Mode of administration does not cause bias in patient-reported outcome results: a meta-analysis.

PURPOSE: Technological advances in recent decades have led to the availability of new modes to administer patient-reported outcomes (PROs). To aid selecting optimal modes of administration (MOA), we undertook a systematic review to determine whether differences in bias (both size and direction) exist among modes. METHODS: We searched five electronic databases from 2004 (date of last comprehensive review on this topic) to April 2014, cross-referenced and searched reference lists. Studies that compared two or more MOA for a health-related PRO measure in adult samples were included. Two reviewers independently applied inclusion and quality criteria and extracted findings. Meta-analyses and meta-regressions were conducted using random-effects models. RESULTS: Of 5100 papers screened, 222 were considered potentially relevant and 56 met eligibility criteria. No evidence of bias was found for: (1) paper versus electronic self-complete; and (2) self-complete versus assisted MOA. Heterogeneity for paper versus electronic comparison was explained by type of construct (i.e. physical vs. psychological). Heterogeneity for self-completion versus assisted modes was in part explained by setting (clinic vs. home); the largest bias was introduced when assisted completion occurred in the clinic and follow-up was by self-completion (either electronic or paper) in the home. CONCLUSIONS: Self-complete paper and electronic MOA can be used interchangeably for research in clinic and home settings. Self-completion and assisted completion produce equivalent scores overall, although heterogeneity may be induced by setting. These results support the use of mixed MOAs within a research study, which may be a useful strategy for reducing missing PRO data.

Comparison of plaque removing ability of one standard and two flexible-head toothbrushes.

PURPOSE: This pilot study compared the plaque removing ability of two flexible-head toothbrushes and one nonflexible-head toothbrush. METHODS: Twenty individuals meeting specific criteria participated. Three quadrants on each subject were disclosed and scored using the Turesky modification of the Quigley-Hein plaque index. For consistency, one dental hygienist performed all brushing and another performed all indices. Pre- and post-brushing scores were compared using t-tests and analysis of variance (ANOVA) to determine differences. RESULTS: Differences between pre- and post-brushing scores of all groups were significant (p > 0.005). However, no significant differences were detected between mean scores of the test toothbrush groups and the control group of the two test toothbrush groups, or among the means of all groups. CONCLUSION: No differences in plaque removing ability were found between or among the toothbrushes tested.