Cox Christopher E, Wysham Nicholas G, Kamal Arif H, Jones Derek M, Cass Brian, Tobin Maria, White Douglas B, Kahn Jeremy M, Hough Catherine L, Carson Shannon S
Christopher E. Cox is an associate professor of medicine, Nicholas G. Wysham is a fellow in the Division of Pulmonary and Critical Care Medicine, and Derek M. Jones is a clinical research project manager, Department of Medicine and Program to Support People and Enhance Recovery, Duke University, Durham, North Carolina. Arif H. Kamal is an assistant professor of medicine, Duke Clinical Research Institute and an oncologist in the Department of Medicine, Duke University. Brian Cass is a project manager and Maria Tobin is a programming specialist, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Douglas B. White and Jeremy M. Kahn are associate professors of medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Catherine L. Hough is an associate professor of medicine, University of Washington, Seattle, Washington. Shannon S. Carson is a professor of medicine, University of North Carolina at Chapel Hill.
Am J Crit Care. 2016 Jul;25(4):340-9. doi: 10.4037/ajcc2016952.
BACKGROUND: Web-based electronic patient-reported outcomes (ePRO) measures are increasingly used to facilitate patient-centered health assessments. However, it is unknown if ePRO completion is feasible for recently ill intensive care unit (ICU) survivors and their families. OBJECTIVE: To develop and evaluate the usability of a novel ePRO system (ePRO to Support People and Enhance Recovery [ePROSPER]) among ICU survivors and their families within an ongoing clinical trial. METHODS: Paper-based PROs were iteratively adapted to electronic forms (ePROs). Then, the usability of ePROSPER was assessed among 60 patients, their family members, and PRO and programming experts via questionnaires (eg, Systems Usability Scale), "think aloud" open-ended feedback, task completion times, and error rates. RESULTS: Input from patients and their families was used to incorporate user-experience modifications into ePROSPER. This feedback also led to inclusion of automated reminders for questionnaire completion and real-time alerts for staff triggered by high symptom levels. Median usability scores increased over testing cycles from 40 to 73 to 95, nearing the maximum score and showing excellent usability. All users completed ePROSPER within 20 minutes; 87% preferred it to a written version. ePROSPER was then implemented in a clinical trial without data errors. CONCLUSIONS: Automated ePRO systems can be successfully integrated in a post-ICU clinical trial setting. The value of integrating such systems in direct clinical care should be assessed in future studies.
背景：基于网络的电子患者报告结局（ePRO）测量方法越来越多地用于促进以患者为中心的健康评估。然而，对于近期患病的重症监护病房（ICU）幸存者及其家属而言，完成ePRO是否可行尚不清楚。 目的：在一项正在进行的临床试验中，开发并评估一种新型ePRO系统（支持患者并促进康复的ePRO [ePROSPER]）在ICU幸存者及其家属中的可用性。 方法：将纸质版的患者报告结局（PRO）逐步改编为电子表格（ePRO）。然后，通过问卷调查（如系统可用性量表）、“出声思考”开放式反馈、任务完成时间和错误率，对60名患者、他们的家庭成员以及PRO和编程专家评估ePROSPER的可用性。 结果：患者及其家属的意见被用于将用户体验改进纳入ePROSPER。这些反馈还导致纳入了问卷完成自动提醒以及由高症状水平触发的工作人员实时警报。可用性中位数得分在测试周期中从40提高到73再到95，接近最高分，显示出极佳的可用性。所有用户均在20分钟内完成了ePROSPER；87%的用户更喜欢它而不是书面版本。然后，ePROSPER在一项临床试验中实施，未出现数据错误。 结论：自动化ePRO系统可以成功整合到ICU后的临床试验环境中。未来的研究应评估将此类系统整合到直接临床护理中的价值。
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