Evidence map›Paper›PMID 37507683›Full record

ArticleBMC medical informatics and decision making2023

Using the sociotechnical model to conduct a focused usability assessment of a breast reconstruction decision tool.

Randi Foraker, Crystal Phommasathit, Kaleigh Clevenger, Clara Lee, Jessica Boateng, Napiera Shareef, Mary C Politi

Abstract read
In one paragraph

Article in BMC medical informatics and decision making, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Randi ForakerDivision of General Medical Sciences, Department of Internal Medicine, Washington University in St. Louis School of Medicine, Saint Louis, MO, USA. randi.foraker@wustl.edu.
Crystal PhommasathitComprehensive Cancer Center, College of Health Sciences, The Ohio State University, Columbus, OH, USA.
Kaleigh ClevengerComprehensive Cancer Center, College of Health Sciences, The Ohio State University, Columbus, OH, USA.
Clara LeeDepartment of Plastic and Reconstructive Surgery, College of Medicine, Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, OH, USA.
Jessica BoatengDivision of Public Health Sciences, Department of Surgery, School of Medicine, Washington University in St Louis, Saint Louis, MO, USA.
Napiera ShareefCollege of Medicine, The Ohio State University, Columbus, OH, USA.
Mary C PolitiDivision of Public Health Sciences, Department of Surgery, School of Medicine, Washington University in St Louis, Saint Louis, MO, USA.

Funding

Implementing a Breast Reconstruction Decision Support Tool in Diverse Practice SettingsR18HS026699 · AHRQ · WASHINGTON UNIVERSITY · PI LEE, CLARA NAN-HI, POLITI, MARY C · 2019 to 2021
$1.2M
AHRQ HHS R18 HS026699
6 · The paper itself

Abstract

introductionBREASTChoice is a web-based breast reconstruction decision aid. The previous clinical trial-prior to the adaptation of this refined tool in which we explored usability-measured decision quality, quality of life, patient activation, shared decision making, and treatment choice. The current usability study was designed to elicit patients' and clinicians' perspectives on barriers and facilitators for implementing BREASTChoice into the clinical workflow.

methodsWe conducted qualitative interviews with patients and clinicians from two Midwestern medical specialty centers from August 2020 to April 2021. Interviews were first double coded until coders achieved a kappa > 0.8 and percent agreement > 95%, then were coded independently. We used a sociotechnical framework to evaluate BREASTChoice's implementation and sustainability potential according to end-users, human-computer interaction, and contextual factors.

resultsTwelve clinicians and ten patients completed interviews. Using the sociotechnical framework we determined the following. People Using the Tool: Patients and clinicians agreed that BREASTChoice could help patients make more informed decisions about their reconstruction and prepare better for their first plastic surgery appointment. Workflow and Communications: They felt that BREASTChoice could improve communication and process if the patient could view the tool at home and/or in the waiting room. Clinicians suggested the information from BREASTChoice about patients' risks and preferences be included in the patient's chart or the clinician electronic health record (EHR) inbox for accessibility during the consultation. Human Computer Interface: Patients and clinicians stated that the tool contains helpful information, does not require much time for the patient to use, and efficiently fills gaps in knowledge. Although patients found the risk profile information helpful, they reported needing time to read and digest.

conclusionBREASTChoice was perceived as highly usable by patients and clinicians and has the potential for sustainability. Future research will implement and test the tool after integrating the stakeholder-suggested changes to its delivery process and content. It is critical to conduct usability assessments such as these prior to decision aid implementation to ensure success of the tool to improve risk communication.

Indexed as

MammaplastyUser-Computer InterfaceCommunicationDecision MakingHumansPatient ParticipationQuality of LifeBreast cancerBreast reconstructionClinical decision aidSociotechnical framework

Identifiers

PMID37507683
PMCPMC10375746

What OpenQuestion holds

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Registered trials

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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.