Evidence map›Paper›PMID 38407255›Full record

ArticleHepatology communications2024

Applying human-centered design to the construction of a cirrhosis management clinical decision support system.

Jin Ge, Ana Buenaventura, Beth Berrean, Jory Purvis, Valy Fontil, Jennifer C Lai, Mark J Pletcher

Open access · goldAbstract read
In one paragraph

Article in Hepatology communications, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.4field-weighted citation impact, top 17% of its field
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

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Article
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 at 2 institutions in 1 country.

Jin GeDepartment of Medicine, Division of Gastroenterology and Hepatology, University of California-San Francisco, San Francisco, California, USA.ORCID 0000-0003-1574-1525
Ana BuenaventuraSchool of Medicine Technology Services, University of California-San Francisco, San Francisco, California, USA.
Beth BerreanSchool of Medicine Technology Services, University of California-San Francisco, San Francisco, California, USA.ORCID 0000-0002-7414-4280
Jory PurvisSchool of Medicine Technology Services, University of California-San Francisco, San Francisco, California, USA.
Valy FontilFamily Health Centers, NYU-Langone Medical Center, Brooklyn, New York, USA.ORCID 0000-0003-0795-3237
Jennifer C LaiDepartment of Medicine, Division of Gastroenterology and Hepatology, University of California-San Francisco, San Francisco, California, USA.ORCID 0000-0003-2092-6380
Mark J PletcherDepartment of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, California, USA.ORCID 0000-0002-6966-1312
University of California, San Francisco · USNYU Langone Health · US

Funding

Clinical and Translational Science InstituteUL1TR001872 · NCATS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI COLLARD, HAROLD R, JACOBY, VANESSA · 2016 to 2025
$112.1M
UCSF Liver Core CenterP30DK026743 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Holger Willenbring · 1986 to 2026
$30.7M
Institutional Career Development Core SupplementKL2TR001870 · NCATS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI KANAYA, ALKA M., SARKAR, URMIMALA · 2016 to 2025
$19.7M
The spectrum of cognitive impairment including Alzheimer’s Disease and Related Dementias after liver transplantationR01AG059183 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Jennifer C. Lai · 2018 to 2026
$9.9M
Bring it Down San Francisco: Harnessing cloud-based technology to improve hypertension management in a low-income underserved populationK23HL136899 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI FONTIL, VALY · 2018 to 2022
$887k
The Impact of Frailty on Liver Transplant Outcomes in Older Adults with Hepatocellular CarcinomaK24AG080021 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Jennifer C. Lai · 2023 to 2026
$755k
NCATS NIH HHS KL2 TR001870NCATS NIH HHS UL1 TR001872NHLBI NIH HHS K23 HL136899NIA NIH HHS K24 AG080021NIA NIH HHS R01 AG059183NIDDK NIH HHS P30 DK026743
6 · The paper itself

Abstract

backgroundElectronic health record (EHR)-based clinical decision support is a scalable way to help standardize clinical care. Clinical decision support systems have not been extensively investigated in cirrhosis management. Human-centered design (HCD) is an approach that engages with potential users in intervention development. In this study, we applied HCD to design the features and interface for a clinical decision support system for cirrhosis management, called CirrhosisRx.

methodsWe conducted technical feasibility assessments to construct a visual blueprint that outlines the basic features of the interface. We then convened collaborative-design workshops with generalist and specialist clinicians. We elicited current workflows for cirrhosis management, assessed gaps in existing EHR systems, evaluated potential features, and refined the design prototype for CirrhosisRx. At the conclusion of each workshop, we analyzed recordings and transcripts.

resultsWorkshop feedback showed that the aggregation of relevant clinical data into 6 cirrhosis decompensation domains (defined as common inpatient clinical scenarios) was the most important feature. Automatic inference of clinical events from EHR data, such as gastrointestinal bleeding from hemoglobin changes, was not accepted due to accuracy concerns. Visualizations for risk stratification scores were deemed not necessary. Lastly, the HCD co-design workshops allowed us to identify the target user population (generalists).

conclusionsThis is one of the first applications of HCD to design the features and interface for an electronic intervention for cirrhosis management. The HCD process altered features, modified the design interface, and likely improved CirrhosisRx's overall usability. The finalized design for CirrhosisRx proceeded to development and production and will be tested for effectiveness in a pragmatic randomized controlled trial. This work provides a model for the creation of other EHR-based interventions in hepatology care.

Indexed as

Decision Support Systems, ClinicalGastroenterologyElectronic Health RecordsHumansLiver CirrhosisRisk Factors

Identifiers

PMID38407255
PMCPMC10898661
OpenAlexW4392155055

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.