Designing a mHealth clinical decision support system for Parkinson’s disease: a theoretically grounded user needs approach
Abstract Background Despite the established evidence and theoretical advances explaining human judgments under uncertainty, developments of mobile health (mHealth) Clinical Decision Support Systems (CDSS) have not explicitly applied the psychology of decision making to the study of user needs. We re...
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| Format: | Article |
| Language: | English |
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BMC
2020-02-01
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| Series: | BMC Medical Informatics and Decision Making |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12911-020-1027-1 |
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| author | L. Timotijevic C. E. Hodgkins A. Banks P. Rusconi B. Egan M. Peacock E. Seiss M. M. L. Touray H. Gage C. Pellicano G. Spalletta F. Assogna M. Giglio A. Marcante G. Gentile I. Cikajlo D. Gatsios S. Konitsiotis D. Fotiadis |
| author_facet | L. Timotijevic C. E. Hodgkins A. Banks P. Rusconi B. Egan M. Peacock E. Seiss M. M. L. Touray H. Gage C. Pellicano G. Spalletta F. Assogna M. Giglio A. Marcante G. Gentile I. Cikajlo D. Gatsios S. Konitsiotis D. Fotiadis |
| author_sort | L. Timotijevic |
| collection | DOAJ |
| description | Abstract Background Despite the established evidence and theoretical advances explaining human judgments under uncertainty, developments of mobile health (mHealth) Clinical Decision Support Systems (CDSS) have not explicitly applied the psychology of decision making to the study of user needs. We report on a user needs approach to develop a prototype of a mHealth CDSS for Parkinson’s disease (PD), which is theoretically grounded in the psychological literature about expert decision making and judgement under uncertainty. Methods A suite of user needs studies was conducted in 4 European countries (Greece, Italy, Slovenia, the UK) prior to the development of PD_Manager, a mHealth-based CDSS designed for Parkinson’s disease, using wireless technology. Study 1 undertook Hierarchical Task Analysis (HTA) including elicitation of user needs, cognitive demands and perceived risks/benefits (ethical considerations) associated with the proposed CDSS, through structured interviews of prescribing clinicians (N = 47). Study 2 carried out computational modelling of prescribing clinicians’ (N = 12) decision strategies based on social judgment theory. Study 3 was a vignette study of prescribing clinicians’ (N = 18) willingness to change treatment based on either self-reported symptoms data, devices-generated symptoms data or combinations of both. Results Study 1 indicated that system development should move away from the traditional silos of ‘motor’ and ‘non-motor’ symptom evaluations and suggest that presenting data on symptoms according to goal-based domains would be the most beneficial approach, the most important being patients’ overall Quality of Life (QoL). The computational modelling in Study 2 extrapolated different factor combinations when making judgements about different questions. Study 3 indicated that the clinicians were equally likely to change the care plan based on information about the change in the patient’s condition from the patient’s self-report and the wearable devices. Conclusions Based on our approach, we could formulate the following principles of mHealth design: 1) enabling shared decision making between the clinician, patient and the carer; 2) flexibility that accounts for diagnostic and treatment variation among clinicians; 3) monitoring of information integration from multiple sources. Our approach highlighted the central importance of the patient-clinician relationship in clinical decision making and the relevance of theoretical as opposed to algorithm (technology)-based modelling of human judgment. |
| first_indexed | 2024-04-13T15:17:34Z |
| format | Article |
| id | doaj.art-35f4429c37e146808bdd7d5685b87cd5 |
| institution | Directory Open Access Journal |
| issn | 1472-6947 |
| language | English |
| last_indexed | 2024-04-13T15:17:34Z |
| publishDate | 2020-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Informatics and Decision Making |
| spelling | doaj.art-35f4429c37e146808bdd7d5685b87cd52022-12-22T02:41:48ZengBMCBMC Medical Informatics and Decision Making1472-69472020-02-0120112110.1186/s12911-020-1027-1Designing a mHealth clinical decision support system for Parkinson’s disease: a theoretically grounded user needs approachL. Timotijevic0C. E. Hodgkins1A. Banks2P. Rusconi3B. Egan4M. Peacock5E. Seiss6M. M. L. Touray7H. Gage8C. Pellicano9G. Spalletta10F. Assogna11M. Giglio12A. Marcante13G. Gentile14I. Cikajlo15D. Gatsios16S. Konitsiotis17D. Fotiadis18Faculty of Health and Medical Sciences, University of SurreyFaculty of Health and Medical Sciences, University of SurreyFaculty of Health and Medical Sciences, University of SurreyFaculty of Health and Medical Sciences, University of SurreyFaculty of Health and Medical Sciences, University of SurreyFaculty of Health and Medical