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Biomedical subjects

Philip Ritter

Publications and source records attributed to Philip Ritter.

2 recordsLinked to original sources

The impact of a moderated e-mail discussion group on use of complementary and alternative therapies in subjects with recurrent back pain.

OBJECTIVE: The purpose was to examine whether or not participation in an e-mail discussion group would affect use of selected complementary and alternative medicine (CAM) modalities during an Internet-based, 1-year randomized, controlled trial on back pain management. METHODS: Intervention subjects (n = 190) participated in a closed, moderated e-mail discussion group; control subjects (n = 231) received usual care. At 1 year, we compared CAM use over the previous 6-month period during which intervention subjects had had interactive discussions about them. Differences in CAM use between groups were compared using Chi-square and t-tests. RESULTS: Subjects did not differ statistically between groups (p > 0.05). They were Caucasian (approximately 91%), male (approximately 60%), in their mid-40s, well educated, had approximately 13 years back pain duration, a disability level approximately 10 (Roland-Morris scale: 0-23; 23 = worst), and >80% had used the Internet for greater than a year before the randomized trial. During the study period, only small proportions in either group had initiated use of glucosamine (13% versus 8%), chiropractic services (5% versus 4%), acupuncture (3%, both), yoga (6% versus 4%), or magnets (6%, both). CONCLUSION: Results suggest that participation in interactive discussions over the Internet about these CAM modalities may not affect their use.

Back Pain↗

Internet versus mailed questionnaires: a randomized comparison.

BACKGROUND: The use of Internet-based questionnaires for collection of data to evaluate patient education and other interventions has increased in recent years. Many self-report instruments have been validated using paper-and-pencil versions, but we cannot assume that the psychometric properties of an Internet-based version will be identical. OBJECTIVES: To look at similarities and differences between the Internet versions and the paper-and-pencil versions of 16 existing self-report instruments useful in evaluation of patient interventions. METHODS: Participants were recruited via the Internet and volunteered to participate (N=397), after which they were randomly assigned to fill out questionnaires online or via mailed paper-and-pencil versions. The self-report instruments measured were overall health, health distress, practice mental stress management, Health Assessment Questionnaire (HAQ) disability, illness intrusiveness, activity limitations, visual numeric for pain, visual numeric for shortness of breath, visual numeric for fatigue, self-efficacy for managing disease, aerobic exercise, stretching and strengthening exercise, visits to MD, hospitalizations, hospital days, and emergency room visits. Means, ranges, and confidence intervals are given for each instrument within each type of questionnaire. The results from the two questionnaires were compared using both parametric and non-parametric tests. Reliability tests were given for multi-item instruments. A separate sample (N=30) filled out identical questionnaires over the Internet within a few days and correlations were used to assess test-retest reliability. RESULTS: Out of 16 instruments, none showed significant differences when the appropriate tests were used. Construct reliability was similar within each type of questionnaire, and Internet test-retest reliability was high. Internet questionnaires required less follow-up to achieve a slightly (non-significant) higher completion rate compared to mailed questionnaires. CONCLUSIONS: Among a convenience sample recruited via the Internet, results from those randomly assigned to Internet participation were at least as good as, if not better than, among those assigned mailed questionnaires, with less recruitment effort required. The instruments administered via the Internet appear to be reliable, and to be answered similarly to the way they are answered when they are administered via traditional mailed paper questionnaires.

Adult↗