Rotterdam Prostate Cancer Risk Calculator: Development and Usability Testing of the Mobile Phone App

Abstract

BackgroundThe use of prostate cancer screening tools that take into account relevant prebiopsy information (ie, risk calculators) is recommended as a way of determining the risk of cancer and the subsequent need for a prostate biopsy. This has the potential to limit prostate cancer overdiagnosis and subsequent overtreatment. mHealth apps are gaining traction in urological practice and are used by both practitioners and patients for a variety of purposes.ObjectiveThe impetus of the study was to design, develop, and assess a smartphone app for prostate cancer screening, based on the Rotterdam Prostate Cancer Risk Calculator (RPCRC).MethodsThe results of the Rotterdam arm of the European Randomized Study of Screening for Prostate Cancer (ERSPC) study were used to elaborate several algorithms that allowed the risk of prostate cancer to be estimated. A step-by-step workflow was established to ensure that depending on the available clinical information the most complete risk model of the RPCRC was used. The user interface was designed and then the app was developed as a native app for iOS. The usability of the app was assessed using the Post-Study System Usability Questionnaire (PSSUQ) developed by IBM, in a group of 92 participants comprising urologists, general practitioners, and medical students.ResultsA total of 11 questions were built into the app, and, depending on the answers, one of the different algorithms of the RPCRC could be used to predict the risk of prostate cancer and of clinically significant prostate cancer (Gleason score ≥7 and clinical stage >T2b). The system usefulness, information quality, and interface quality scores were high—92% (27.7/30), 87% (26.2/30), and 89% (13.4/15), respectively. No usability problems were identified.ConclusionsThe RPCRC app is helpful in predicting the risk of prostate cancer and, even more importantly, clinically significant prostate cancer. Its algorithms have been externally validated before and the usability score shows the app’s interface is well designed. Further usability testing is required in different populations to verify these results and ensure that it is easy to use, to warrant a broad appeal, and to provide better patient care.

Launching and evaluating a mobile phone app to provide contemporary, evidence-based advice about self-treatable conditions

“…The authors hope that this paper encourages others to consider undertaking a similar project. The key findings are similar to those reported elsewhere in relation to usefulness as an educational tool at undergraduate level for medical and pharmacy students (16)(17)(18) and to support clinical decision-making in practice (19)(20)(21)(22)(23) .…”

Designing a health referral mobile application for high-mobility end users in Indonesia

“…Improvements were made based on the results of the first iteration's evaluation, including changes in the use of language in the ICD-9/ICD-10 field, which also improved information quality. Per [35], information quality is defined as when information that is provided by a system can be easily understood and can effectively assist in the completion of tasks. The information quality dimension underwent many improvements based on the results of the first iteration evaluation, including changing the order of the data that refer to emergencies, adding information on actions that have been given, changing the language in the ICD-9/ICD-10 field, and adding information on patient data automatically if it has been registered in the system previously.…”

External validation of a cancer risk prediction model for suspected head and neck cancer referrals

“…Nevertheless, it did not include HNC . Risk calculators for common cancers have been extensively explored and externally validated over recent years . These calculators are based on biochemical markers, tumour growth characteristics based on imaging or clinical examination and patients' family and past‐medical history, and some of them are available to use online.…”

“…These calculators are based on biochemical markers, tumour growth characteristics based on imaging or clinical examination and patients' family and past‐medical history, and some of them are available to use online. The use of the prostate cancer risk calculator by GPs in the primary care setting was successful as an aid to risk stratify prostate cancer and triage patients requiring referral for biopsy following initial blood testing to complement physical examination . Nevertheless, none of these cancer risk calculators are primarily based on patients' symptoms which would simplify their application in the primary care setting.…”

“…10 Risk calculators for common cancers have been extensively explored and externally validated over recent years. 10,11 These calculators are based on biochemical markers, tumour growth characteristics based on imaging or clinical examination and patients' family and past-medical history, and some of them are available to use online. The use of the prostate cancer risk calculator by GPs in the primary care setting was successful as an aid to risk stratify prostate cancer and triage patients requiring referral for biopsy following initial blood testing to complement physical examination.…”