Effects of Team Size and a Decision Support Tool on Healthcare Providers' Workloads in Simulated Neonatal Resuscitation

e19207 Background: Expanding systemic therapy options continue to improve outcomes for patients (pts) with pancreatic cancer (PCa) in both the unresectable and resectable disease settings. We developed an online treatment (Tx) decision support tool designed to provide community healthcare providers (HCPs) with case-specific recommendations from 5 PCa experts. Here, we report an analysis of cases entered into the tool by HCPs, comparing their planned Tx with expert recommendations and assessing the impact of those recommendations on intended HCP Tx decisions. Methods: In July 2019, 5 expert panelists provided Tx recommendations for numerous distinct PCa cases. To use the tool, HCPs entered specific pt/disease factors along with their intended Tx plan for the case, after which they received expert Tx recommendations followed by a survey asking if the recommendations had changed their planned Tx course. Results: 251 HCPs entered 347 pt cases into the tool (83% by physicians). 68% of respondents reported treating < 15 pts with PCa per yr, and 60% sought recommendations for a specific pt. Variance was observed between experts and HCPs for cases in several Tx settings (Table); eg, although FOLFIRINOX was the primary panel recommendation for many younger, healthier pts requiring neoadjuvant or adjuvant therapy or first-line Tx for unresectable disease, most HCPs did not select this therapy for these pts at baseline. Among HCPs whose planned Tx differed from the experts, 51% indicated that they would change their Tx based on panel recommendations. Conclusions: Analysis of data from an online Tx decision support tool for PCa revealed variance between expert recommendations and the intended Tx of HCPs for numerous scenarios, with education provided by the tool potentially increasing the number of clinicians who made optimal Tx decisions. A full analysis of Tx trends will be presented. [Table: see text]

Download Full-text

A Decision Support Tool for Allogenic Hematopoietic Stem Cell Transplantation for Children: An Acceptability and Usability Study (Preprint)

10.2196/preprints.30093 ◽

2021 ◽

Author(s):

Anirudh Veludhandi ◽

Diana Ross ◽

Cynthia Sinha ◽

Courtney McCracken ◽

Nitya Bakshi ◽

...

Keyword(s):

Decision Making ◽

Stem Cell ◽

Decision Support ◽

Hematopoietic Stem Cell Transplantation ◽

Decision Aid ◽

Healthcare Providers ◽

Decision Support Tool ◽

Decision Making Process ◽

Hematopoietic Stem ◽

Support Tool

BACKGROUND Individuals living with sickle cell disease (SCD) may benefit from a variety of disease-modifying therapies including hydroxyurea, voxelotor, crizanlizumab, L-Glutamine, and chronic blood transfusions, but allogenic hematopoietic stem cell transplantation (HCT) remains the only treatment with curative intent. Since HCT outcomes can be influenced by the complex interaction of several risk factors, HCT can be a difficult decision for healthcare providers to make for their SCD patients. OBJECTIVE The objective of this study was to determine the acceptability and usability of a prototype decision support tool to healthcare providers in decision making about HCT for SCD in conjunction with patients and their families. METHODS Based on published transplant registry data, we developed the Sickle Options decision support tool which provides healthcare providers with personalized transplant survival and risk estimates for their patients to help them make informed decisions regarding their patients’ management of SCD. To evaluate the tool for its acceptability and usability, we conducted beta-tests of the tool and surveys with physicians using the Ottawa Decision Support framework (ODSF) and mHealth App Usability Questionnaire (MAUQ) respectively. RESULTS On the MAUQ survey, the overall usability of the tool was high (mean 6.15, SD 0.79, 4.2-7). On the ODSF survey, acceptability of the decision support tool’s presentation of information was also high (mean 2.94, SD 0.63, 2-4) but mixed regarding the tool’s amount of it (mean 2.59, SD 0.5, 2-3). 87% of participants expressed that they would use the tool in their own patient consults, with 89% suggesting that the tool would ease the decision-making process regarding HCT. The four major emergent themes from the qualitative analysis of participant beta-tests include user interface, data content, usefulness during a patient consult, and potential for a patient-focused decision aid. A majority of participants welcomed the idea of a patient-focused decision aid but suggested to provide more background on HCT and a simplification of medical terminology. CONCLUSIONS We report the development, acceptability, and usability of a prototype decision support tool app to provide individualized risk and survival estimates to patients interested in HCT. The use of such a tool may encourage better physician-patient collaboration regarding the decision-making process and help to deliver evidence-based care to patients. Further incorporation of patient-specific measures including the HCT co-morbidity index and quality of life (QoL) post-transplant may improve the applicability of the decision support tool in a healthcare setting.

Download Full-text