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. 2023 Aug 1;23(1):145.
doi: 10.1186/s12911-023-02249-6.

Design and evaluation of a Mobile-Based decision support system to enhance lung transplant candidate assessment and management: knowledge translation integrated with clinical workflow

Hamidreza Abtahi  1 , Leila Shahmoradi  2   3 , Shahideh Amini  4 , Marsa Gholamzadeh  5   6
Affiliations

Design and evaluation of a Mobile-Based decision support system to enhance lung transplant candidate assessment and management: knowledge translation integrated with clinical workflow

Hamidreza Abtahi et al. BMC Med Inform Decis Mak. .

Abstract

Background: Accurate and timely decision-making in lung transplantation (LTx) programs is critical. The main objective of this study was to develop a mobile-based evidence-based clinical decision support system (CDSS) to enhance the management of lung transplant candidates.

Method: An iterative participatory software development process was employed to develop the ImamLTx CDSS. This study was accomplished in three phases. First, required data and standard clinical workflow were identified according to the literature review and expert consensus. Second, a rule-based knowledge-based CDSS application was developed. In the third phase, this CDSS was evaluated. The evaluation was done using the standard Post-Study System Usability Questionnaire (PSSUQ 18.3) and ten usability heuristics factors for user interface design.

Results: According to expert consensus, fifty-five data items were identified as essential data sets using the Content Validity Ratio (CVR) formula. By integrating information flow in clinical practices with clinical protocols, more than 450 rules and 500 knowledge statements were extracted. This CDSS provides clinical decision support on an Android platform regarding inclusion and exclusion referral criteria, optimum transplant time based on the type of lung disease, findings of initial assessment, and the overall evaluation of lung transplant candidates. Evaluation results showed high usability ratings due to the fact provided accuracy and sensitivity of this lung transplant CDSS with the information quality domain receiving the highest score (6.305 from 7).

Conclusion: Through a stepwise approach, the ImamLTx CDSS was developed to provide LTx programs with timely patient data access via a mobile platform. Our results suggest integration with existing workflow to support clinical decision-making and provide patient-specific recommendations.

Keywords: Clinical decision support system; Clinical protocols; Expert system; Lung transplantation; M-health.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The methodology model of our study
Fig. 2
Fig. 2
The architecture of the ImamLTx CDSS.
Fig. 3
Fig. 3
The identified problems and challenges
Fig. 4
Fig. 4
The six-point decision model and information flow of candidate management
Fig. 5
Fig. 5
Summary of approved data sets by the experts in eight categories
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Fig. 6
The conceptual model of the CDSS for lung transplantation management
Fig. 7
Fig. 7
The LTxImam application
See this image and copyright information in PMC

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