Patient Challenges and Needs in Comprehending Laboratory Test Results: Mixed Methods Study (Preprint)

Abstract

BACKGROUND Patients are increasingly able to access their laboratory test results via patient portals. However, merely providing access does not guarantee comprehension. Patients could experience confusion or even anxiety when reviewing their test results. OBJECTIVE Our objective was to examine the challenges and needs that patients have when comprehending laboratory test results. METHODS We conducted an online survey with 203 participants and a set of semi-structured interviews with13 participants. We assessed 1) patients’ perceived challenges and needs (both informational and technological needs) when they attempt to comprehend test results; 2) what factors are associated with patients’ perceptions; and 3) strategies for improving the design of patient portals to communicate lab test results more effectively. Descriptive statistics and thematic analysis were used to analyze the survey and interview data, respectively. RESULTS We found sociodemographic factors and lab result normality have significant impacts on people’s perceptions of using portals to view and interpret lab results. Patients need a variety of information to comprehend lab results, which are grouped into two categories – generic information (e.g., medical terminology, reference range, and diagnostic abilities of a specific test), and personalized or contextual information (e.g., the meaning of lab value in relation to their health, what to do next, and what to ask their doctor in clinic visit). The desired enhancements of patient portals include providing easy-to-understand data visualization and terminologies, explaining the result in the context of the patient’s health, supplementing educational services, increasing usability and accessibility, as well as incorporating artificial intelligence (AI)-based technology. CONCLUSIONS Patients face significant challenges in interpreting the meaning of lab test results. Designers and developers of patient portals should consider employing user-centered approaches to improve the design of patient portals to present information in a more meaningful way.

User-Centered System Design for Communicating Clinical Laboratory Test Results: Design and Evaluation Study

“…For example, the standard reference range of a laboratory test may not be applicable to older adults with chronic conditions [10]. Prior work has found that people often provided personal health information (eg, laboratory test results, age, medical history, and lifestyle) when posting questions on health forums to receive personalized recommendations from their peers [23,24]. From this perspective, providing information support tailored to the medical contexts of the patients could be very useful for them to determine whether results are worrisome and what might be appropriate for them to do.…”

“…When patients attempted to make sense of their results, they often turned to the internet to seek further information [23]. However, information on the web is sometimes either too general or misleading.…”