Abstract
Background We developed a prototype patient decision aid, EyeChoose, to assist college-aged
students in selecting a refractive surgery. EyeChoose can educate patients on refractive
errors and surgeries, generate evidence-based recommendations based on a user's medical
history and personal preferences, and refer patients to local refractive surgeons.
Objectives We conducted an evaluative study on EyeChoose to assess the alignment of surgical
modality recommendations with a user's medical history and personal preferences, and
to examine the tool's usefulness and usability.
Methods We designed a mixed methods study on EyeChoose through simulations of test cases
to provide a quantitative measure of the customized recommendations, an online survey
to evaluate the usefulness and usability, and a focus group interview to obtain an
in-depth understanding of user experience and feedback.
Results We used stratified random sampling to generate 245 test cases. Simulated execution
indicated EyeChoose's recommendations aligned with the reference standard in 243 (99%).
A survey of 55 participants with 16 questions on usefulness, usability, and general
impression showed that 14 questions recorded more than 80% positive responses. A follow-up
focus group with 10 participants confirmed EyeChoose's useful features of patient
education, decision assistance, surgeon referral, as well as good usability with multimedia
resources, visual comparison among the surgical modalities, and the overall aesthetically
pleasing design. Potential areas for improvement included offering nuances in soliciting
user preferences, providing additional details on pricing, effectiveness, and reversibility
of surgeries, expanding the function of surgeon referral, and fixing specific usability
issues.
Conclusion The initial evaluation of EyeChoose suggests that it could provide effective patient
education, generate appropriate recommendations, connect to local refractive surgeons,
and demonstrate good system usability in a test environment. Future research is required
to enhance the system functions, fully implement and evaluate the tool in naturalistic
settings, and examine the findings' generalizability to other populations.
Keywords
refractive surgical procedures - computer-assisted decision-making - patient education
as topic - benefits and impact assessments - application of evaluation methodology
evaluation guidelines
