Usability of an Atrial Fibrillation Anticoagulation Decision-Support Tool.
ABSTRACT In individuals with nonvalvular atrial fibrillation, anticoagulant therapy with warfarin reduces the rate of thromboembolic events but increases the risk of bleeding. Treatment decisions frequently are inconsistent with guidelines. A new web-based atrial fibrillation decision-support tool (AF-DST) provides patient-specific information on the risk-benefit tradeoff of anticoagulation.
The authors performed a pilot usability testing study of the AF-DST with 4 medical house officers and 4 attending physicians by simulating 9 outpatient clinical encounters involving tradeoffs between risks and benefits of anticoagulation. They recorded positive and negative critical incidents in the simulations and assessed satisfaction with use of the AF-DST by the Computer System Usability Questionnaire (CSUQ; score range on each item: 1 = strongly disagree to 7 = strongly agree).
Users found the AF-DST to be helpful and had high CSUQ scores (mean item score, 6.3). Usability testing identified 6 positive and 14 negative critical incidents. Participants felt that the AF-DST guided them toward the correct decision. Nevertheless, they desired more information on the "black box" calculations and ignored alerts. Training level appeared to affect how the AF-DST was used, in particular, how users interacted with the AF-DST.
Overall satisfaction with the AF-DST was high and the tool effectively communicated recommendations and uncertainty. Usability testing identified design issues and potential errors caused by decision-support tool use; these gaps should be addressed prior to clinical implementation.
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ABSTRACT: Biomedical applications are often built on top of knowledge bases that contain medical images and clinical reports. Currently, these bases are being used to improve diagnosis, research and teaching, but in many cases, the infrastructure required has a prohibitive cost for many medical centres. However, resources can be attached from existing e-Science infrastructures. Therefore, many efforts have been made to establish best practices that allow the use of such infrastructures. However, e-Science relies on open, distributed, collaborative environments, built on top of very specialized technologies, such as Grid and Cloud computing, which require reasonable technical skills for their usage. Therefore, science gateways have become essential tools that assist users in interacting with e-Science applications. This paper describes TRENCADIS, a technology that supports the creation and operation of virtual knowledge bases. To this end, it provides developers with components and APIs for building secure data services that can be annotated and queried through ontology templates, based on DICOM and DICOM-SR. This technology was used in this paper to build a gateway for assisting diagnosis and research in breast cancer. We also present here the results of a study conducted to evaluate the gateway, from the point of view of the usability perceived by a group of physicians and radiologists.Journal of Grid Computing 12/2012; 10(4):665-688. DOI:10.1007/s10723-012-9243-2 · 1.67 Impact Factor