Presentation of laboratory test results in patient portals: influence of interface design on risk interpretation and visual search behaviour

被引:23
作者
Fraccaro, Paolo [1 ,2 ,3 ]
Vigo, Markel [5 ]
Balatsoukas, Panagiotis [7 ]
van der Veer, Sabine N. [2 ,3 ]
Hassan, Lamiece [2 ,3 ]
Williams, Richard [1 ,2 ,3 ]
Wood, Grahame [4 ]
Sinha, Smeeta [4 ]
Buchan, Iain [6 ]
Peek, Niels [1 ,2 ,3 ]
机构
[1] Univ Manchester, NIHR Greater Manchester Primary Care Patient Safe, Manchester, Lancs, England
[2] Farr Inst Hlth Informat Res, Hlth eRes Ctr, London, England
[3] Univ Manchester, Ctr Hlth Informat, Div Informat Imaging & Data Sci, Manchester, Lancs, England
[4] Salford Royal NHS Trust, Renal Clin, Salford, Lancs, England
[5] Univ Manchester, Sch Comp Sci, Manchester, Lancs, England
[6] Microsoft Res, Microsoft Healthcare, Cambridge, England
[7] City Univ London, Ctr Hlth Informat, London, England
基金
英国工程与自然科学研究理事会;
关键词
User-computer interface [MeSH; Computers/utilization [MeSH; Decision making [MeSH; Personal health record [MeSH; Patient access to records [MeSH; Patient portals; Decision support systems clinical [MeSH; Personal health records; Patients access to records; Laboratory test results; Computer utilization; Eye tracking; ELECTRONIC MEDICAL-RECORDS; PATIENTS ACCESS; HEALTH; COMMUNICATION; OVERVIEWS; LITERACY; NUMERACY; OUTCOMES; GRAPHS;
D O I
10.1186/s12911-018-0589-7
中图分类号
R-058 [];
学科分类号
摘要
Background: Patient portals are considered valuable instruments for self-management of long term conditions, however, there are concerns over how patients might interpret and act on the clinical information they access. We hypothesized that visual cues improve patients' abilities to correctly interpret laboratory test results presented through patient portals. We also assessed, by applying eye-tracking methods, the relationship between risk interpretation and visual search behaviour. Methods: We conducted a controlled study with 20 kidney transplant patients. Participants viewed three different graphical presentations in each of low, medium, and high risk clinical scenarios composed of results for 28 laboratory tests. After viewing each clinical scenario, patients were asked how they would have acted in real life if the results were their own, as a proxy of their risk interpretation. They could choose between: 1) Calling their doctor immediately (high interpreted risk); 2) Trying to arrange an appointment within the next 4 weeks (medium interpreted risk); 3) Waiting for the next appointment in 3 months (low interpreted risk). For each presentation, we assessed accuracy of patients' risk interpretation, and employed eye tracking to assess and compare visual search behaviour. Results: Misinterpretation of risk was common, with 65% of participants underestimating the need for action across all presentations at least once. Participants found it particularly difficult to interpret medium risk clinical scenarios. Participants who consistently understood when action was needed showed a higher visual search efficiency, suggesting a better strategy to cope with information overload that helped them to focus on the laboratory tests most relevant to their condition. Conclusions: This study confirms patients' difficulties in interpreting laboratories test results, with many patients underestimating the need for action, even when abnormal values were highlighted or grouped together. Our findings raise patient safety concerns and may limit the potential of patient portals to actively involve patients in their own healthcare.
引用
收藏
页数:12
相关论文
共 54 条
[21]  
Gotz David, 2011, AMIA Annu Symp Proc, V2011, P481
[22]  
Greene S, 2000, J AM SOC INFORM SCI, V51, P380, DOI 10.1002/(SICI)1097-4571(2000)51:4<380::AID-ASI7>3.0.CO
[23]  
2-5
[24]   Absolute risk representation in cardiovascular disease prevention: comprehension and preferences of health care consumers and general practitioners involved in a focus group study [J].
Hill, Sophie ;
Spink, Janet ;
Cadilhac, Dominique ;
Edwards, Adrian ;
Kaufman, Caroline ;
Rogers, Sophie ;
Ryan, Rebecca ;
Tonkin, Andrew .
BMC PUBLIC HEALTH, 2010, 10
[25]   Patients promised online access to their medical records by 2018 [J].
Iacobucci, Gareth .
BMJ-BRITISH MEDICAL JOURNAL, 2015, 351
[26]  
Jakob N., 2006, ALERTBOX CURR ISSUES
[27]  
Johnson Constance M, 2012, AMIA Annu Symp Proc, V2012, P427
[28]  
Klimov Denis, 2005, AMIA Annu Symp Proc, P405
[29]  
Kruse CS, 2015, J MED INTERNET RES, V17, P70, DOI [10.2196/jmir.3703, 10.2196/jmir.3171]
[30]   Users can change their web search tactics: Design guidelines for categorized overviews [J].
Kules, Bill ;
Shneiderman, Ben .
INFORMATION PROCESSING & MANAGEMENT, 2008, 44 (02) :463-484