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Revista Española de Cirugía Ortopédica y Traumatología (English Edition)
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Original Article
Level of response to telematic questionnaires on health-related quality of life on total knee replacement
Nivel de cumplimiento vía telemática de cuestionarios relacionados con la calidad de vida en artroplastia total de rodilla
M. Besalduch-Balaguera,
Corresponding author
mbesalduch@santpau.cat

Corresponding author.
, X. Aguilera-Roiga, G. Urrútia-Cuchíb, A. Puntonet-Brucha, M. Jordan-Salesa, A. González-Osunaa, F. Celaya-Ibáñeza, J. Colomina-Moralesa
a Servicio de Cirugía Ortopédica y Traumatología, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain
b Servicio de Epidemiología Clínica y Salud Pública, CIBERESP, Hospital de la Santa Creu i Sant Pau, Instituto de Investigación Biomédica Sant Pau, Barcelona, Spain
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efforts are also made to collect data on patients&#8217; quality of life&#44; using self-assessment questionnaires which refer to health-related quality of life &#40;HRQOL&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">These questionnaires must be reliable and quantify the impact of medical interventions on patients&#8217; quality of life in the most objective and accurate manner possible&#44; providing a starting point from which to assess and improve our activity&#46; Furthermore&#44; they help to respond to public demand in order to achieve relevant outcomes&#46; Finally&#44; they provide a tool for weighing up the cost&#8211;benefit of these interventions&#59; without them a significant part of scientific literature would lose its validty&#46;<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">1&#8211;4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Patient&#39;s quality of life assessment is not a standard procedure in our speciality&#44; not least because of the difficulty in collecting data due to lack of time and familiarity with the questionnaires&#46; The desire therefore exists to develop strategies based on the use of communication technologies in order to respond to this need&#46;<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">5&#44;6</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">This study was designed for patients scheduled to undergo total knee replacement surgery &#40;TKR&#41;&#44; the main objective being to evaluate their ability to respond telematically in a satisfactory manner to HRQOL questionnaires&#46; The secondary objective was to create a valid and reliable electronic platform so that these HRQOL measures could be routinely obtained in normal clinical practice&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Material and methods</span><p id="par0030" class="elsevierStylePara elsevierViewall">A unicentric&#44; transversal observational study was carried out on a consecutive cohort of patients scheduled to undergo TKR in the Hospital of Santa Creu y Sant Pau &#40;University Hospital of Barcelona&#41;&#46; The study protocol was approved by our hospital&#39;s ethical committee of clinical research &#40;code number&#58; IIBSP-OUT-2012-01&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Patients undergoing TKR were selected because this is one of the most standard surgical procedures in our OTS department&#44; and because it has a high impact on patients&#8217; quality of life&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">7</span></a> It should be taken into consideration that this type of patient is highly affected by their condition&#44; causing them limitations in their daily lives&#44; and we therefore believed they would be more than willing to participate in the study&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Patients were recruited between March 2012 and March 2013&#46; During the preoperative outpatient visit to the OTS department&#44; patients were informed in detail about the study&#44; and they were offered the possibility of participating&#44; regardless of whether they had access to the internet or not&#46; Information was verbally communicated&#44; always by the same person &#40;co-author of the study&#41;&#44; and patients were given a detailed information sheet about the study&#44; for which their informed consent was obtained&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Those patients who refused to take part in the study were asked to provide details of their reasons&#44; without this being detrimental or harmful in any way to their treatment or clinical follow-up of their condition&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">A website was contracted for the survey&#46; During the above-mentioned preoperative visit&#44; those patients who decided to participate were given the access code to the website &#40;<a href="http://www.surveymonkey.com/TKRSANTPAU">www&#46;surveymonkey&#46;com&#47;TKRSANTPAU</a>&#41; and the private user code to respond to 2 HRQOL questionnaires&#44; in addition to a survey for evaluating their perception of the difficulty of accessing HRQOL telematically&#46; They were asked to fill in the questionnaires prior to surgery&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">From among the great variety of available questionnaires we chose those most regularly used in OTS<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">8&#44;9</span></a> &#40;the shortened versions&#41;&#58; the WOMAC questionnaire of 7 items validated in Spanish&#44;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">2&#44;3&#44;10&#44;11</span></a> and the general