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Table 1 Key features of PGx-CDS display design

From: Utilizing a user-centered approach to develop and assess pharmacogenomic clinical decision support for thiopurine methyltransferase

Subsequent design decision

Human factors principle(s) applied or Interview results

1. Important information is presented on a single screen

Hazard control hierarchy [26, 27]

2. Action buttons are color coded

Blue for “Accept” button, red for “Override” button

Visual Cue [28]

3. Risk bar visualization indicates the danger of mutation

Red for homozygous mutation, orange for heterozygous mutation

The risk is categorized into high, moderate, low

Attention switch [29, 30]

4. Information is grouped into categories

Decision-making alignment

Chunking [31]

Three main criteria are: genotype result, dosing adjustment recommendation from references, and new medication order recommended

5. Recommendation(s) from the PGx-CDS is positioned so physicians can visually compare it to their current medication order

Proximity compatibility principle [32]

Minimize user memory load [33]

6. Additional information (e.g., lab values, references, calculations, immunization such as flu shot, TB) and contact information) are presented as supplemental information (via clickable buttons) to avoid information overload

Minimize user memory load [33]

Flexibility for user control of data display [33]

Interview results: PGx-CDS Content

Examples from the interviews:

Less is more,

“One of the biggest things to know is the ANC [absolute neutrophil count], the platelet… so you can [evaluate the new order recommended]”

“[Information from referencces] was condensed, it could be more helpful if you could turn things [certain lab values, calculations] off.”

7. Supplemental information (e.g. calculation, lab values) can be view simultaneously with the main information

Minimize user memory load [33]

8. Physicians can choose between two options for reviewing reference sources: 1) access information online or 2) send references to their own, individual email

Flexibility [33]

Interview results: PGx-CDS content

Example: “It would be nice to have [two options for reviewing reference sources] because most clinicians are not going to have time to read it right there