Hakimjavadi Ramtin, Hong Heather A, Fallah Nader, Humphreys Suzanne, Kingwell Stephen, Stratton Alexandra, Tsai Eve, Wai Eugene K, Walden Kristen, Noonan Vanessa K, Phan Philippe
Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Praxis Spinal Cord Institute, Blusson Spinal Cord Centre, Vancouver, BC, Canada.
Front Neurol. 2023 Dec 5;14:1219307. doi: 10.3389/fneur.2023.1219307. eCollection 2023.
Several clinical prediction rules (CPRs) have been published, but few are easily accessible or convenient for clinicians to use in practice. We aimed to develop, implement, and describe the process of building a web-based CPR for predicting independent walking 1-year after a traumatic spinal cord injury (TSCI).
Using the published and validated CPR, a front-end web application called "Ambulation" was built using HyperText Markup Language (HTML), Cascading Style Sheets (CSS), and JavaScript. A survey was created using QualtricsXM Software to gather insights on the application's usability and user experience. Website activity was monitored using Google Analytics. Ambulation was developed with a core team of seven clinicians and researchers. To refine the app's content, website design, and utility, 20 professionals from different disciplines, including persons with lived experience, were consulted.
After 11 revisions, Ambulation was uploaded onto a unique web domain and launched (www.ambulation.ca) as a pilot with 30 clinicians (surgeons, physiatrists, and physiotherapists). The website consists of five web pages: Home, Calculation, Team, Contact, and Privacy Policy. Responses from the user survey ( = 6) were positive and provided insight into the usability of the tool and its clinical utility (e.g., helpful in discharge planning and rehabilitation), and the overall face validity of the CPR. Since its public release on February 7, 2022, to February 28, 2023, Ambulation had 594 total users, 565 (95.1%) new users, 26 (4.4%) returning users, 363 (61.1%) engaged sessions (i.e., the number of sessions that lasted 10 seconds/longer, had one/more conversion events e.g., performing the calculation, or two/more page or screen views), and the majority of the users originating from the United States (39.9%) and Canada (38.2%).
Ambulation is a CPR for predicting independent walking 1-year after TSCI and it can assist frontline clinicians with clinical decision-making (e.g., time to surgery or rehabilitation plan), patient education and goal setting soon after injury. This tool is an example of adapting a validated CPR for independent walking into an easily accessible and usable web-based tool for use in clinical practice. This study may help inform how other CPRs can be adopted into clinical practice.
已经发表了几种临床预测规则（CPR），但很少有易于获取或方便临床医生在实践中使用的。我们旨在开发、实施并描述构建一个基于网络的CPR的过程，该CPR用于预测创伤性脊髓损伤（TSCI）后1年的独立行走能力。
使用已发表并经过验证的CPR，使用超文本标记语言（HTML）、层叠样式表（CSS）和JavaScript构建了一个名为“Ambulation”的前端网络应用程序。使用QualtricsXM软件创建了一项调查，以收集有关该应用程序可用性和用户体验的见解。使用谷歌分析监测网站活动。Ambulation由七名临床医生和研究人员组成的核心团队开发。为了完善应用程序的内容、网站设计和实用性，咨询了包括有实际经验者在内的来自不同学科的20名专业人员。
经过11次修订后，Ambulation被上传到一个独特的网络域名并作为试点推出（www.ambulation.ca），有30名临床医生（外科医生、物理医学与康复医生和物理治疗师）参与。该网站由五个网页组成：主页、计算、团队、联系我们和隐私政策。用户调查（n = 6）的反馈是积极的，提供了有关该工具可用性及其临床实用性（例如，有助于出院计划和康复）以及CPR整体表面效度的见解。自2022年2月7日公开发布至2023年2月28日，Ambulation共有594名用户，其中565名（95.1%）是新用户，26名（4.4%）是回访用户，363名（61.1%）有参与会话（即持续10秒及以上、有一个或多个转化事件（例如进行计算）或两个或多个页面或屏幕浏览量的会话），大多数用户来自美国（39.9%）和加拿大（38.2%）。
Ambulation是一种用于预测TSCI后1年独立行走能力的CPR，它可以协助一线临床医生进行临床决策（例如手术时间或康复计划）、患者教育以及受伤后不久的目标设定。这个工具是将经过验证的用于独立行走的CPR改编成一个易于获取和使用的基于网络的工具以用于临床实践的一个例子。这项研究可能有助于说明其他CPR如何能够被应用于临床实践。
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