SF8 quesionnaire&#44;<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">8&#44;12</span></a> to assist in its completion&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">2&#44;4</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">The additional survey consisted of 3 questions aimed at assessing the degree of difficulty in accessing a computer with Internet connection&#44; the need for help to go on-line and to fill in the questionnaires&#44; and the perception of the level of difficulty of the questions in both questionnaires&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Prior to the study&#44; 10 patients completed a pilot test&#44; aimed at detecting possible problems or errors in the telematic platform where the questionnaires would be filled out&#44; and also the viability of the study&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">The information recorded in the telematic platform was collected and analysed&#44; with 2 possible patient categories being determined&#44; those who were &#8220;capable&#8221; and those who were &#8220;incapable&#8221; of completing all the questions on the questionnaires&#44; regardless of the number of attempts made and whether they had received external assistance in completing them&#46; This definition is based on the premise that the HRQOL are only useful when all items are completed&#46; In addition&#44; the patients classified as &#8220;incapable&#8221; were divided into 3 subcategories&#58; &#40;1&#41; those patients who since the beginning had decided not to participate in the study&#59; &#40;2&#41; those who after accepting&#44; had not accessed the website&#59; and &#40;3&#41; those who accessed the website but did not complete the questionnaires&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Once the study came to an end we contacted the &#8220;incapable&#8221; patients who had initially consented to participate &#40;corresponding to categories 2 and 3&#41;&#44; to find out the reason why they had not been able to complete the questionnaires&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">All data were collected anonymously and treated confidentially using the telematic platform&#46; They were subsequently evaluated by the epidemiological department in our hospital&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Statistical analysis</span><p id="par0085" class="elsevierStylePara elsevierViewall">According to our hypothesis&#44; and assuming a priori a response rate of 80&#37; and precision rate of 8&#37;&#44; the sample size was fixed at 97 patients&#46; We decided to include all consecutive patients assessed in the preoperative TKR visits from March 2012 up to the completion of an &#8220;<span class="elsevierStyleItalic">n</span>&#8221; of 100 patients&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">The statistical programme SPSS was used for analysis&#46; Patient percentages in each category &#40;&#8220;capable&#8221; and &#8220;incapable&#8221;&#41; and in the established subcategories were calculated&#46; These were compared using the Chi-squared test&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">For the comparison of the patients&#8217; mean age&#44; an analysis was performed using Student&#39;s <span class="elsevierStyleItalic">t</span>-test for independent samples and equal variances&#46;</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0100" class="elsevierStylePara elsevierViewall">Of the 100 cases initially selected&#44; 2 were subsequently excluded because they were repeated &#40;they were erroneously given 2 codes&#41;&#44; with 98 valid patients in total&#46; Mean patient age was 72&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#46;02&#44; with a range between 49 and 87 years of age&#46; Of these&#44; 14 refused to participate&#44; indicating as their main reason the impossibility of accessing the Internet&#44; whilst 84 patients &#40;85&#46;7&#37;&#41; did accept&#46; Out of these&#44; 42 patients &#40;50&#37;&#41; finally indicated that they would participate but then later did not access the website&#44; 6 gained access to the website but did not know how to respond or only partially responded to the surveys and the remaining 36 patients responded completely to the questionnaires &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Consequently&#44; only 37&#37; of the participants were considered capable of satisfactorily responding telematically to the survey&#44; as opposed to the 80&#37; assumed in our initial hypothesis&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">The mean age of the 36 capable patients was 71&#46;1 &#40;8&#46;3&#41;&#44; compared with 73&#46;7 &#40;&#177;&#41; of the incapable ones&#59; this difference was not statistically significant &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;085&#41;&#46; There were no significant differences regarding gender either &#40;37&#46;7&#37; females and 35&#46;6&#37; males&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;823&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">Of the 62 patients &#40;63&#46;2&#37;&#41; considered incapable&#44; only 14 &#40;22&#46;6&#37;&#41; stated in the preoperative visit that they would not participate in the study because they had no Internet access&#46; Of the remainder who did agree to participate in the study&#44; 42 &#40;43&#37;&#41; did not access the Internet and the response of 6 &#40;9&#46;6&#37;&#41; was incomplete&#46; Of the 42 patients who had accepted to participate in the study but did not access the Internet&#44; 19 &#40;30&#46;6&#37;&#41; reported they had difficulties in doing