A Novel Electronic Data Collection System for Large-Scale Surveys of Neglected Tropical Diseases

Abstract

BackgroundLarge cross-sectional household surveys are common for measuring indicators of neglected tropical disease control programs. As an alternative to standard paper-based data collection, we utilized novel paperless technology to collect data electronically from over 12,000 households in Ethiopia.MethodologyWe conducted a needs assessment to design an Android-based electronic data collection and management system. We then evaluated the system by reporting results of a pilot trial and from comparisons of two, large-scale surveys; one with traditional paper questionnaires and the other with tablet computers, including accuracy, person-time days, and costs incurred.Principle FindingsThe electronic data collection system met core functions in household surveys and overcame constraints identified in the needs assessment. Pilot data recorders took 264 (standard deviation (SD) 152 sec) and 260 sec (SD 122 sec) per person registered to complete household surveys using paper and tablets, respectively (P = 0.77). Data recorders felt a lack of connection with the interviewee during the first days using electronic devices, but preferred to collect data electronically in future surveys. Electronic data collection saved time by giving results immediately, obviating the need for double data entry and cross-correcting. The proportion of identified data entry errors in disease classification did not differ between the two data collection methods. Geographic coordinates collected using the tablets were more accurate than coordinates transcribed on a paper form. Costs of the equipment required for electronic data collection was approximately the same cost incurred for data entry of questionnaires, whereas repeated use of the electronic equipment may increase cost savings.Conclusions/SignificanceConducting a needs assessment and pilot testing allowed the design to specifically match the functionality required for surveys. Electronic data collection using an Android-based technology was suitable for a large-scale health survey, saved time, provided more accurate geo-coordinates, and was preferred by recorders over standard paper-based questionnaires.

Implementing electronic data capture at a well-established health and demographic surveillance site in rural northern Malawi

“…Our quantitative results on data quality are consistent with findings from other evaluations [3,6,7,10,11,15–19]. On paper forms, the level of missing data increased with the complexity of skip patterns, while almost the opposite pattern was seen in EDC, showing the usefulness of programmed automatic skip patterns in guiding interviewers to the correct questions.…”

“…In other evaluations, respondents tended to have accepted the new methods [8,23], but some concerns were raised over ‘outsider’ technology [4,14], and one study found a higher refusal rate with EDC [15]; the respondents we spoke to had no reservations regarding the technology. This acceptance in our setting may be due to the long-running nature of the project and good relationships with the community.…”

“…We did not measure the length of each interview, but fieldworkers generally thought that EDC interviews took longer, while respondents felt the opposite. Misperception about interview length has been observed elsewhere [15], and may be due to the delays on loading and saving forms being more apparent to fieldworkers than delays incurred while using paper (for example, manually navigating the skip patterns). Using EDC reduced the time needed before and after data collection, as printing and data entry were largely eliminated; the latter reflected in the reduction in the average number of days from data collection to availability to scientists.…”

“…Data quality : Systems of double-entry, checks, and verification ensure a high level of data quality in a paper-based system, and EDC must meet the same standards: most evaluations found that EDC was less prone to errors than paper [3,6,10,11,15–18]. …”

Do surveys with paper and electronic devices differ in quality and cost? Experience from the Rufiji Health and demographic surveillance system in Tanzania

“…As in previous studies, our findings support the use of electronic tools to address some of the known challenges of data management in traditional paper-based health surveys. They include a reduction in turnaround time for results availability, improvements on quality of data, and cost savings [28,29]. We found that electronic surveys, compared with the paper method, involved fewer staff, shortened survey procedures, and improved quality of data at lower costs.…”