BPI22-017: An Assessment of the NAVIFY Guidelines Application Using Clinical Simulation Research Methods

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Jack Halligan Policy Fellow, Institute of Global Health Innovation at Imperial College London, London, UK
Prova Health

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 MB, BCH, BAO, LRCP & SI, MBA
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Matthew Prime Policy Fellow, Institute of Global Health Innovation at Imperial College London, London, UK
Prova Health

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 MBBS, PhD
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Gianluca Fontana Roche Information Solutions

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 BA, MSc
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Chaohui Guo Roche Information Solutions

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 MPhil, PhD
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Saira Ghafur Policy Fellow, Institute of Global Health Innovation at Imperial College London, London, UK
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 MBChB, MRCP
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Background: NAVIFY Guidelines is a software application that digitizes National Comprehensive Cancer Network (NCCN) Guidelines and allows the user to navigate guidelines in a stepwise manner to reach a clinical decision. The application has been designed to simplify access and improve adherence to guidelines in the management of oncology patients. This study assessed the usability of the NAVIFY Guidelines application using simulation-based research methods to inform ongoing product development. Methods: 10 oncologists (six breast oncologists, four general oncologists) were recruited to participate. During each session, the oncologists were asked to review clinical information for 10 synthetic breast cancer patient cases, which were developed by a medical oncologist, a surgical oncologist, a radiologist and a histopathologist. Participants were tasked to select the most appropriate guideline recommended decision for each case. For five cases the oncologist used NAVIFY Guidelines, and for five cases they were provided with a PDF of the NCCN Guidelines. Participants were instructed to approach the exercise with the same level of scrutiny as in a real clinical setting. To assess the usability of NAVIFY Guidelines, a survey was conducted immediately after each session. The survey included the system usability scale (SUS), a validated 10-item questionnaire for measuring the usability of software applications. A 10-minute interview was also conducted. Results: NAVIFY Guidelines overall score on the SUS questionnaire was in the 70th percentile. Two of the 10 items scored in the top decile – the application’s ease of use, and the ability to learn how to use the application quickly. The aspect of NAVIFY Guidelines application considered to be most useful was the stepwise nature in which guidelines were navigated (5 of 10 participants). The aspect of NAVIFY Guidelines considered most challenging was decision tree resetting when participants navigated back to the patient case information (4 of 10) and difficulty when choosing a starting point for the decision tree (3 of 10). Conclusion: These findings suggest that NAVIFY Guidelines is a user-friendly and easy to learn tool to enable better access to clinical guidelines. The results have been used to inform iterative product development and the next version release prevents decision tree resetting. This supports the use of simulation-based research methods to assess the usability of software applications in oncology.

Corresponding Author: Jack Halligan, MBA
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