Steiermärkische Krankenanstaltengesellschaft m.b.H. (KAGes), Information and Process Management, Graz, Austria.
Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Auenbruggerplatz 2, 8036, Graz, Austria.
J Med Syst. 2021 Mar 1;45(4):48. doi: 10.1007/s10916-021-01727-6.
Early identification of patients with life-threatening risks such as delirium is crucial in order to initiate preventive actions as quickly as possible. Despite intense research on machine learning for the prediction of clinical outcomes, the acceptance of the integration of such complex models in clinical routine remains unclear. The aim of this study was to evaluate user acceptance of an already implemented machine learning-based application predicting the risk of delirium for in-patients. We applied a mixed methods design to collect opinions and concerns from health care professionals including physicians and nurses who regularly used the application. The evaluation was framed by the Technology Acceptance Model assessing perceived ease of use, perceived usefulness, actual system use and output quality of the application. Questionnaire results from 47 nurses and physicians as well as qualitative results of four expert group meetings rated the overall usefulness of the delirium prediction positively. For healthcare professionals, the visualization and presented information was understandable, the application was easy to use and the additional information for delirium management was appreciated. The application did not increase their workload, but the actual system use was still low during the pilot study. Our study provides insights into the user acceptance of a machine learning-based application supporting delirium management in hospitals. In order to improve quality and safety in healthcare, computerized decision support should predict actionable events and be highly accepted by users.
早期识别有生命危险风险的患者,如谵妄,对于尽快采取预防措施至关重要。尽管机器学习在预测临床结果方面的研究非常深入,但此类复杂模型在临床常规中的应用接受程度仍不清楚。本研究旨在评估用户对已实施的基于机器学习的应用程序的接受程度,该应用程序可预测住院患者发生谵妄的风险。我们采用混合方法设计,收集了经常使用该应用程序的医疗保健专业人员(包括医生和护士)的意见和关注点。该评估框架是基于技术接受模型,评估了应用程序的感知易用性、感知有用性、实际系统使用和输出质量。来自 47 名护士和医生的问卷调查结果以及 4 次专家组会议的定性结果均对谵妄预测的整体有用性给予了积极评价。对于医疗保健专业人员来说,可视化和呈现的信息是可以理解的,应用程序易于使用,并且对谵妄管理的附加信息也很赞赏。该应用程序没有增加他们的工作量,但在试点研究期间,实际系统的使用仍然很低。本研究提供了关于支持医院谵妄管理的基于机器学习的应用程序的用户接受度的见解。为了提高医疗保健的质量和安全性,计算机化的决策支持应该预测可操作的事件,并得到用户的高度认可。