Web-based eHealth Clinical Decision Support System as a tool for the treat-to-target management of patients with systemic lupus erythematosus: development and initial usability evaluation .

Background: Treat-to-target (T2T) is a therapeutic strategy currently being studied for its application in systemic lupus erythematosus (SLE). Patients and rheumatologists have little support in making the best treatment decision in the context of a T2T strategy, thus, the use of information technology for systematically processing data and supporting information and knowledge may improve routine decision-making practices, helping to deliver value-based care.
Objective: To design and develop an online Clinical Decision Support Systems (CDSS) tool "SLE-T2T", and test its usability for the implementation of a T2T strategy in the management of patients with SLE.
Methods: A prototype of a CDSS was conceived as a web-based application with the task of generating appropriate treatment advice based on entered patients' data. Once developed, a System Usability Score (SUS) questionnaire was implemented to test whether the eHealth tool was user-friendly, comprehensible, easy-to-deliver and workflow-oriented. Data from the participants' comments were synthesised, and the elements in need for improvement were identified.
Results: The beta version web-based system was developed based on the interim usability and acceptance evaluation. 7 participants completed the SUS survey. The median SUS score of SLE-T2T was 79 (scale 0 to 100), categorising the application as 'good' and indicating the need for minor improvements to the design.
Conclusions: SLE-T2T is the first eHealth tool to be designed for the management of SLE patients in a T2T context. The SUS score and unstructured feedback showed high acceptance of this digital instrument for its future use in a clinical trial.
Competing Interests: Competing interests: RV declares that he has received research support (institutional grants) from BMS, GSK, Lilly and UCB and support for educational programs from Pfizer and Roche. RV declares that he has also received consulting fees from AbbVie, AstraZeneca, Biogen, Biotest, BMS, Galapagos, Gilead, Janssen, Pfizer, Sanofi, Servier, UCB and Vielabio and personal honoraria as a speaker from AbbVie, Galapagos, GSK, Janssen, Pfizer and UCB. AV declares that he has received research support (institutional grants) from GSK and UCB. AV declares that he has also received consulting fees from GSK, AstraZeneca, Roche and personal honoraria as a speaker from GSK.
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