Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, the Netherlands.
Department of Internal Medicine, Division of Infectious Diseases, Erasmus University Medical Center, Rotterdam, the Netherlands.
PLoS One. 2019 Sep 25;14(9):e0223073. doi: 10.1371/journal.pone.0223073. eCollection 2019.
A clinical decision support system (CDSS) for empirical antibiotic treatment has the potential to increase appropriate antibiotic use. Before using such a system on a broad scale, it needs to be tailored to the users preferred way of working. We have developed a CDSS for empirical antibiotic treatment in hospitalized adult patients. Here we determined in a usability study if the developed CDSS needed changes.
Four prespecified patient cases, based on real life clinical scenarios, were evaluated by 8 medical residents in the study. The "think-aloud" method was used, and sessions were recorded and analyzed afterwards. Usability was assessed by 3 evaluators using an augmented classification scheme, which combines the User Action Framework with severity rating of the usability problems and the assessment of the potential impact of these problems on the final task outcomes.
In total 51 usability problems were identified, which could be grouped into 29 different categories. Most (n = 17/29) of the usability problems were cosmetic problems or minor problems. Eighteen (out of 29) of the usability categories could have an ordering error as a result. Classification of the problems showed that some of the problems would get a low priority based on their severity rating, but got a high priority for their impact on the task outcome. This effectively provided information to prioritize system redesign efforts.
Usability studies improve lay-out and functionality of a CDSS for empirical antibiotic treatment, even after development by a multidisciplinary system.
临床决策支持系统（CDSS）在经验性抗生素治疗中有提高合理使用抗生素的潜力。在广泛应用此类系统之前，需要根据用户的工作偏好对其进行调整。我们已经开发了一种适用于住院成年患者经验性抗生素治疗的 CDSS。在此，我们通过一项可用性研究确定该开发的 CDSS 是否需要更改。
评估了 8 名住院医师对基于真实临床场景的 4 个预设患者案例的看法。使用“思考 aloud”方法，并在之后对会话进行记录和分析。使用增强分类方案（将用户操作框架与可用性问题的严重程度评分以及这些问题对最终任务结果的潜在影响评估相结合），由 3 名评估员评估可用性。
共确定了 51 个可用性问题，可以将其分为 29 个不同类别。大多数（n = 17/29）可用性问题是外观问题或较小的问题。其中 18 个（29 个中的 18 个）可用性类别可能会导致排序错误。问题分类表明，根据严重程度评分，某些问题的优先级较低，但对任务结果的影响优先级较高。这实际上为确定系统重新设计工作的优先级提供了信息。
即使由多学科系统开发，可用性研究也可以改善经验性抗生素治疗 CDSS 的布局和功能。