so&#44; 9 &#40;14&#46;5&#37;&#41; forgot to do the survey despite having access to the Internet&#44; 2 did not know how to get onto the website&#44; one changed their mind and decided not to participate and one stated that the website did not work&#46; It was not possible to contact another 10 patients to find out the reason why they had not participated in the survey&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">The 36 who were capable of satisfactorily completing the questionnaires&#44; responded to the additional evaluation survey on the difficulty of access to the website and its content&#44; and whether they required help in completing it&#46; Of these&#44; 28 &#40;77&#46;8&#37;&#41; indicated that responding telematically to the survey presented no major difficulty for them &#40;15 responded normal&#44; 5 easy and 8 very easy&#41;&#46; A great majority &#40;30&#41; indicated they had received help from a family member&#46; With regard to survey content&#44; only one patient stated that they had found it very difficult&#46; Finally&#44; 27 &#40;75&#37;&#41; completed the survey at a single attempt &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0120" class="elsevierStylePara elsevierViewall">Of the patients who underwent TKR in our hospital&#44; a very much lower percentage than expected were capable of satisfactorily responding telematically to the quality of life questionnaires &#40;36&#46;7&#37;&#41;&#44; despite the fact that the majority of patients stated they had Internet access&#46; For a variety of reasons&#44; approximately one-quarter of the participants were incapable of completing the questionnaires despite having Internet access&#46; In our study&#44; although 61&#46;5&#37; reported they had access to the Internet&#44; the majority required external aid to complete the questionnaires&#44; and a cultural component therefore came into play which we had not evaluated regarding the availability or predisposition of family members and&#47;or friends to help the survey participants&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">One possible explanation for the low rate of completion of the telematic survey in our study could be the advanced age of the patients &#40;mean age of 72&#46;7 years&#41;&#46; According to the National Institute of Statistics&#44;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">16</span></a> in this age range&#44; the percentage which accessed Internet in the last month was 12&#46;9&#37;&#44; as opposed to 92&#46;9&#37; of the population aged between 16 and 24 or 82&#46;8&#37; of those aged between 25 and 34&#46; This indicates a marked negative tendency to use the Internet as one gets older&#46; It is possible that the outcome would have been different in other pathologies in younger patients&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Despite the above&#44; we were unable to observe any differences regarding age or gender which could explain the differences between the patients who were capable and incapable of satisfactorily completing the questionnaires&#46; Other variables of potential interest such as educational or socio-economic level were not evaluated&#44; since no information was available in this regard&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">With the appearance of new technologies and the extension of Internet usage&#44; new systems have been established for self-completion of HRQOL questionnaires telematically&#46;<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">6&#44;13</span></a> Collection of this valuable information is generally difficult and is inconvenient for professionals&#44; especially because of the huge amount of time and resources required&#44; and because they are not accustomed to it&#44; many orthopaedic surgeons choose not to do so in the majority of cases&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">3&#44;15</span></a> It was therefore assumed that using the Internet would improve completion&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Notwithstanding&#44; according to Keurentjes et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">17</span></a> there is a clear preference for patients who are to undergo knee and hip replacement operations to respond to questionnaires in paper format &#40;86&#46;8&#37; and 81&#46;8&#37; respectively&#41;&#46; However&#44; we consider that for our specialty&#44; although patients may have this preference&#44; it would be feasible for them to be equally capable of responding to surveys telematically&#44; especially bearing in mind increasing Internet usage&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">By using this technology&#44; information is directly introduced by the patient&#44; reducing the time they spend in the surgery and avoiding human transcription errors&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">It has been shown that patients familiarised with the use of these technologies respond to telematic questionnaires in less time than written or telephone ones&#46; Help windows may be added to facilitate comprehension&#44; providing additional information in response to possible doubts&#46; Moreover&#44; periodic reminders may be sent via email&#44; SMS or similar means&#44; to ensure their completion and alerts may be incorporated into the survey itself to detect when information is incomplete or the recorded responses are incorrect&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">15</span></a></p><p id="par0155" class="elsevierStylePara elsevierViewall">Notwithstanding&#44; prior to coming to a decision on the systematic recording of