Sciences, University of SurreyDepartment of Psychology, University of BournemouthFaculty of Health and Medical Sciences, University of SurreyFaculty of Health and Medical Sciences, University of SurreyDepartment of Neurorehabilitation, Fondanzione Santa LuciaDepartment of Neurorehabilitation, Fondanzione Santa LuciaDepartment of Neurorehabilitation, Fondanzione Santa LuciaFondanzione Ospedale San Camillo (I.R.C.C.S.), Parkinson’s Department Institute of NeurologyFondanzione Ospedale San Camillo (I.R.C.C.S.), Parkinson’s Department Institute of NeurologyFondanzione Ospedale San Camillo (I.R.C.C.S.), Parkinson’s Department Institute of NeurologyUniversity Rehabilitation InstituteDepartment of Material Sciences and Engineering, University of IoanninaNurology, Faculty of Medicine, School of Health Sciences, University of IoanninaDepartment of Material Sciences and Engineering, University of IoanninaAbstract Background Despite the established evidence and theoretical advances explaining human judgments under uncertainty, developments of mobile health (mHealth) Clinical Decision Support Systems (CDSS) have not explicitly applied the psychology of decision making to the study of user needs. We report on a user needs approach to develop a prototype of a mHealth CDSS for Parkinson’s disease (PD), which is theoretically grounded in the psychological literature about expert decision making and judgement under uncertainty. Methods A suite of user needs studies was conducted in 4 European countries (Greece, Italy, Slovenia, the UK) prior to the development of PD_Manager, a mHealth-based CDSS designed for Parkinson’s disease, using wireless technology. Study 1 undertook Hierarchical Task Analysis (HTA) including elicitation of user needs, cognitive demands and perceived risks/benefits (ethical considerations) associated with the proposed CDSS, through structured interviews of prescribing clinicians (N = 47). Study 2 carried out computational modelling of prescribing clinicians’ (N = 12) decision strategies based on social judgment theory. Study 3 was a vignette study of prescribing clinicians’ (N = 18) willingness to change treatment based on either self-reported symptoms data, devices-generated symptoms data or combinations of both. Results Study 1 indicated that system development should move away from the traditional silos of ‘motor’ and ‘non-motor’ symptom evaluations and suggest that presenting data on symptoms according to goal-based domains would be the most beneficial approach, the most important being patients’ overall Quality of Life (QoL). The computational modelling in Study 2 extrapolated different factor combinations when making judgements about different questions. Study 3 indicated that the clinicians were equally likely to change the care plan based on information about the change in the patient’s condition from the patient’s self-report and the wearable devices. Conclusions Based on our approach, we could formulate the following principles of mHealth design: 1) enabling shared decision making between the clinician, patient and the carer; 2) flexibility that accounts for diagnostic and treatment variation among clinicians; 3) monitoring of information integration from multiple sources. Our approach highlighted the central importance of the patient-clinician relationship in clinical decision making and the relevance of theoretical as opposed to algorithm (technology)-based modelling of human judgment.http://link.springer.com/article/10.1186/s12911-020-1027-1mHealthM-healthDigital healthClinical decision support systemCDSSUser needs |
| spellingShingle | L. Timotijevic C. E. Hodgkins A. Banks P. Rusconi B. Egan M. Peacock E. Seiss M. M. L. Touray H. Gage C. Pellicano G. Spalletta F. Assogna M. Giglio A. Marcante G. Gentile I. Cikajlo D. Gatsios S. Konitsiotis D. Fotiadis Designing a mHealth clinical decision support system for Parkinson’s disease: a theoretically grounded user needs approach BMC Medical Informatics and Decision Making mHealth M-health Digital health Clinical decision support system CDSS User needs |
| title | Designing a mHealth clinical decision support system for Parkinson’s disease: a theoretically grounded user needs approach |
| title_full | Designing a mHealth clinical decision support system for Parkinson’s disease: a theoretically grounded user needs approach |
| title_fullStr | Designing a mHealth clinical decision support system for Parkinson’s disease: a theoretically grounded user needs approach |
| title_full_unstemmed | Designing a mHealth clinical decision support system for Parkinson’s disease: a theoretically grounded user needs approach |
| title_short | Designing a mHealth clinical decision support system for Parkinson’s disease: a theoretically grounded user needs approach |
| title_sort | designing a mhealth clinical decision support system for parkinson s disease a theoretically grounded user needs approach |
| topic | mHealth M-health Digital health Clinical decision support system CDSS User needs |
| url | http://link.springer.com/article/10.1186/s12911-020-1027-1 |
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