Table 2 User-testing findings of barriers and issues and solutions to inform iterations of the encounter decision aids
Barriers and issues discovered during the user testing | Changes in the subsequent iterations | |
|---|---|---|
Accessibility | Lack of contrast in text and pictographs Scrolling was needed to see all content when tablet was vertical Wi-Fi issues in hospitals | Enhanced contrasts, changed colours Scrolling removed Created off-line version and print version |
Usability | Suggestion of a top layer to ease the introduction to the tool Difficulty coming up with language to use the tool Suggestion to combine the tool with information provided to patient before encounter Suggestion to have the possibility to change the denominator in the icons (and possibly in the numbers) | Supportive sentence “What aspect would you like to discuss next? Choose and compare” outcomes to raise choice awareness Possibility to change data entry and display directly in MAGICapp feeding in the interactive decision aid content |
Understandability | Concept of certainty Medical abbreviations difficult to understand Generic drugs names confusing | Main reason for uncertainty made available one click away Names and descriptions of outcomes can be edited |
Usefulness | Great variability in the perception of the appropriate amount of information, in particular the number and order of outcomes Useful to have something to bring home Suggestion of a feature that could compare several options | Number of outcomes and their order can be selected independently of underlying evidence profile Print version developed Multiple comparisons prototype in development |
Identification | The patient’s risk might be different from what is shown in the tool | Highlight during demonstration and in quick educational modules that this is encounter decision aid to be used together with a clinician, who can adapt content to each patient, highlighting potential similarities or differences |
Credibility | Different colour of outcome card for practical issues could lead to selection bias | Specific design developed to display practical issues and navigate across them [12] |
Findability | Clinician needed more information on evidence behind estimates in decision aids | Integration with MAGICapp with decision aids directly linked to GRADE evidence summaries |