Maramba Inocencio Daniel, Chatterjee Arunangsu
Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom.
JMIRx Med. 2022 Jan 6;3(1):e31679. doi: 10.2196/31679.
Anesthetic preoperative assessment (POA) is now a common part of the surgical care pathway, and guidelines support its routine use. MyPreOp (Ultramed Ltd) is a web-based POA system that enables remote assessments. Usability is a key factor in the success of digital health solutions.
This study aims to assess the usability of the MyPreOp system through patient feedback, investigate the amount of time it took for patients to complete the POA questionnaire and the factors that influenced completion time, and explore the effect on completion times of implementing a validated eHealth usability scale, as compared to using a simple but unvalidated usability evaluation scale, and to test the feasibility of administering a more detailed usability evaluation scale in a staggered manner so as not to unduly increase completion times.
In this cross-sectional study, anonymized data sets were extracted from the MyPreOp system. The participants were adults (aged ≥18 years), scheduled for nonurgent surgical procedures performed in hospitals in the United Kingdom, who gave consent for their anonymized data to be analyzed. Data collected included age, gender, American Society of Anesthesiology (ASA) physical classification status, and completion time. Two user experience evaluations were used: in Phase 1, 2 questions asking about overall experience and ease of use, and in Phase 2, a previously validated usability questionnaire, with its 20 questions equally distributed among 5 succeeding patient cohorts. There were 2593 respondents in total (Phase 1: n=1193; Phase 2: n=1400). The median age of the participants was 46 years, and 1520 (58.62%) of the 2593 respondents were female. End points measured were the median completion times in Phase I and Phase II. The data were collected by extracting a subset of records from the database and exported to a spreadsheet for analysis (Excel, Microsoft Corporation). The data were analyzed for differences in completion times between Phase I and Phase II, as well as for differences between age groups, genders, and ASA classifications.
MyPreOp scored well in usability in both phases. In Phase 1, 81.64% (974/1193) of respondents had a good or better experience, and 93.8% (1119/1193) found it easy to use. The usability rating in Phase 2 was 4.13 out of a maximum of 5, indicating high usability. The median completion time was 40.4 minutes. The implementation of the longer usability evaluation scale in Phase 2 did not negatively impact the completion times. Age and ASA physical status were found to be moderately associated with increased completion times.
MyPreOp rates high in both user experience and usability. The method of dividing the questionnaire into 5 blocks is valid and does not negatively affect completion times. Further research into the factors affecting completion time is recommended.
麻醉术前评估（POA）如今是手术护理流程中的常见环节，且相关指南支持其常规使用。MyPreOp（Ultramed有限公司）是一个基于网络的POA系统，可进行远程评估。可用性是数字健康解决方案成功的关键因素。
本研究旨在通过患者反馈评估MyPreOp系统的可用性，调查患者完成POA问卷所需的时间以及影响完成时间的因素，探讨与使用简单但未经验证的可用性评估量表相比，实施经过验证的电子健康可用性量表对完成时间的影响，并测试以交错方式施用更详细的可用性评估量表以避免过度增加完成时间的可行性。
在这项横断面研究中，从MyPreOp系统中提取匿名数据集。参与者为成年人（年龄≥18岁），计划在英国医院进行非紧急外科手术，且同意对其匿名数据进行分析。收集的数据包括年龄、性别、美国麻醉医师协会（ASA）身体分类状态和完成时间。使用了两种用户体验评估：在第1阶段，有2个关于总体体验和易用性的问题；在第2阶段，使用一份先前经过验证的可用性问卷，其20个问题平均分配给5个后续患者队列。总共有2593名受访者（第1阶段：n = 1193；第2阶段：n = 1400）。参与者的中位年龄为46岁，2593名受访者中有1520名（58.62%）为女性。测量的终点是第I阶段和第II阶段的中位完成时间。通过从数据库中提取记录子集并导出到电子表格进行分析（Excel，微软公司）来收集数据。分析了第I阶段和第II阶段之间完成时间的差异，以及年龄组、性别和ASA分类之间的差异。
MyPreOp在两个阶段的可用性方面得分都很高。在第1阶段，81.64%（974/1193）的受访者有良好或更好的体验，93.8%（１１１９/１１９３）的受访者认为其易于使用。第2阶段的可用性评分为4.13（满分5分），表明可用性较高。中位完成时间为40.4分钟。在第2阶段实施更长的可用性评估量表并未对完成时间产生负面影响。发现年龄和ASA身体状况与完成时间增加呈中度相关。
MyPreOp在用户体验和可用性方面评分都很高。将问卷分为5个部分的方法是有效的，且不会对完成时间产生负面影响。建议进一步研究影响完成时间的因素。
