Online Decision Support Tool for Personalized Cancer Symptom Checking in the Community (REACT): Acceptability, Feasibility, and Usability Study

Abstract

BackgroundImproving cancer survival in the UK, despite recent significant gains, remains a huge challenge. This can be attributed to, at least in part, patient and diagnostic delays, when patients are unaware they are suffering from a cancerous symptom and therefore do not visit a general practitioner promptly and/or when general practitioners fail to investigate the symptom or refer promptly. To raise awareness of symptoms that may potentially be indicative of underlying cancer among members of the public a symptom-based risk assessment model (developed for medical practitioner use and currently only used by some UK general practitioners) was utilized to develop a risk assessment tool to be offered to the public in community settings. Such a tool could help individuals recognize a symptom, which may potentially indicate cancer, faster and reduce the time taken to visit to their general practitioner. In this paper we report results about the design and development of the REACT (Risk Estimation for Additional Cancer Testing) website, a tool to be used in a community setting allowing users to complete an online questionnaire and obtain personalized cancer symptom-based risk estimation.ObjectiveThe objectives of this study are to evaluate (1) the acceptability of REACT among the public and health care practitioners, (2) the usability of the REACT website, (3) the presentation of personalized cancer risk on the website, and (4) potential approaches to adopt REACT into community health care services in the UK.MethodsOur research consisted of multiple stages involving members of the public (n=39) and health care practitioners (n=20) in the UK. Data were collected between June 2017 and January 2018. User views were collected by (1) the “think-aloud” approach when participants using the website were asked to talk about their perceptions and feelings in relation to the website, and (2) self-reporting of website experiences through open-ended questionnaires. Data collection and data analysis continued simultaneously, allowing for website iterations between different points of data collection.ResultsThe results demonstrate the need for such a tool. Participants suggest the best way to offer REACT is through a guided approach, with a health care practitioner (eg, pharmacist or National Health Service Health Check nurse) present during the process of risk evaluation. User feedback, which was generally consistent across members of public and health care practitioners, has been used to inform the development of the website. The most important aspects were: simplicity, ability to evaluate multiple cancers, content emphasizing an inviting community “feel,” use (when possible) of layperson language in the symptom screening questionnaire, and a robust and positive approach to cancer communication relying on visual risk representation both with affected individuals and the entire population at risk.ConclusionsThis study illustrates the benefits of involving public and stakeholders in developing and implementing a simple cancer sympt...

Sähköisten oirearvioiden käytettävyys

“…Tämän monimenetelmätutkimuksen tavoitteena on arvioida Omaolo-palvelun sähköisten oirearvioiden käytön hyväksyttävyyttä potilaiden keskuudessa, sekä selvittää käytettävyyttä ja muita mahdollisia hoidon tarpeen arviointiin (HTA) vaikuttavia tekijöitä terveyskeskusten päivystysvastaanoton ympäristössä. Tutkimuksessa selvitetään myös millaiset tekijät vaikuttavat potilaiden sähköisten oirearvioiden käytettävyyteen [10][11][12][13]. Laadullisessa osiossa avointen kysymysten vastaukset analysoitiin hyödyntäen sisällön teemaanalyysiä, jossa aineistosta esiin nousseita merkityksellisiä lauseita poimittiin ensin ns.…”

Status and Recommendations of Technological and Data-Driven Innovations in Cancer Care: Focus Group Study

“…Participatory design is one of the pillars of the revolutionary predictive, personalized, preventive, and participatory (P4) cancer medicine [ 30 , 31 ], and it requires the active involvement of users in the design or development phase of an eHealth system. Participatory design can provide a unique perspective on user acceptability, system usability, and the feasibility of the overall effort [ 32 ]. By involving a representative sample of a population of patients with cancer in the design or development of an eHealth system or service, one can eventually build an innovative solution that is expected to have good engagement with the target population.…”

Can early cancer detection be improved in deprived areas by involving community pharmacists?

“… 16 Another study that assessed approaches to adopt a web-based cancer risk estimation tool, the Risk Estimation for Additional Cancer Testing (REACT), suggested that the best way to offer the service was to adopt a supportive approach, whereby patients complete the tool with the assistance of a healthcare professional, such as a pharmacist. 17 …”