Clinical decision support software for diabetic foot risk stratification: development and formative evaluation.

Area of Science:

• Health Informatics
• Clinical Decision Support Systems
• Diabetic Foot Complications

Background:

• Diabetic foot complications pose a significant risk, necessitating effective prevention in primary healthcare.
• Diabetic foot risk stratification systems are crucial for predicting ulceration.
• Developing user-centered tools is key for successful implementation.

Purpose of the Study:

• To explore end-user experiences during the development of an electronic diabetic foot risk stratification tool.
• To evaluate the accuracy of the developed tool against evidence-based guidelines.
• To refine the tool based on formative evaluation and user feedback.

Main Methods:

• A mixed-methods approach was used over eight months, incorporating formative evaluation.
• Methods included semi-structured interviews, focus groups, participant observation, and online surveys.
• Expert review, guideline comparison, and clinical testing were integral to the evaluation.

Main Results:

• 43 healthcare practitioners participated in trialling the clinical decision support system.
• User feedback led to significant software modifications, addressing design flaws and functional limitations.
• The final tool accurately calculates risk and provides recommendations aligned with Australian Guidelines.

Conclusions:

• An iterative, multidisciplinary development process involving feedback and testing optimizes computerised clinical decision support systems.
• Evidence-based guidelines are essential for developing accurate diabetic foot risk stratification tools.
• Collaboration between end-users and technology experts enhances tool development and clinical utility.