Presented by: Emily Serrell MD
University of Wisconsin

Introduction

The Wisconsin Stone Quality of Life (WISQOL) is a stone-specific health-related quality of life (HRQOL) survey that is validated for in-person use. Telemedicine has increasingly replaced in-person visits. We compared the feasibility and reliability of remote administration of WISQOL.

Materials

WISQOL responses of patients from 4/1/2020 to 12/31/2022 from 2 institutions were collected. Patients completed WISQOL in-person in clinic or remotely by telephone, mail, or electronic medical record (EMR). Univariate analysis was used to compare responses. Internal consistency was assessed with Cronbach alpha coefficient.

Results

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WISQOL was completed by patients in clinic (n=90) or by telephone (n=90), mail (n=90), or EMR (n=90). Telephone surveys were completed in mean 8.3±2.4 minutes, compared to 5 minutes in clinic (prior study). Mail respondents (mean age 62.6 years) were significantly older than clinic (54.1y) and telephone (56.6y; p<0.05); EMR (59.4y) were older than clinic (p<0.05).

All survey methods demonstrated reliability with high Cronbach alpha coefficients > 0.97.

No significant differences were seen in stone symptoms by survey method (yes symptoms: 32% clinic, 37% telephone, 27% mail, 22% EMR, p>0.05). In asymptomatic patients, no significant differences across methods were seen in total WISQOL scores. Except lower vitality reported by EMR vs telephone (77.9 vs 88.4 score, p<0.05), there were no other differences for WISQOL domain scores.

Compared to asymptomatic patients, patients with symptoms reported worse HRQOL across all survey methods (p<0.001 for all groups). Symptomatic patients surveyed by mail had lower total WISQOL scores than other methods (45.1 vs 62.7 telephone, 69.7 EMR, 56.5 clinic; all p<0.05); no differences in WISQOL domains were seen between clinic, telephone, and EMR group responses. This was consistent across all domains (Figure).

Conclusion

WISQOL responses were reliable and internally consistent for in-person and remote administration. Remote surveillance of stone symptoms is a practical option in the telemedicine era. Patients responding by mail were more likely to report lower HRQOL than by other survey methods. Further investigation should examine difference in response rates between methods and mail respondents’ HRQOL.

Funding

None

Lead Authors

Stephen Nakada, MD, FACS
University of Wisconsin

Emily Davidson, MD
University of Wisconsin

Christopher Haas, MD
Tufts University School of Medicine

MARGARET KNOEDLER, MD
University of Wisconsin

Scott Quarrier, MD
University of Rochester

Rajat Jain, MD
University of Rochester

Rachael Sherrer, MD
University of Wisconsin

Shuang Li,
University of Wisconsin

Kristina Penniston, PHD
University of Wisconsin