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Development of an Electronic Healthcare Tool to Elicit Patient Preferences in Older Adults Diagnosed with Hematologic Malignancies

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Human Aspects of IT for the Aged Population. Technology in Everyday Living (HCII 2022)

Part of the book series: Lecture Notes in Computer Science ((LNCS,volume 13331))

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Abstract

The objective of this study was to develop and evaluate iterative prototypes for an electronic healthcare tool (EHT) using three versions of a discrete choice experiment (DCE) designed to elicit the treatment preferences of older adults with hematologic malignancies. We used a mixed-methods approach including qualitative assessments (think-aloud sessions and semi-structured interviews) to develop an affinity diagram for thematic analysis, and questionnaires (Post-Study System Usability and the National Aeronautical and Space administration’s Task Load Index [NASA-TLX]) to evaluate human-computer interaction, human factors and ergonomics standards on the perceived usability of, and the cognitive workload (CWL) required to perform tasks within the prototypes. DCEs included object case, profile case and multi-profile case. Iterative changes to the prototype were planned after each 5 participants. Overall, 15 healthy volunteers completed all assessments with 3 prototypes. Participants reported the prototypes were easy to complete and straightforward but usability issues around definitions, instructions, information overload, and navigation were revealed. Participants also reported feeling overwhelmed at the information presented in the DCEs and having difficulty understanding definitions. Usability and CWL levels were acceptable for all prototypes. The profile case DCE had higher frustration scores than the other versions (NASA-TLX subscale, p = 0.04). Iterative improvements were guided by usability principles and included easier access to definitions, the addition of instructive videos and the inclusion of a more straightforward DCE (object case). This process should improve the validity of results from the DCE and the feasibility of clinical implementation of the EHT.

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Acknowledgments

We would like to thank UNC Health for their ongoing support devoted to our research efforts. We thank Paul Mihas for his help in preparing an interview guide for use in soliciting participants’ comments and feedback about the prototypes. We thank Terri Ottosen for assisting with assessing and providing reports on the terminology used within the prototypes.

Author information

Authors and Affiliations

  1. Carolina Health Informatics Program, University of North Carolina, Chapel Hill, NC, USA

    Amy Cole, Karthik Adapa & Lukasz Mazur

  2. Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC, USA

    Amro Khasawneh & Lukasz Mazur

  3. UNC Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA

    Daniel R. Richardson

Authors
  1. Amy Cole
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  2. Amro Khasawneh
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  3. Karthik Adapa
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  4. Lukasz Mazur
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  5. Daniel R. Richardson
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Corresponding author

Correspondence to Amy Cole .

Editor information

Editors and Affiliations

  1. Tsinghua University, Beijing, China

    Qin Gao

  2. Chongqing University, Chongqing, China

    Jia Zhou

Appendix A

Appendix A

Semi-structured Interview Guide (asked after completing each prototype):

  1. 1.

    What is your overall impression of the prototype?

    1. a.

      What did you like about the prototype?

    2. b.

      What did you not like about it?

    3. c.

      What additional features would you like?

  2. 2.

    Did you find the prototype challenging to complete?

    1. a.

      Can you tell me more about that?

  3. 3.

    [Multi-Profile Case] You were presented with 10 questions that asked you to choose between drug a and drug b. Can you walk me through how you made a decision regarding treatment preferences in the prototype?

  4. 4.

    [Profile Case/Object Case] You were asked to think about what was most important and least important. Can you walk me through how you made a decision regarding treatment preferences in this prototype.

Semi-structured Interview Guide (asked after completing both prototypes):

  1. 5.

    Did the definitions of the attributes make sense to you as they were presented?

  2. 6.

    Did you feel that you understood the definitions of the attributes well enough to complete the prototype?

  3. 7.

    Could you distinguish between the levels of each attribute as they were presented in the prototype? For example, the levels presented for remission were 40%, 50%, or 60%.

    1. a.

      Can you tell me more about that?

  4. 8.

    When you read the words mild, moderate, and severe, what kinds of things came to mind?

  5. 9.

    You were asked 10 questions about drug a and drug b. You were also asked 7 questions about what was most important and least important.

    1. a.

      Which of these question series, if either, would help you have a more informed discussion with your providers?

  6. 10.

    Do you think patients with newly diagnosed cancer and their family caregivers will use this? If they do use this, do you think they will trust it?

    1. a.

      Can you tell me more about that? (What are the barriers and facilitators?)

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Cole, A., Khasawneh, A., Adapa, K., Mazur, L., Richardson, D.R. (2022). Development of an Electronic Healthcare Tool to Elicit Patient Preferences in Older Adults Diagnosed with Hematologic Malignancies. In: Gao, Q., Zhou, J. (eds) Human Aspects of IT for the Aged Population. Technology in Everyday Living. HCII 2022. Lecture Notes in Computer Science, vol 13331. Springer, Cham. https://doi.org/10.1007/978-3-031-05654-3_14

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  • DOI: https://doi.org/10.1007/978-3-031-05654-3_14

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