Presentation of laboratory test results in patient portals: influence of interface design on risk interpretation and visual search behaviour
Abstract 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 correctl...
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doaj-85ad4b08652c4ca787820051fd3ba7fa2020-11-24T23:32:46ZengBMCBMC Medical Informatics and Decision Making1472-69472018-02-0118111210.1186/s12911-018-0589-7Presentation of laboratory test results in patient portals: influence of interface design on risk interpretation and visual search behaviourPaolo Fraccaro0Markel Vigo1Panagiotis Balatsoukas2Sabine N. van der Veer3Lamiece Hassan4Richard Williams5Grahame Wood6Smeeta Sinha7Iain Buchan8Niels Peek9NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre, The University of ManchesterSchool of Computer Science, The University of ManchesterCentre for Health Informatics, City UniversityHealth eResearch Centre, Farr Institute for Health Informatics ResearchHealth eResearch Centre, Farr Institute for Health Informatics ResearchNIHR Greater Manchester Primary Care Patient Safety Translational Research Centre, The University of ManchesterRenal Clinic, Salford Royal NHS TrustRenal Clinic, Salford Royal NHS TrustMicrosoft Healthcare, Microsoft ResearchNIHR Greater Manchester Primary Care Patient Safety Translational Research Centre, The University of ManchesterAbstract 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.http://link.springer.com/article/10.1186/s12911-018-0589-7User-computer interface [MeSH]Computers/utilization [MeSH]Decision making [MeSH]Personal health record [MeSH]Patient access to records [MeSH]Patient portals |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Paolo Fraccaro Markel Vigo Panagiotis Balatsoukas Sabine N. van der Veer Lamiece Hassan Richard Williams Grahame Wood Smeeta Sinha Iain Buchan Niels Peek |
spellingShingle |
Paolo Fraccaro Markel Vigo Panagiotis Balatsoukas Sabine N. van der Veer Lamiece Hassan Richard Williams Grahame Wood Smeeta Sinha Iain Buchan Niels Peek Presentation of laboratory test results in patient portals: influence of interface design on risk interpretation and visual search behaviour BMC Medical Informatics and Decision Making User-computer interface [MeSH] Computers/utilization [MeSH] Decision making [MeSH] Personal health record [MeSH] Patient access to records [MeSH] Patient portals |
author_facet |
Paolo Fraccaro Markel Vigo Panagiotis Balatsoukas Sabine N. van der Veer Lamiece Hassan Richard Williams Grahame Wood Smeeta Sinha Iain Buchan Niels Peek |
author_sort |
Paolo Fraccaro |
title |
Presentation of laboratory test results in patient portals: influence of interface design on risk interpretation and visual search behaviour |
title_short |
Presentation of laboratory test results in patient portals: influence of interface design on risk interpretation and visual search behaviour |
title_full |
Presentation of laboratory test results in patient portals: influence of interface design on risk interpretation and visual search behaviour |
title_fullStr |
Presentation of laboratory test results in patient portals: influence of interface design on risk interpretation and visual search behaviour |
title_full_unstemmed |
Presentation of laboratory test results in patient portals: influence of interface design on risk interpretation and visual search behaviour |
title_sort |
presentation of laboratory test results in patient portals: influence of interface design on risk interpretation and visual search behaviour |
publisher |
BMC |
series |
BMC Medical Informatics and Decision Making |
issn |
1472-6947 |
publishDate |
2018-02-01 |
description |
Abstract 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. |
topic |
User-computer interface [MeSH] Computers/utilization [MeSH] Decision making [MeSH] Personal health record [MeSH] Patient access to records [MeSH] Patient portals |
url |
http://link.springer.com/article/10.1186/s12911-018-0589-7 |
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