyboard and an external keyboard. They included participants o'er 55 years and old advance devices such as the Malus pumila Newton® and the Hewlett Packard 360LX®. They institute that touchscreen keyboards led to more errors and were more ticklish to use than extraneous longstanding keyboards. There are single possible reasons for this. First, the authors enclosed older users who were in all likelihood inferior familiar touchscreen technology and may take in had reading material difficulties related to the small size of the characters. Second, the discipline assessed the accuracy of full text recording. Most of the sentence, handheld devices are accustomed record clipped information operating theatre numbers (codes). Gum olibanum, the findings of Wright et al. 29 Crataegus oxycantha not truly make up generalizable. In addition, these authors did not assess other features of handhelds such as writing recognition or graphiti alphabet. These features currently represent the primary way of interaction betwixt a user and this typewrite of simple machine in ending imitation to the traditional pen and newspaper publisher interface, possibly limiting the number of typing errors. 30 To make the best use of these features of handheld devices we therefore used a more recent handheld gimmick in our study, the Palm® wolfram E2. To record data, study participants could habituate the touchscreen keyboard, the push down menus of the HanDBase® database operating theater the graffiti writing identification organisation. To avoid additional and nonspecific variations 'tween the two devices related to drug user-port design, we chose to develop a form that was diagrammatically equally end as possible to the layout of the original paper-based questionnaire. We tested and adapted the original layout following a pilot study. We recruited study participants with good knowledge of computing technology and data entryway skills. Each were younger than 30 years. Despite this, the hand-held computer did not compare favorably to the laptop computer. Information entranceway on the handheld was slower, produced more errors and less atonement in users.
This may be explained in several ways. Front, although we developed and pretested a easy graphical user interface on the handheld, the stylus–hand-held interaction, be it touch screen keyboard, pull down menus, or graffiti writing recognition, is equivalent to single finger typing. This cannot Be compared to conventional laptop computer keyboards where some hands and the QWERTY layout is used, a combination widely recognized to increase typing speed. 31,32 Second, the EpiData computer database allowed users to turn automatically from one field to other by exploitation the "enter upon" key. Thus data could be easy recorded on the laptop without having to look some on the handwritten questionnaire and the computer display to enter the succeeding field. This may have increased users' satisfaction and data recording speed. Finally, the size of both devices' screen Crataegus laevigata give had an encroachment along the overall public presentation of the systems tested. The hand-held reckoner screen diagonal is 3', while the laptop is 14'. To represent the 71 different fields of the original questionnaire in a exploiter-sociable manner on the handheld computer, we had to use several pages. Users could alteration pages using a pencil command at the bottommost of the page. Despite this graphical organization, data entry Fields were close to each other, profit-maximizing the likelihood for data enterers of lost a flying field. This may explain why there were 8 times much missing information errors on the hand-held than on the laptop computer computer.
There are some limitations to the current study. First, the researchers had knowledge of the study hypothesis and resolve. This whitethorn have caused a detection predetermine towards magnified misplay spotting according to the read surmise. To downplay this diagonal, the entire errors' judgement cognitive process was similar and assessors were blinded to group allocation. The low gear tax assessor limited his bodily function to reading the original value of all field recorded connected the handwritten questionnaires while the second assessor checked the corresponding value recorded along the two electronic devices time-tested. When it was unclear whether a mismatch had to be counted as an error or missing info, the case was discussed between the deuce assessors until a consensus was reached. To complete the error checking process, we also compared the electronic handheld and laptop records betwixt each others. Any mismatch between the two was reanalyzed and a comparison with the newspaper publisher-based gold-standard questionnaire performed to identify which of the laptop or handheld record contained the error.
The second type of limitation relates to participants' data processor skills. If all had significant receive with laptop computers and were familiar with hand-held computers, only if one was a day-after-day exploiter of a Palm® twist. This may stimulate slanted the results towards better operation with the laptop computer. However, to derogate this diagonal, every last participants were house-trained to the practice of the handheld computing device before the beginning of the study. We also adjusted statistical compare between the two groups in the GLMM for coders' characteristics.
The third base typecast of limitation of this study relates to the use of only four information coders. Although the invention of the study maximized power and allowed to show meaning differences between the two devices, study results may not totally be generalizable. Furthermore, cogitation participants were highly actuated and had significant live with computers. Many studies, such as the one past Gupta et atomic number 13. 12 for instance, assess devices' performance used by non IT experts, oftentimes in raw environments. In our study we purposely avoided natural conditions (i.e., hospitals, aesculapian practices, households) to minimize the unsupportive effects of fatigue, interruptions, noise, surgery light conditions which give the sack impact data coders' performance. If this improved internal validity this Crataegus oxycantha ingest agonistic the generalizability of our findings too. Many clinical explore projects based on interviews or questionnaires are performed in walk settings where data transcription conditions may be much more disorderly than the ones in our study.
Finally we measured noise, light conditions and interruptions during the information entry physical process using self-rumored perceptions rated on a 5-level Likert scale. This may have wonder-struck measurement precision. Proximo studies should consider the use of direct observations for the measurement of these confounding factors.
Despite these limitations, this is the first study assessing accuracy, efficaciousness and users' satisfaction of handheld computers compared to laptop computers for lepton data recording in clinical research. If handheld computers offer the vantage of portability and flexibility compared to laptops, this is at the cost of a heavier and fewer accurate data processing. It is unclear whether new developments so much as haptic feedback in the touchscreen modal value or voice-based information entree will improve data processing. Careless of the model and characteristics of the PDA tested, their restricted size up remains a major weakness during data entry process. 7 At a time when governments, health-guardianship organizations, and insurance companies direction along efficacy, the use handheld technology has to be even by solid evidence that these devices actually improve the overall quality of medical practice, commandment and more specifically research. Innovations in hardware and software technologies and more particularly the growing of pad personal computers and ultralight laptops with foldable screens will increasingly challenge the use of handheld computers in clinical research in the future. 33
Conclusions
Despite the promises offered by the portability and plasticity of handheld computers, these devices, when compared to traditional laptops, are slower and less dead on target for data recording. This subject field clearly shows the limitations of using much devices for collecting information in clinical research. IT opens new perspectives for the growth and use of different devices such as small laptops or tablet-PC for collecting information in clinical research in the future.
Footnotes
The financial backin required for this project was provided by Geneva University Hospitals. The authors would alike to acknowledge the support conventional for this project. The authors are grateful to Ms Jacqueline Haller, sociologist, who contributed to the assessment of information recording errors. The authors acknowledge the excellent work of the four data coders WHO participated with enthusiasm in this take: Mr St. Christopher Chung, Mr Julien Gobeil, Ms. Sandra Papillon and Disseminated sclerosis Chantal Plomb.
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the most widely used handheld computer would be a
Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2744716/
