Table 1 Amendments to alpha prototype of COMPASS resulting from usability testing
From: Development of a computerised decision aid for thrombolysis in acute stroke care
Amendment | Rationale |
|---|---|
• Landscape orientation with ‘tabs’ to switch between risk presentations | • Analogous to existing systems (e.g., Internet explorer) |
• Headers ‘inputs’ and ‘outcomes’ amended to ‘Patient details’ and ‘Predicted clinical outcomes’ respectively | • Reflects the language used in clinical practice, and to reduce perception of an artificial level of certainty |
• Order of patient details (demographics, medical history, blood results, examinations and CT scan) | • Sequence that information ‘typically’ becomes available during the hyperacute period |
• Amendments to labels for patient details and menu of operational definitions for patient details | • Avoid ambiguity, expedite data entry and security with data validation |
• Separate text boxes for entering information on stroke onset time and time likely to treat | • Security with data validation - with only one text box for ‘stroke onset time to treatment’ there is no reference point for stroke onset time or an explicit target treatment time |
• Automatic deletion of entered values when editing (and clearing risk presentation to indicate that calculation of outcomes needs to be repeated) | • Security with data validation by reducing risk of data mis-entry/accidental changes to patient details |
• Amendments to risk presentations: | • Consistency with preferences of clinicians and patients/relatives |
o use of the letter H to denote SICH and impact of SICH in the pictograph for treated outcomes | |
o re-ordering information in the clustered bar graph and flowchart diagram (independence, dependence, death) | |
• Inclusion of additional features: | • Increased acceptability and usability - enhanced governance/consent processes; and facilitating case review and use as a clinical training aid |
o weight conversion tool (Stones/lbs to kg); | |
o NIHSS calculator; | |
o ‘timeline’ function showing decrease in likely benefit from treatment as a function of stroke onset time to treatment; | |
o ability to save and print the risk presentations |