OBJECTIVES: Current guidance recommends usability testing and cognitive debriefing with patients when migrating paper patient-reported outcomes (PRO) to electronic format. This study aimed to evaluate whether an online-only method of performing usability and cognitive debriefing could be a feasible alternative to the standard interview method, and whether similar data can be generated.

METHODS: A mobile responsive web-based Treatment Satisfaction Questionnaire for Medication (TSQM) was developed. The survey was programmed to first administer the eTSQM; then to bring back two TSQM items (at random) and administer item-specific usability questions (concurrent probing) and finally to administer general usability questions (retrospective probing). The survey was administered to all subjects of an online patient community (n=350,000) in the US, UK, France, Germany, Spain and Australia. Other data collected included basic demography, indication and treatment, and device characteristics from the device user agent.

RESULTS: Integration of randomized item-specific usability questions was feasibly implemented into the web-based survey platform. Most patients who responded had some college education, female and mean 50 years of age. The majority of patients completed the survey on an iPhone smartphone (n=35%), android smartphone (24%), computer (23%) or any tablet (18%). Regarding all items overall, most patients said the electronic version of the TSQM was readable or very readable (89%), and they were able to select the response options appropriately with the device they used (87%).

CONCLUSIONS: With only minor modification to the ePRO, concurrent and retrospective probing data were captured rapidly online, from available subject populations in multiple countries. We believe the results of this feasibility study will be important to researchers to consider as an alternative to interviewing for the generation of usability and cognitive debriefing data during PRO migration.