The influence of mode of remote delivery on health-related quality of life outcome measures in British Sign Language: a mixed methods pilot randomised crossover trial

Objectives: Little is known about the efficacy of remotely delivered outcome measures (psychological/health-related assessments) in a signed language for Deaf people. The objective is to explore the equivalence of two modes of remote delivery of health-related quality of life outcome measures in British Sign Language (BSL): asynchronous online assessment versus synchronous live face-to-face online assessment in sign language.

Methods: Thirty-one participants were recruited through Deaf networks and sign language media. Measures used were validated BSL versions of the EQ-5D-5L, EQ-VAS and CORE-10. A randomised, crossover trial was conducted between March and May 2023 with seventeen first receiving asynchronous assessment and sixteen first receiving synchronous live online assessment. This study explored whether the outcomes of the two assessments are equivalent regardless of modality of delivery. Demographic data were collected, and eight participants took part in semi-structured qualitative interviews exploring modality preferences and the impact of each modality.

Results: The mean difference between pre-recorded and live modes was 0.034 for EQ-5D-5L BSL (90% CI 0.015-0.051), 4.33 mean difference for EQ-VAS BSL (90% CI 0.697-8.083), and mean difference of 0.17 for CORE-10 BSL (90% CI - 1.4065 to 1.1775). The confidence intervals for each of the EQ-5D-5L BSL, EQ-VAS BSL, and CORE-10 BSL lie within the prespecified equivalence margins which suggested that the two modes are equivalent.

Conclusion: The results demonstrate that EQ-5D-5L BSL, EQ-VAS BSL, and CORE-10 BSL may be considered as equivalent across modes of remote delivery. This further strengthens the validation of existing standardised assessments in BSL. A BSL version of the abstract is available in Supplementary Video 1.