Whereas interaction with patient portals has been extensively studied, their influence on users' decision-making remains under-investigated. Methodological approaches to evaluating usage and usability of portals showed room for improvement. To unlock the potential of patient portals, more (robust) research should focus on better understanding the complex process of how portals lead to improved health and care.

BackgroundPatient 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.MethodsWe 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.ResultsMisinterpretation 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.ConclusionsThis 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.Electronic supplementary materialThe online version of this article (10.1186/s12911-018-0589-7) contains supplementary material, which is available to authorized users.

This item was submitted to Loughborough's Institutional Repository (https://dspace.lboro.ac.uk/) by the author and is made available under the following Creative Commons Licence conditions.For the full text of this licence, please go to: http://creativecommons.org/licenses/by-nc-nd/2.5 / 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 AbstractInformation about the design and construction of buildings can be structured in a particular way. This is especially correct given the increasing complexity of building product models and the emergence of Building Information Models with project documents linked to them. In addition, engineers usually have distinct information needs. Research shows that engineers working with Building Information Models place particular importance on the understanding of retrieved content before using it or applying it, and that exploration of context is essential for this understanding. Both these factors (the nature of engineering content and the information needs of engineers) make general information retrieval techniques for computing relevance and visualizing search results less applicable in civil engineering information retrieval systems. This paper argues that granularity is a fundamental concept that needs to be considered when measuring relevance and visualizing search results in information retrieval systems for repositories of building design and construction content. It is hypothesized that the design of systems with careful regard for granularity would improve engineers' relevance judgment behaviour. In order to test this hypothesis, a prototype system, called CoMem-XML, was developed and evaluated in terms of the time needed for users to find relevant information, the Manuscript (SECOND revised version) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 Demian&d Balatsoukas, Ms. No. CPENG-318 resubmitted to JCCE, September 2010 2 accuracy of their relevance judgment and their subjective satisfaction with the prototype. A user study was conducted where test subjects were asked to complete tasks using various forms of the prototype, to complete a satisfaction questionnaire, and to be interviewed. The findings show that users perform better and are more satisfied when the search result interface of the CoMem-XML system presents only relevant information in context. On the other hand, interfaces that present the retrieved information out of context (i.e. without highlighting its position in the parts hierarchy) are less effective for participants to judge relevance. KeywordsInformation retrieval, information management, knowledge management, search results, Building Information Modelli...

ObjectivesThe present study explored public’s willingness to use COVID-19 immunity certificates across six different domestic scenarios.DesignCross-sectional online survey.SettingUK representative survey conducted on 3 August 2021.Participants534 UK residents over 18 years old.InterventionsParticipants replied to the same set of questions.Primary and secondary outcome measuresThe primary outcome measure was willingness to use immunity certificates across three different domestic settings: (1) visiting the general practitioner (GP) for a non-urgent health issue; (2) dining in a restaurant and (3) attending a performance in a theatre. For each setting two options, one prioritising convenience (option A) and the other privacy (option B), were offered. Our secondary outcome measures were computed indices from items adapted from the Health Belief Model; attitudes towards sharing immunity status with service providers; prior to COVID-19 lifestyle. In addition, we recorded data about respondents’ sociodemographic characteristics.ResultsRespondents were more willing to use immunity certificates that prioritised convenience (92%), rather than privacy (76%), when visiting their GP . However, privacy was more favourable in the other two settings (dining in a restaurant (84%) and going to a theatre (83%)) compared with convenience (38% and 39% respectively). Personal beliefs about COVID-19 and immunity certificates were associated with variations in willingness to use these across all scenarios. No variations were observed across sociodemographics and lifestyle.ConclusionsThe findings of this survey suggest that there is not one-size-fits-all solution for designing immunity certificates. Immunity certificates are complex sociotechnical systems, any attempt to implement these for domestic use should be tailored to different settings and user needs. The design of certification services requires a more evidence-based approach and further research is needed to understand how different settings, design elements (like convenience or privacy) and personal beliefs about the pandemic should inform their design.