Stagg Brian C, Tullis Benton, Asare Afua, Stein Joshua D, Medeiros Felipe A, Weir Charlene, Borbolla Damian, Hess Rachel, Kawamoto Kensaku
Department of Ophthalmology and Visual Sciences, John Moran Eye Center, University of Utah, Salt Lake City, Utah.
Department of Population Health Sciences, University of Utah, Salt Lake City, Utah.
Ophthalmol Sci. 2023 Feb 2;3(3):100279. doi: 10.1016/j.xops.2023.100279. eCollection 2023 Sep.
To rigorously develop a prototype clinical decision support (CDS) system to help clinicians determine the appropriate timing for follow-up visual field testing for patients with glaucoma and to identify themes regarding the context of use for glaucoma CDS systems, design requirements, and design solutions to meet these requirements.
Semistructured qualitative interviews and iterative design cycles.
Clinicians who care for patients with glaucoma, purposefully sampled to ensure a representation of a range of clinical specialties (glaucoma specialist, general ophthalmologist, optometrist) and years in clinical practice.
Using the established User-Centered Design Process framework, we conducted semistructured interviews with 5 clinicians that addressed the context of use and design requirements for a glaucoma CDS system. We analyzed the interviews using inductive thematic analysis and grounded theory to generate themes regarding the context of use and design requirements. We created design solutions to address these requirements and used iterative design cycles with the clinicians to refine the CDS prototype.
Themes regarding decision support for determining the timing of visual field testing for patients with glaucoma, CDS design requirements, and CDS design features.
We identified 9 themes that addressed the context of use for the CDS system, 9 design requirements for the prototype CDS system, and 9 design features intended to address these design requirements. Key design requirements included the preservation of clinician autonomy, incorporation of currently used heuristics, compilation of data, and increasing and communicating the level of certainty regarding the decision. After completing 3 iterative design cycles using this preliminary CDS system design solution, the design was satisfactory to the clinicians and was accepted as our prototype glaucoma CDS system.
We used a systematic design process based on the established User-Centered Design Process to rigorously develop a prototype glaucoma CDS system, which will be used as a starting point for a future, large-scale iterative refinement and implementation process. Clinicians who care for patients with glaucoma need CDS systems that preserve clinician autonomy, compile and present data, incorporate currently used heuristics, and increase and communicate the level of certainty regarding the decision.
Proprietary or commercial disclosure may be found after the references.
严格开发一个临床决策支持（CDS）系统原型，以帮助临床医生确定青光眼患者后续视野检查的合适时机，并确定有关青光眼CDS系统使用背景、设计要求以及满足这些要求的设计解决方案的主题。
半结构化定性访谈和迭代设计周期。
照顾青光眼患者的临床医生，经过有目的抽样以确保涵盖一系列临床专业（青光眼专科医生、普通眼科医生、验光师）以及不同临床实践年限。
使用既定的以用户为中心的设计流程框架，我们对5名临床医生进行了半结构化访谈，内容涉及青光眼CDS系统的使用背景和设计要求。我们使用归纳主题分析和扎根理论对访谈进行分析，以生成有关使用背景和设计要求的主题。我们创建了设计解决方案以满足这些要求，并与临床医生使用迭代设计周期来完善CDS原型。
有关为青光眼患者确定视野检查时机的决策支持、CDS设计要求以及CDS设计特征的主题。
我们确定了9个涉及CDS系统使用背景的主题、原型CDS系统的9个设计要求以及旨在满足这些设计要求的9个设计特征。关键设计要求包括保留临床医生的自主权、纳入当前使用的启发法、数据汇编以及提高并传达决策的确定性水平。使用此初步CDS系统设计解决方案完成3个迭代设计周期后，该设计令临床医生满意，并被接受为我们的青光眼CDS系统原型。
我们使用了基于既定的以用户为中心的设计流程的系统设计过程，严格开发了一个青光眼CDS系统原型，该原型将作为未来大规模迭代完善和实施过程的起点。照顾青光眼患者的临床医生需要CDS系统，这些系统要保留临床医生的自主权、汇编并呈现数据、纳入当前使用的启发法，并提高并传达决策的确定性水平。
专有或商业披露信息可在参考文献之后找到。
