Laursen Sisse H, Buus Amanda A, Brandi Lisbet, Vestergaard Peter, Hejlesen Ole K
The Danish Diabetes Academy, Odense University Hospital, Odense, Denmark.
Dept. of Orthopedic Surgery, Aalborg University Hospital, Aalborg, Denmark.
Stud Health Technol Inform. 2018;247:810-814.
Hyperphosphatemia is known as one of the more challenging conditions in end-stage renal disease patients. This study set out to present and evaluate a healthcare-oriented decision support tool in the management of hyperphosphatemia within hemodialysis therapy. A prototype module was designed to fit into the interface of a modern dialysis machine (Fresenius 5008). The prototype included three main functions: 1) immediate bedside blood sample access, 2) a model based prognosis tool with estimates of P-phosphate and 3) an overview of the user's phosphate related activities during dialysis treatments. The prototype was evaluated by a) heuristic evaluation with five human computer interaction experts and b) user testing with think-aloud by three users as (clinical) domain experts. The two evaluation procedures identified a total of 103 usability problems and led to some specific amendments to improve its practical potential. The overall results will guide further development of the decision support tool to ensure that the functions will support the user's needs. In conclusion, the prototype was evaluated to be relevant and potentially beneficial in the management of hyperphosphatemia in hemodialysis patients. Furthermore, it was found that some of the functions could be used for educational purposes or as decision support for some patient groups, e.g. for patient doing home-dialysis.
高磷血症是终末期肾病患者面临的更具挑战性的病症之一。本研究旨在展示和评估一种以医疗保健为导向的决策支持工具，用于血液透析治疗中高磷血症的管理。设计了一个原型模块，以适配现代透析机（费森尤斯5008）的界面。该原型包括三个主要功能：1）即时床边血样采集，2）基于模型的预后工具，可估算血磷水平，3）透析治疗期间用户与磷相关活动的概述。通过以下方式对该原型进行评估：a）由五位人机交互专家进行启发式评估，b）由三位作为（临床）领域专家的用户通过出声思考法进行用户测试。这两种评估程序共识别出103个可用性问题，并导致了一些具体的修改，以提高其实际应用潜力。总体结果将指导决策支持工具的进一步开发，以确保其功能能够满足用户需求。总之，该原型在血液透析患者高磷血症的管理中被评估为具有相关性且可能有益。此外，还发现其中一些功能可用于教育目的，或作为某些患者群体（如进行家庭透析的患者）的决策支持。
