Visualizing Complex Patient-Reported Outcome Data to Support Follow-Up of Head and Neck Cancer Patients

In the follow-up of patients with head and neck cancers (HNC), Patient-Reported Outcomes (PRO) are insufficiently used as immediate treatment feedback although they could support both physician-patient communication and physicians’ decision making. Physicians’ everyday work in routine clinical care is often characterized by lack of time, workload pressure and inadequate resources. To allow for efficient and effective review of the complex heterogeneous outcome data, a hierarchical information structure was developed with regard to a dashboard paradigm for an interactive tablet-based system. Applying a user-centered process, a structure of top-level categories and their contents was constructed in cooperation with physicians specialized in Otolaryngology. These categories contain both questionnaire scores and standalone metrics with indicators for need of intervention. Considering the suitability of a patient overview dashboard, corresponding design guidelines have been identified. The developed application, which is currently used in the follow-care of HNC patients in a prospective nonrandomized controlled monocentric care trial, has been iteratively tailored for routine clinical care using a rapid prototyping approach. A particular focus was on the form factor, interaction capabilities and limitations of tablet computers regarding the overall usability of the dashboard.

[1]  Jakob Nielsen,et al.  Usability engineering , 1997, The Computer Science and Engineering Handbook.

[2]  P. Deshpande,et al.  Patient-reported outcomes: A new era in clinical research , 2011, Perspectives in clinical research.

[3]  M. Kris,et al.  Overall Survival Results of a Trial Assessing Patient-Reported Outcomes for Symptom Monitoring During Routine Cancer Treatment , 2017, JAMA.

[4]  C. Wakefield,et al.  Primary Care Physicians’ Perspectives of Their Role in Cancer Care: A Systematic Review , 2016, Journal of General Internal Medicine.

[5]  Jeffery L. Belden,et al.  Defining and testing EMR usability: Principles and proposed methods of EMR usability evaluation and rating. , 2009 .

[6]  C. Cleeland,et al.  How to assess cancer pain. , 1992 .

[7]  D. Lavallee,et al.  Health Affairs And Enhance Care Incorporating Patient-Reported Outcomes Into Health Care To Engage Patients , 2016 .

[8]  S. Zipfel,et al.  Screening psychischer Störungen mit dem "Gesundheitsfragebogen für Patienten (PHQ-D)" Ergebnisse der deutschen Validierungsstudie , 2004 .

[9]  Jakob Nielsen,et al.  Improving a human-computer dialogue , 1990, CACM.

[10]  Ben Shneiderman,et al.  Designing the User Interface: Strategies for Effective Human-Computer Interaction , 1998 .

[11]  Karen Holtzblatt,et al.  Contextual design , 1997, INTR.

[12]  L. Doward,et al.  Defining patient-reported outcomes. , 2004, Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research.

[13]  S. Rogers,et al.  Development of ICF core sets for head and neck cancer , 2009, Head & neck.

[14]  D. Howell,et al.  Patient-reported outcomes in routine cancer clinical practice: a scoping review of use, impact on health outcomes, and implementation factors. , 2015, Annals of oncology : official journal of the European Society for Medical Oncology.

[15]  James H. Tiessen,et al.  The provider perspective: investigating the effect of the Electronic Patient-Reported Outcome (ePRO) mobile application and portal on primary care provider workflow , 2017, Primary Health Care Research & Development.

[16]  Ben Shneiderman,et al.  The eyes have it: a task by data type taxonomy for information visualizations , 1996, Proceedings 1996 IEEE Symposium on Visual Languages.