User-Centered Development of an Online Platform for Drug Dosing Recommendations in Pediatrics

Rödle, Wolfgang; Wimmer, Stefan Jakob; Zahn, Julia; Prokosch, Hans‐Ulrich; Hinkes, Bernward; Neubert, Antje; Rascher, Wolfgang; Kraus, Stefan; Toddenroth, Dennis; Sedlmayr, Brita

doi:10.1055/s-0039-1693714

Cited by 11 publications

(16 citation statements)

References 26 publications

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“…Thirty items focused on the pharmacological, pharmaceutical part of the PDIS and are subject of the present analysis. The technical development of the prototype database and corresponding parts of the online user test has already been published elsewhere [ 14 ].…”

Section: Methodsmentioning

confidence: 99%

“…During the user test, participants had full access to the web-based PDIS. The user test started with two scenarios for each occupational group [ 14 ]. Each scenario illustrated a situation in which the HCP could make use of the PDIS in daily practice.…”

Section: Methodsmentioning

confidence: 99%

“…Reasons were the valuable overview of available formulations (dosage forms, strengths, problematic excipients) in general and information such as flavours of liquid oral formulations in particular. Adapted from [14].…”

Section: Online User Testmentioning

confidence: 99%

“…of participants (n = 12) of the online user test classified by using a five-point Likert scale. Adapted from[14].…”

mentioning

confidence: 99%

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Development and Evaluation of a Web-Based Paediatric Drug Information System for Germany

et al. 2021

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Background: Off-label use is frequent in paediatrics but that does not necessarily mean that the risk-benefit ratio is negative. Nevertheless, evidence-based data is essential for safe drug therapy. In Germany, there is no publicly available compendium providing transparent, evidence-based information for paediatric pharmacotherapy to date. This work describes the development of a web-based paediatric drug information system (PDIS) for Germany and its evaluation by health care professionals (HCP). Methods: Since 2012, a PDIS is being developed by the authors and is supported by the Federal Ministry of Health since 2016. Dosing recommendations were established based on systematic literature reviews and subsequent evaluation by clinical experts. The prototype was evaluated by HCP. Based on the results, the further development was concluded. Results: 92% of HCP believed that the PDIS could improve the quality of prescribing, as currently available information is deficient. Besides the license and formulations, dosing recommendations were the most relevant modules. A dosage calculator was the most wanted improvement. To facilitate sustainability of future development, a collaboration with the Dutch Kinderformularium was established. As of 2021, the database will be available to German HCP. Conclusion: The fundamentals for a German PDIS were established, and vital steps were taken towards successful continuation.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Online User Testmentioning

confidence: 99%

“…of participants (n = 12) of the online user test classified by using a five-point Likert scale. Adapted from[14].…”

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confidence: 99%

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Development and Evaluation of a Web-Based Paediatric Drug Information System for Germany

et al. 2021

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“…39 Pediatricians in this study echoed findings by Rödle et al where comprehensive information was needed with additional drug safety functionality such as medication alternatives. 40 In addition, participants in this study were enrolled using purposeful sampling to ensure a broad range of expertise and clinical backgrounds in the field of pediatrics. Consistently the participants required additional information in a bidirectional flow with pharmacists, senior clinicians, and specialists in a field for higher order clinical decision making.…”

Section: Informed Decision Makingmentioning

confidence: 99%

Clinician Perceptions of Timing and Presentation of Drug-Drug Interaction Alerts

et al. 2020

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Objective Alert presentation of clinical decision support recommendations is a common method for providing information; however, many alerts are overridden suggesting presentation design improvements can be made. This study attempts to assess pediatric prescriber information needs for drug–drug interactions (DDIs) alerts and to evaluate the optimal presentation timing and presentation in the medication ordering process. Methods Six case scenarios presented interactions between medications used in pediatric specialties of general medicine, infectious disease, cardiology, and neurology. Timing varied to include alert interruption at medication selection versus order submission; or was noninterruptive. Interviews were audiotaped, transcribed, and independently analyzed to derive central themes. Results Fourteen trainee and attending clinicians trained in pediatrics, cardiology, and neurology participated. Coders derived 8 central themes from 929 quotes. Discordance exists between medication prescribing frequency and DDI knowledge; providers may commonly prescribe medications for which they do not recognize DDIs. Providers wanted alerts at medication selection rather than at order signature. Alert presentation themes included standardizing text, providing interaction-specific incidence/risk information, DDI rating scales, consolidating alerts, and providing alternative therapies. Providers want alerts to be actionable, for example, allowing medication discontinuation and color visual cues for essential information. Despite alert volume, participants did not “mind being reminded because there is always the chance that at that particular moment (they) do not remember it” and acknowledged the importance of alerts as “essential in terms of patient safety.” Conclusion Clinicians unanimously agreed on the importance of receiving DDI alerts to improve patient safety. The perceived alert value can be improved by incorporating clinician preferences for timing and presentation.

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Usability of clinical decision support systems

et al. 2022

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Usability is considered a major success factor for current and future decision support systems. Such systems are increasingly used to assist human decision-makers in high-stakes tasks in complex domains such as health care, jurisdiction or finance. Yet, many if not most expert systems—especially in health care—fail to deliver the degree of quality in terms of usability that its expert users are used to from their personal digital consumer products. In this article, we focus on clinical decision support systems (CDSS) as an example for how important a human-centered design approach is when designing complex software in complex contexts. We provide an overview of CDSS classes, discuss the importance of systematically exploring mental models of users, and formulate challenges and opportunities of future design work on CDSS. We further provide a case study from a current research project to illustrate how we used codesign as a practical approach to produce usable software in a real-world context.Practical Relevance: We make a point for usability to be considered a major success factor and non-negotiable characteristic of expert software. With software evolving into virtual coworkers in terms of supporting human decision-making in complex, high-risk domains, the necessity of and demand for systems that are unambiguously understandable and interpretable for their expert users have never been higher. We show that this is a real-world problem with high practical relevance by describing our work in the domain of clinical decision support systems (CDSS) as an example. We introduce the topic and a classification of CDSS. Thus, we highlight a conceptual framework of how to approach complex domains from a technology designer’s point of view. We continue by explaining why usability must be regarded as a major goal in software development. We derive challenges and opportunities that may well be transferred to other domains. Finally, be including a real-world example from our own professional work we propose a practical approach towards taking the challenges and exploiting the associated opportunities.

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User-Centered Development of an Online Platform for Drug Dosing Recommendations in Pediatrics

Cited by 11 publications

References 26 publications

Development and Evaluation of a Web-Based Paediatric Drug Information System for Germany

Development and Evaluation of a Web-Based Paediatric Drug Information System for Germany

Clinician Perceptions of Timing and Presentation of Drug-Drug Interaction Alerts

Usability of clinical decision support systems

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