Pulmonary and Critical Care Medicine Department, Thoracic Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Health Information Management and Medical Informatics Department, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran.
BMC Med Inform Decis Mak. 2023 Aug 1;23(1):145. doi: 10.1186/s12911-023-02249-6.
Accurate and timely decision-making in lung transplantation (LTx) programs is critical. The main objective of this study was to develop a mobile-based evidence-based clinical decision support system (CDSS) to enhance the management of lung transplant candidates.
An iterative participatory software development process was employed to develop the ImamLTx CDSS. This study was accomplished in three phases. First, required data and standard clinical workflow were identified according to the literature review and expert consensus. Second, a rule-based knowledge-based CDSS application was developed. In the third phase, this CDSS was evaluated. The evaluation was done using the standard Post-Study System Usability Questionnaire (PSSUQ 18.3) and ten usability heuristics factors for user interface design.
According to expert consensus, fifty-five data items were identified as essential data sets using the Content Validity Ratio (CVR) formula. By integrating information flow in clinical practices with clinical protocols, more than 450 rules and 500 knowledge statements were extracted. This CDSS provides clinical decision support on an Android platform regarding inclusion and exclusion referral criteria, optimum transplant time based on the type of lung disease, findings of initial assessment, and the overall evaluation of lung transplant candidates. Evaluation results showed high usability ratings due to the fact provided accuracy and sensitivity of this lung transplant CDSS with the information quality domain receiving the highest score (6.305 from 7).
Through a stepwise approach, the ImamLTx CDSS was developed to provide LTx programs with timely patient data access via a mobile platform. Our results suggest integration with existing workflow to support clinical decision-making and provide patient-specific recommendations.
在肺移植（LTx）项目中，准确和及时的决策至关重要。本研究的主要目的是开发一种基于移动的循证临床决策支持系统（CDSS），以加强肺移植候选者的管理。
采用迭代参与式软件开发过程来开发 ImamLTx CDSS。本研究分三个阶段完成。首先，根据文献回顾和专家共识确定所需的数据和标准临床工作流程。其次，开发基于规则的基于知识的 CDSS 应用程序。在第三阶段，评估了这个 CDSS。评估使用标准的 Post-Study System Usability Questionnaire（PSSUQ 18.3）和十个用户界面设计可用性启发式因素进行。
根据专家共识，使用内容有效性比（CVR）公式确定了 55 个数据项作为必要数据集。通过将临床实践中的信息流与临床方案相结合，提取了超过 450 条规则和 500 条知识陈述。该 CDSS 在 Android 平台上提供有关纳入和排除转诊标准、基于肺病类型的最佳移植时间、初步评估结果以及肺移植候选者的整体评估的临床决策支持。评估结果显示，由于该肺移植 CDSS 提供的信息质量域的准确性和灵敏度很高，因此具有很高的可用性评分（7 分中的 6.305 分）。
通过逐步方法，开发了 ImamLTx CDSS，以便通过移动平台为 LTx 项目提供及时的患者数据访问。我们的结果表明，与现有工作流程的整合可以支持临床决策并提供针对特定患者的建议。
