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Surgeons need clinical decision support software (CDSS) to be interpretable and efficient. Key design principles include transparent risk models, user-friendly interfaces, and seamless workflow integration for successful adoption.

Keywords:
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Area of Science:

  • Surgical Informatics
  • Health Informatics
  • Clinical Decision Support Systems

Background:

  • Effective clinical decision support software (CDSS) implementation hinges on integration into clinical context and workflow.
  • This study aimed to define surgeon-centric design principles for a novel CDSS app.

Purpose of the Study:

  • To prospectively define surgeon-centric design principles for a novel CDSS app.
  • To combine incisional hernia risk prediction with patient outcomes tracking.

Main Methods:

  • A three-round online modified-Delphi panel of 30 surgeons from eight specialties assessed a pilot CDSS app.
  • Feasibility, importance, and acceptability of the risk model, user interface, and workflow integration were assessed using Likert scales and qualitative analysis.

Main Results:

  • Surgeons defined acceptable performance metrics for risk models (e.g., FN rate <10%, FP rate <15%, AUC ≥0.8).
  • Visual risk depictions, transparent weighting, team-based data entry, and customizable reminders were crucial for usability and mitigating user burden.
  • Risk models are mainly used for high-risk patients to enhance communication; statistical literacy and workflow integration are key for adoption.

Conclusions:

  • Findings provide surgeon-informed principles for developing surgical CDSS tools.
  • Successful CDSS must be interpretable, efficient, and augment clinical judgment.
  • Addressing end-user needs for transparency, statistical literacy, and workflow integration is essential for CDSS adoption.