Testing and improving the acceptability of a web-based platform for collective intelligence to improve diagnostic accuracy in primary care clinics.

clinical reasoning collective intelligence diagnostic accuracy diagnostic error human diagnosis project

Journal

JAMIA open
ISSN: 2574-2531
Titre abrégé: JAMIA Open
Pays: United States
ID NLM: 101730643

Informations de publication

Date de publication:
Apr 2019
Historique:
received: 21 08 2018
revised: 22 10 2018
accepted: 05 12 2018
entrez: 28 1 2020
pubmed: 28 1 2020
medline: 28 1 2020
Statut: epublish

Résumé

Usable tools to support individual primary care clinicians in their diagnostic processes could help to reduce preventable harm from diagnostic errors. We conducted a formative study with primary care providers to identify key requisites to optimize the acceptability of 1 online collective intelligence platform (Human Diagnosis Project; Human Dx). We conducted semistructured interviews with practicing primary care clinicians in a sample of the US community-based clinics to examine the acceptability and early usability of the collective intelligence online platform using standardized clinical cases and real-world clinical cases from the participants' own practice. We used an integrated inductive-deductive qualitative analysis approach to analyze the interview transcripts. Perceived usefulness, perceived accuracy, quality assurance, trust, and ease of use emerged as essential domains of acceptability required for providers to use a collective intelligence tool in clinical practice. Participants conveyed that the collective opinion should: (1) contribute to their clinical reasoning, (2) boost their confidence, (3) be generated in a timely manner, and (4) be relevant to their clinical settings and use cases. Trust in the technology platform and the clinical accuracy of its collective intelligence output emerged as an incontrovertible requirement for user acceptance and engagement. We documented key requisites to building a collective intelligence technology platform that is trustworthy, useful, and acceptable to target end users for assistance in the diagnostic process. These key lessons may be applicable to other provider-facing decision support platforms.

Identifiants

pubmed: 31984344
doi: 10.1093/jamiaopen/ooy058
pii: ooy058
pmc: PMC6952011
doi:

Types de publication

Journal Article

Langues

eng

Pagination

40-48

Subventions

Organisme : AHRQ HHS
ID : K08 HS022561
Pays : United States
Organisme : NHLBI NIH HHS
ID : K23 HL136899
Pays : United States
Organisme : AHRQ HHS
ID : P30 HS023558
Pays : United States

Informations de copyright

© The Author(s) 2019. Published by Oxford University Press on behalf of the American Medical Informatics Association.

Références

Eur J Gen Pract. 2015 Sep;21 Suppl:8-13
pubmed: 26339829
PLoS One. 2016 Mar 08;11(3):e0148991
pubmed: 26954234
Med Decis Making. 2017 Aug;37(6):715-724
pubmed: 28355975
JAMA Dermatol. 2015 Oct;151(10):1075-80
pubmed: 25993262
BMJ Qual Saf. 2012 Jul;21(7):535-57
pubmed: 22543420
Ann Intern Med. 2016 Jan 5;164(1):59-61
pubmed: 26414299
JAMA Dermatol. 2015 Dec 1;151(12):1346-1353
pubmed: 26501400
BMJ Qual Saf. 2014 Sep;23(9):727-31
pubmed: 24742777
JAMA. 2015 Jan 20;313(3):303-4
pubmed: 25603003
JAMA. 2018 Jan 23;319(4):329-331
pubmed: 29362789
Health Serv Res. 2007 Aug;42(4):1758-72
pubmed: 17286625
Mayo Clin Proc. 2014 May;89(5):687-96
pubmed: 24797646
Acta Radiol. 2006 Sep;47(7):655-9
pubmed: 16950700
Jt Comm J Qual Patient Saf. 2014 Oct;40(10):461-1
pubmed: 26111306
Science. 2010 Oct 29;330(6004):686-8
pubmed: 20929725
J Hosp Med. 2014 Jul;9(7):451-6
pubmed: 24740747
Br J Cancer. 2009 Mar 24;100(6):901-7
pubmed: 19259088
PLoS One. 2015 Aug 12;10(8):e0134269
pubmed: 26267331
J Biomed Inform. 2010 Feb;43(1):159-72
pubmed: 19615467

Auteurs

Valy Fontil (V)

UCSF Division of General Internal Medicine, San Francisco, California, USA.
UCSF Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, San Francisco, California, USA.

Kate Radcliffe (K)

UCSF Division of General Internal Medicine, San Francisco, California, USA.
UCSF Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, San Francisco, California, USA.

Helena C Lyson (HC)

UCSF Division of General Internal Medicine, San Francisco, California, USA.
UCSF Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, San Francisco, California, USA.

Neda Ratanawongsa (N)

UCSF Division of General Internal Medicine, San Francisco, California, USA.
UCSF Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, San Francisco, California, USA.

Courtney Lyles (C)

UCSF Division of General Internal Medicine, San Francisco, California, USA.
UCSF Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, San Francisco, California, USA.

Delphine Tuot (D)

UCSF Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, San Francisco, California, USA.
UCSF Division of Nephrology, San Francisco, California, USA.

Kaeli Yuen (K)

Keck School of Medicine, University of Southern California, Los Angeles, California, USA.

Urmimala Sarkar (U)

UCSF Division of General Internal Medicine, San Francisco, California, USA.
UCSF Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, San Francisco, California, USA.

Classifications MeSH