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风湿性?一种针对疑似风湿性疾病患者的诊断决策支持工具:混合方法的可用性和可接受性研究。

Rheumatic? A diagnostic decision support tool for individuals suspecting rheumatic diseases: Mixed-methods usability and acceptability study.

作者信息

Jakobi Stefan, Boy Katharina, Wagner Magali, May Susann, Temiz Alp, Liphardt Anna-Maria, Araujo Elizabeth, Carmona Loreto, Knevel Rachel, Schett Georg, Knitza Johannes, Muehlensiepen Felix, Morf Harriet

机构信息

Department of Internal Medicine 3 - Rheumatology & Immunology, Universitätsklinikum Erlangen Friedrich-Alexander-Universität Erlangen-Nürnberg, Ulmenweg 18, 91054, Erlangen, Germany.

Deutsches Zentrum für Immuntherapie (DZI), Friedrich-Alexander-Universität Erlangen-Nürnberg and Uniklinikum Erlangen, Erlangen, Germany.

出版信息

BMC Rheumatol. 2025 May 23;9(1):59. doi: 10.1186/s41927-025-00507-w.

Abstract

BACKGROUND

The early diagnosis of inflammatory rheumatic diseases (IRDs) is of paramount importance in order to prevent irreversible damage to joints and to optimize treatment outcomes. Nevertheless, conventional care pathways frequently entail diagnostic delays spanning several months. Symptom checkers (SCs) have the potential to provide a solution by offering validated symptom assessments, improving triage systems and expediting diagnostic evaluations. The objective of this mixed-methods study is to assess the usability and acceptability of the SC Rheumatic? among individuals with suspected rheumatic diseases.

METHODS

A total of 105 individuals with suspected IRDs who were newly presenting at an outpatient rheumatology clinic completed the Rheumatic? symptom checker and an evaluation questionnaire. The questionnaire comprised the System Usability Scale (SUS) and Net Promoter Score (NPS). Additionally, 14 participants were interviewed by telephone in order to gain further insights through the qualitative method.

RESULTS

The Rheumatic? symptom checker received a "good" usability score, with an average SUS of 78 ± 16 (range 0-100). Younger participants reported significantly higher usability scores (p < 0.03). However, the NPS was - 15 (range - 100 to 100), indicating lower acceptability. Qualitative data supported the positive usability ratings but emphasized the need for enhancements to increase user engagement and perceived value, such as a current perceived lack of immediate benefit for many users. Their experience varied in terms of impact, with some patients suggesting an increased awareness of their symptoms while others did not notice any difference.

CONCLUSION

Rheumatic? demonstrates good usability, particularly among younger users. Interviews revealed valuable suggestions for improvements, which could enhance overall acceptability and user satisfaction. Implementing Rheumatic? could lead to more efficient triage, potentially reducing diagnostic delays and an optimized allocation of resources. Future iterations should prioritize implementation strategies to maximize user impact and benefit.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

背景

炎症性风湿性疾病(IRDs)的早期诊断对于预防关节不可逆损伤和优化治疗效果至关重要。然而,传统的护理路径常常导致数月的诊断延迟。症状检查器(SCs)有可能通过提供经过验证的症状评估、改善分诊系统和加快诊断评估来提供解决方案。这项混合方法研究的目的是评估SC Rheumatic? 在疑似风湿性疾病患者中的可用性和可接受性。

方法

共有105名新到门诊风湿病诊所就诊的疑似IRDs患者完成了Rheumatic? 症状检查器和一份评估问卷。问卷包括系统可用性量表(SUS)和净推荐值(NPS)。此外,为了通过定性方法获得更深入的见解,对14名参与者进行了电话访谈。

结果

Rheumatic? 症状检查器获得了“良好”的可用性评分,平均SUS为78±16(范围0 - 100)。年轻参与者报告的可用性评分显著更高(p < 0.03)。然而,NPS为 - 15(范围 - 100至100),表明可接受性较低。定性数据支持了积极的可用性评级,但强调需要改进以提高用户参与度和感知价值,例如目前许多用户认为缺乏即时益处。他们的体验在影响方面各不相同,一些患者表示对自己的症状有了更高的认识,而另一些患者则没有注意到任何差异。

结论

Rheumatic? 具有良好的可用性,特别是在年轻用户中。访谈揭示了有价值的改进建议,这可以提高整体可接受性和用户满意度。实施Rheumatic? 可以导致更有效的分诊,有可能减少诊断延迟并优化资源分配。未来的迭代应优先考虑实施策略,以最大限度地提高用户影响和益处。

临床试验编号

不适用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b05a/12101040/79bbafaccd20/41927_2025_507_Fig1_HTML.jpg

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