ArticleBMJ open2023
Design and validation of a new Healthcare Systems Usability Scale (HSUS) for clinical decision support systems: a mixed-methods approach.
Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- Optimizing Clinical Decision Support System Functionality by Leveraging Specific Human-Computer Interaction Elements: Insights From a Systematic Review.JMIR human factors · 2025Pooled it
- Machine learning approaches in the therapeutic outcome prediction in major depressive disorder: a systematic review.Frontiers in psychiatry · 2025Pooled it
- Effect of an electronic health record-integrated machine learning asthma risk marker on pediatrician prognostic accuracy during preschool age: a pilot randomized clinical trial.Scientific reports · 2026Trial
- Bringing usability testing to the front lines: IV smart pump evaluation with critical care nurses at a national conference.MethodsX · 2026Article
- A hybrid effectiveness-implementation trial to integrate precision skin cancer risk feedback in federally qualified health centers.Contemporary clinical trials · 2026Article
- Usability and Quality of UCISAB, a Clinical Decision Support System for Optimization of Analgesia and Sedation Infusions in the ICU: A Multicenter, Cross-Sectional, Mixed-Methods Usability Evaluation in Colombia.Journal of clinical medicine · 2026Article
- Clinical Decision Support for Digital Dietary Counseling Under GLP-1 Receptor Agonist Therapy: Convergent Mixed Methods Usability and Treatment Satisfaction Pilot Study of the Personalized Nutrition Advisor.JMIR formative research · 2026Article
- A Systematic Review of Factors Affecting Utilization of Decision Support Systems: The Interplay Between Technology, Users, and the Healthcare Environment.Health science reports · 2026Review
- Combining Subjective Perceptions and Objective Behavioral Metrics With the Elderly Digital Twin System: Quantitative Usability Study.JMIR aging · 2026Article
- Feasibility and acceptability of a passive digital marker for childhood asthma risk prognosis: a pilot cross-sectional study.Pilot and feasibility studies · 2026Article
- Content Validation of an Electronic Health Record-Based Diabetes Self-Management Support Tool for Older Adults With Type 2 Diabetes: Qualitative Study.JMIR diabetes · 2026Article
- Assessing a virtual scenario-based training system for enhancing clinical reasoning and communication in dental education.BMC oral health · 2026Article
- Perceived Usability of Zoom™ for a Single-Session Telehealth Fall-Risk Screening in Community-Dwelling Older Adults.International journal of telerehabilitation · 2026Article
- Mapping the landscape of standardized usability questionnaires in healthcare: a 26-year scoping review.Frontiers in digital health · 2026Review
- Human Factors in Airway Management: Designing Systems for Safer, Team-Based Care.Journal of clinical medicine · 2025Review
- Usability and adoption in a randomized trial of GutGPT a GenAI tool for gastrointestinal bleeding.NPJ digital medicine · 2025Article
- EMR usability and patient safety: a national survey of physicians.NPJ digital medicine · 2025Article
- Evaluation of IMPALA 2.0: Addressing Patient Monitoring in Low-Resource Hospitals in Malawi.Medical science monitor : international medical journal of experimental and clinical research · 2024Article
- A Systematic Review of Artificial Intelligence-Based Clinical Decision Support Systems in Prostate Cancer Management.Healthcare technology lettersReview
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveTo develop and validate a questionnaire to assess the usability of clinical decision support systems (CDSS) and to assist in the early identification of usability issues that may impact patient safety and quality of care.
designMixed research methods were used to develop and validate the questionnaire. The qualitative study involved scale item development, content and face validity. Pilot testing established construct validity using factor analysis and facilitated estimates for reliability and internal consistency using the Cronbach's alpha coefficient.
settingTwo hospitals within a single National Health Service Trust.
participantsWe recruited a panel of 7 experts in usability and questionnaire writing for health purposes to test content validity; 10 participants to assess face validity and 78 participants for the pilot testing. To be eligible for this last phase, participants needed to be health professionals with at least 3 months experience using the local hospital electronic patient record system.
resultsFeedback from the face and content validity phases contributed to the development and improvement of scale items. The final Healthcare Systems Usability Scale (HSUS) proved quick to complete, easy to understand and was mostly worded by potential users. Exploratory analysis revealed four factors related to patient safety, task execution, alerts or recommendations accuracy, the effects of the system on workflow and ease of system use. These separate into four subscales: patient safety and decision effectiveness (seven items), workflow integration (six items), work effectiveness (five items) and user control (four items). These factors affect the quality of care and clinician's ability to make informed and timely decisions when using CDSS. The HSUS has a very good reliability with global Cronbach's alpha 0.914 and between 0.702 and 0.926 for the four subscales.
conclusionThe HSUS is a valid and reliable tool for usability testing of CDSS and early identification of usability issues that may cause medical adverse events.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.