data using this method&#44; we would have to explore the possible difficulties which may limit its viability&#44; such as the barriers patients have in accessing new technologies&#44; their inability to use them and the difficulties in correctly completing the questionnaires or the lack of assistance&#44; particularly by family members with a higher level of competence in Internet usage&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">One must take into account that the percentage of homes with Internet access in Spain is lower than the other EU countries &#40;67&#37; compared with 76&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">14</span></a> Furthermore&#44; predictably&#44; older patients have greater difficulty using it and in completing questionnaires&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">There are studies which argue that the cost of carrying out this type of questionnaire is lower than paper-based ones&#44;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">18</span></a> although other studies support the fact that the cost of the questionnaires using this type of platform would depend on the sample size&#44; larger samples being more profitable or beneficial&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">15</span></a> In our case&#44; there was no evaluation of this type at the start of the study and therefore no calculation could be made&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">It is probable that there will be a trend towards an increase in access to new technologies in Spanish homes&#44; as has occurred up until now&#44; thus increasing the capacity to respond to medical online surveys&#44; when the population around us is more familiar with Internet usage and IT devices&#46; The generations which currently use this type of technology will be our future study samples and probably fewer difficulties will be encountered for completing this type of survey&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">The application used for completing the questionnaires was the website <a href="http://www.surveymonkey.com/">www&#46;surveymonkey&#46;com</a>&#46; Despite being a reliable and confidential site&#44; probably the fact that it is external to the hospital leads patients to being somewhat reluctant to use it&#46; Another telematic option to consider could be responding to surveys using a tablet which would collect the data in a computerised way&#46; Easier and simpler-to-use tools or devices could possibly be designed which would help with completion of surveys but which at present we do not generally have at our disposition&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">It is also worth mentioning that since survey completion in this study was low&#44; the secondary objective regarding the creation of a valid and reliable telematic platform for obtaining HRQOL questionnaire measurements could focus on participants with better Internet access and a willingness to complete&#46; We could also therefore address the possibility of having a mixed survey&#44; whereby the patient chooses whether to complete the survey online or on paper&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Our study had several limitations&#59; no relevant information was collected on patients&#8217; social class or educational level&#44; or the availability of assistance by a third party if required&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">It is also of note that the opinion surveys used put forward 4 very subjective categories and without any definition of the criteria for each one of them&#46; However&#44; roughly speaking&#44; they express the perception of patient difficulty&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">To conclude&#44; for the patients of our hospital scheduled for TKR surgery&#44; Internet usage is not a viable strategy to ensure that quality of life data is obtained in a thorough and satisfactory manner&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Level of evidence</span><p id="par0200" class="elsevierStylePara elsevierViewall">Evidence level V&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Ethical responsibilities</span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Protection of human beings and animals</span><p id="par0205" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this investigation&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Data confidentiality</span><p id="par0210" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their centre of work on the publication of patient data&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Right to privacy and informed consent</span><p id="par0215" class="elsevierStylePara elsevierViewall">The authors have obtained the informed consent of patients and&#47;or subjects referred to in this article&#46; This document is in the possession of the corresponding author&#46;</p></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Financing</span><p id="par0220" class="elsevierStylePara elsevierViewall">The necessary resources for subscription and the web platform maintenance &#40;300&#8364;&#41; were financed by H&#46;R&#46;&#44; Fungibles S&#46;L&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Conflict of interests</span><p id="par0225" class="elsevierStylePara elsevierViewall">The authors have no conflict of interests to declare&#46;</p></span></span>"
