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Acceptance of a digital therapy recommender system for psoriasis

BACKGROUND: About 2% of the German population are affected by psoriasis. A growing number of cost-intensive systemic treatments are available. Surveys have shown high proportions of patients with moderate to severe psoriasis are not adequately treated despite a high disease burden. Digital therapy r...

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Autores principales: Graf, Lisa, Tesch, Falko, Gräßer, Felix, Harst, Lorenz, Siegels, Doreen, Schmitt, Jochen, Abraham, Susanne
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10401871/
https://www.ncbi.nlm.nih.gov/pubmed/37542251
http://dx.doi.org/10.1186/s12911-023-02246-9
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author Graf, Lisa
Tesch, Falko
Gräßer, Felix
Harst, Lorenz
Siegels, Doreen
Schmitt, Jochen
Abraham, Susanne
author_facet Graf, Lisa
Tesch, Falko
Gräßer, Felix
Harst, Lorenz
Siegels, Doreen
Schmitt, Jochen
Abraham, Susanne
author_sort Graf, Lisa
collection PubMed
description BACKGROUND: About 2% of the German population are affected by psoriasis. A growing number of cost-intensive systemic treatments are available. Surveys have shown high proportions of patients with moderate to severe psoriasis are not adequately treated despite a high disease burden. Digital therapy recommendation systems (TRS) may help implement guideline-based treatment. However, little is known about the acceptance of such clinical decision support systems (CDSSs). Therefore, the aim of the study was to access the acceptance of a prototypical TRS demonstrator. METHODS: Three scenarios (potential test patients with psoriasis but different sociodemographic and clinical characteristics, previous treatments, desire to have children, and multiple comorbidities) were designed in the demonstrator. The TRS demonstrator and test patients were presented to a random sample of 76 dermatologists attending a national dermatology conference in a cross-sectional face-to-face survey with case vignettes. The dermatologist were asked to rate the demonstrator by system usability scale (SUS), whether they would use it for certain patients populations and barriers of usage. Reasons for potential usage of the TRS demonstrator were tested via a Poisson regression with robust standard errors. RESULTS: Acceptance of the TRS was highest for patients eligible for systemic therapy (82%). 50% of participants accepted the system for patients with additional comorbidities and 43% for patients with special subtypes of psoriasis. Dermatologists in the outpatient sector or with many patients per week were less willing to use the TRS for patients with special psoriasis-subtypes. Dermatologists rated the demonstrator as acceptable with an mean SUS of 76.8. Participants whose SUS was 10 points above average were 27% more likely to use TRS for special psoriasis-subtypes. The main barrier in using the TRS was time demand (47.4%). Participants who perceived time as an obstacle were 22.3% less willing to use TRS with systemic therapy patients. 27.6% of physicians stated that they did not understand exactly how the recommendation was generated by the TRS, with no effect on the preparedness to use the system. CONCLUSION: The considerably high acceptance and the preparedness to use the psoriasis CDSS suggests that a TRS appears to be implementable in routine healthcare and may improve clinical care. Main barrier is the additional time demand posed on dermatologists in a busy clinical setting. Therefore, it will be a major challenge to identify a limited set of variables that still allows a valid recommendation with precise prediction of the patient-individual benefits and harms. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12911-023-02246-9.
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spelling pubmed-104018712023-08-05 Acceptance of a digital therapy recommender system for psoriasis Graf, Lisa Tesch, Falko Gräßer, Felix Harst, Lorenz Siegels, Doreen Schmitt, Jochen Abraham, Susanne BMC Med Inform Decis Mak Research BACKGROUND: About 2% of the German population are affected by psoriasis. A growing number of cost-intensive systemic treatments are available. Surveys have shown high proportions of patients with moderate to severe psoriasis are not adequately treated despite a high disease burden. Digital therapy recommendation systems (TRS) may help implement guideline-based treatment. However, little is known about the acceptance of such clinical decision support systems (CDSSs). Therefore, the aim of the study was to access the acceptance of a prototypical TRS demonstrator. METHODS: Three scenarios (potential test patients with psoriasis but different sociodemographic and clinical characteristics, previous treatments, desire to have children, and multiple comorbidities) were designed in the demonstrator. The TRS demonstrator and test patients were presented to a random sample of 76 dermatologists attending a national dermatology conference in a cross-sectional face-to-face survey with case vignettes. The dermatologist were asked to rate the demonstrator by system usability scale (SUS), whether they would use it for certain patients populations and barriers of usage. Reasons for potential usage of the TRS demonstrator were tested via a Poisson regression with robust standard errors. RESULTS: Acceptance of the TRS was highest for patients eligible for systemic therapy (82%). 50% of participants accepted the system for patients with additional comorbidities and 43% for patients with special subtypes of psoriasis. Dermatologists in the outpatient sector or with many patients per week were less willing to use the TRS for patients with special psoriasis-subtypes. Dermatologists rated the demonstrator as acceptable with an mean SUS of 76.8. Participants whose SUS was 10 points above average were 27% more likely to use TRS for special psoriasis-subtypes. The main barrier in using the TRS was time demand (47.4%). Participants who perceived time as an obstacle were 22.3% less willing to use TRS with systemic therapy patients. 27.6% of physicians stated that they did not understand exactly how the recommendation was generated by the TRS, with no effect on the preparedness to use the system. CONCLUSION: The considerably high acceptance and the preparedness to use the psoriasis CDSS suggests that a TRS appears to be implementable in routine healthcare and may improve clinical care. Main barrier is the additional time demand posed on dermatologists in a busy clinical setting. Therefore, it will be a major challenge to identify a limited set of variables that still allows a valid recommendation with precise prediction of the patient-individual benefits and harms. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12911-023-02246-9. BioMed Central 2023-08-04 /pmc/articles/PMC10401871/ /pubmed/37542251 http://dx.doi.org/10.1186/s12911-023-02246-9 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Graf, Lisa
Tesch, Falko
Gräßer, Felix
Harst, Lorenz
Siegels, Doreen
Schmitt, Jochen
Abraham, Susanne
Acceptance of a digital therapy recommender system for psoriasis
title Acceptance of a digital therapy recommender system for psoriasis
title_full Acceptance of a digital therapy recommender system for psoriasis
title_fullStr Acceptance of a digital therapy recommender system for psoriasis
title_full_unstemmed Acceptance of a digital therapy recommender system for psoriasis
title_short Acceptance of a digital therapy recommender system for psoriasis
title_sort acceptance of a digital therapy recommender system for psoriasis
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10401871/
https://www.ncbi.nlm.nih.gov/pubmed/37542251
http://dx.doi.org/10.1186/s12911-023-02246-9
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