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User stories as lightweight requirements for agile clinical decision support development

OBJECTIVE: We sought to demonstrate applicability of user stories, progressively elaborated by testable acceptance criteria, as lightweight requirements for agile development of clinical decision support (CDS). MATERIALS AND METHODS: User stories employed the template: As a [type of user], I want [s...

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Autores principales: Kannan, Vaishnavi, Basit, Mujeeb A, Bajaj, Puneet, Carrington, Angela R, Donahue, Irma B, Flahaven, Emily L, Medford, Richard, Melaku, Tsedey, Moran, Brett A, Saldana, Luis E, Willett, Duwayne L, Youngblood, Josh E, Toomay, Seth M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6798563/
https://www.ncbi.nlm.nih.gov/pubmed/31512730
http://dx.doi.org/10.1093/jamia/ocz123
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author Kannan, Vaishnavi
Basit, Mujeeb A
Bajaj, Puneet
Carrington, Angela R
Donahue, Irma B
Flahaven, Emily L
Medford, Richard
Melaku, Tsedey
Moran, Brett A
Saldana, Luis E
Willett, Duwayne L
Youngblood, Josh E
Toomay, Seth M
author_facet Kannan, Vaishnavi
Basit, Mujeeb A
Bajaj, Puneet
Carrington, Angela R
Donahue, Irma B
Flahaven, Emily L
Medford, Richard
Melaku, Tsedey
Moran, Brett A
Saldana, Luis E
Willett, Duwayne L
Youngblood, Josh E
Toomay, Seth M
author_sort Kannan, Vaishnavi
collection PubMed
description OBJECTIVE: We sought to demonstrate applicability of user stories, progressively elaborated by testable acceptance criteria, as lightweight requirements for agile development of clinical decision support (CDS). MATERIALS AND METHODS: User stories employed the template: As a [type of user], I want [some goal] so that [some reason]. From the “so that” section, CDS benefit measures were derived. Detailed acceptance criteria were elaborated through ensuing conversations. We estimated user story size with “story points,” and depicted multiple user stories with a use case diagram or feature breakdown structure. Large user stories were split to fit into 2-week iterations. RESULTS: One example user story was: As a rheumatologist, I want to be advised if my patient with rheumatoid arthritis is not on a disease-modifying anti-rheumatic drug (DMARD), so that they receive optimal therapy and can experience symptom improvement. This yielded a process measure (DMARD use), and an outcome measure (Clinical Disease Activity Index). Following implementation, the DMARD nonuse rate decreased from 3.7% to 1.4%. Patients with a high Clinical Disease Activity Index improved from 13.7% to 7%. For a thromboembolism prevention CDS project, diagrams organized multiple user stories. DISCUSSION: User stories written in the clinician’s voice aid CDS governance and lead naturally to measures of CDS effectiveness. Estimation of relative story size helps plan CDS delivery dates. User stories prove to be practical even on larger projects. CONCLUSIONS: User stories concisely communicate the who, what, and why of a CDS request, and serve as lightweight requirements for agile development to meet the demand for increasingly diverse CDS.
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spelling pubmed-67985632019-10-24 User stories as lightweight requirements for agile clinical decision support development Kannan, Vaishnavi Basit, Mujeeb A Bajaj, Puneet Carrington, Angela R Donahue, Irma B Flahaven, Emily L Medford, Richard Melaku, Tsedey Moran, Brett A Saldana, Luis E Willett, Duwayne L Youngblood, Josh E Toomay, Seth M J Am Med Inform Assoc Research and Applications OBJECTIVE: We sought to demonstrate applicability of user stories, progressively elaborated by testable acceptance criteria, as lightweight requirements for agile development of clinical decision support (CDS). MATERIALS AND METHODS: User stories employed the template: As a [type of user], I want [some goal] so that [some reason]. From the “so that” section, CDS benefit measures were derived. Detailed acceptance criteria were elaborated through ensuing conversations. We estimated user story size with “story points,” and depicted multiple user stories with a use case diagram or feature breakdown structure. Large user stories were split to fit into 2-week iterations. RESULTS: One example user story was: As a rheumatologist, I want to be advised if my patient with rheumatoid arthritis is not on a disease-modifying anti-rheumatic drug (DMARD), so that they receive optimal therapy and can experience symptom improvement. This yielded a process measure (DMARD use), and an outcome measure (Clinical Disease Activity Index). Following implementation, the DMARD nonuse rate decreased from 3.7% to 1.4%. Patients with a high Clinical Disease Activity Index improved from 13.7% to 7%. For a thromboembolism prevention CDS project, diagrams organized multiple user stories. DISCUSSION: User stories written in the clinician’s voice aid CDS governance and lead naturally to measures of CDS effectiveness. Estimation of relative story size helps plan CDS delivery dates. User stories prove to be practical even on larger projects. CONCLUSIONS: User stories concisely communicate the who, what, and why of a CDS request, and serve as lightweight requirements for agile development to meet the demand for increasingly diverse CDS. Oxford University Press 2019-09-12 /pmc/articles/PMC6798563/ /pubmed/31512730 http://dx.doi.org/10.1093/jamia/ocz123 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of the American Medical Informatics Association. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Research and Applications
Kannan, Vaishnavi
Basit, Mujeeb A
Bajaj, Puneet
Carrington, Angela R
Donahue, Irma B
Flahaven, Emily L
Medford, Richard
Melaku, Tsedey
Moran, Brett A
Saldana, Luis E
Willett, Duwayne L
Youngblood, Josh E
Toomay, Seth M
User stories as lightweight requirements for agile clinical decision support development
title User stories as lightweight requirements for agile clinical decision support development
title_full User stories as lightweight requirements for agile clinical decision support development
title_fullStr User stories as lightweight requirements for agile clinical decision support development
title_full_unstemmed User stories as lightweight requirements for agile clinical decision support development
title_short User stories as lightweight requirements for agile clinical decision support development
title_sort user stories as lightweight requirements for agile clinical decision support development
topic Research and Applications
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6798563/
https://www.ncbi.nlm.nih.gov/pubmed/31512730
http://dx.doi.org/10.1093/jamia/ocz123
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