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    "fechaRecibido" => "2014-06-29"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Questionnaires measuring health-related quality of life are difficult to perform and obtain for patients and professionals&#46; Computerised tools are now available to collect this information&#46; The objective of this study was to assess the ability of patients undergoing total knee replacement to fill in health-related quality-of-life questionnaires using a telematic platform&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Material and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Ninety eight consecutive patients undergoing total knee arthroplasty were included&#46; Participants were given an access code to enter the website where they had to respond to 2 questionnaires &#40;SF8 and the reduced WOMAC&#41;&#44; and 3 additional questions about the difficulty in completing the questionnaires&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A total of 98 patients agreed to participate&#58; 45 males and 53 females &#40;mean age 72&#46;7 years&#41;&#46; Fourteen did not agree to participate due to lack of internet access&#46; Of the final 84 participants&#44; 50&#37; entered the website&#44; and only 36 answered all questions correctly&#46; Of the patients who answered the questionnaire&#44; 80&#37; were helped by a relative or friend&#44; and 22&#37; reported difficulty accessing internet&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The use of telematic systems to respond to health-related quality of life questionnaires should be used cautiously&#44; especially in elderly population&#46; It is likely that the population they are directed at is not prepared to use this type of technology&#46; Therefore&#44; before designing telematics questionnaires it must be ensured that they are completed properly&#46;</p></span>"
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            "identificador" => "abst0010"
            "titulo" => "Material and methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
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      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La realizaci&#243;n y obtenci&#243;n de cuestionarios de calidad de vida relacionada con la salud por el paciente y el profesional es complicada&#46; Actualmente&#44; disponemos de herramientas inform&#225;ticas para recoger esta informaci&#243;n&#46; Nuestro objetivo fue evaluar la capacidad de los pacientes intervenidos de pr&#243;tesis total de rodilla para rellenar cuestionarios de calidad de vida relacionada con la salud&#44; utilizando una plataforma telem&#225;tica&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Material y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Fueron incluidos 98 pacientes consecutivos intervenidos de artroplastia total de rodilla&#46; A los que aceptaron participar en el estudio se les solicit&#243; responder&#44; en una p&#225;gina web&#44; a 2 cuestionarios de calidad de vida relacionada con la salud &#40;SF8 y WOMAC reducido&#41; y 3 preguntas adicionales de opini&#243;n sobre dichos cuestionarios&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Noventa y ocho pacientes &#40;45 hombres y 53 mujeres&#41;&#44; con una media de edad de 72&#44;7 a&#241;os&#46; Catorce no aceptaron participar por no disponer de acceso a Internet&#46; De los 84 pacientes que aceptaron&#44; el 50&#37; entr&#243; en la p&#225;gina web&#44; de los cuales solamente 36 contestaron correctamente a todas las preguntas&#46; De estos&#44; el 80&#37; fue ayudado por un familiar o amigo y el 22&#37; refiri&#243; dificultades para acceder a Internet&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Conclusi&#243;n</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La utilizaci&#243;n de sistemas telem&#225;ticos para responder a cuestionarios de calidad de vida debe ser usada de forma cautelosa&#44; especialmente en poblaci&#243;n de edad avanzada&#46; Probablemente&#44; la poblaci&#243;n a la que va dirigida no est&#225; preparada para utilizar este tipo de tecnolog&#237;a&#46; Por ello&#44; antes de dise&#241;ar cuestionarios telem&#225;ticos debemos asegurarnos de si ser&#225;n debidamente cumplimentados&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
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          1 => array:2 [
            "identificador" => "abst0030"
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          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
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          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusi&#243;n"
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      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Besalduch-Balaguer M&#44; Aguilera-Roig X&#44; Urr&#250;tia-Cuch&#237; G&#44; Puntonet-Bruch A&#44; Jordan-Sales M&#44; Gonz&#225;lez-Osuna A&#44; et al&#46; Nivel de cumplimiento v&#237;a telem&#225;tica de cuestionarios relacionados con la calidad de vida en artroplastia total de rodilla&#46; Rev Esp Cir Ortop Traumatol&#46; 2015&#59;59&#58;254&#8211;259&#46;</p>"
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Capable &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>36&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
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          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Results of opinion polls regarding the difficulty in undertaking the study &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>36&#41;&#46;</p>"
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      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:18 [
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ISSN: 19888856
Original language: English
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