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Douze L, Schiro J, Heyndels L, Pazart L, Pelayo S. Evaluations of medical device usability during clinical investigations: a scoping review of clinical study protocols. Expert Rev Med Devices 2024:1-8. [PMID: 38982753 DOI: 10.1080/17434440.2024.2378093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 05/28/2024] [Indexed: 07/11/2024]
Abstract
OBJECTIVE Combining clinical investigations with usability studies provides valuable information for medical devices evaluation. But both types of study are very different in terms of objectives and methodologies. How are usability studies integrated into clinical investigations in practice? METHODS We searched the ClinicalTrials.gov database for clinical investigation protocols that included usability outcome(s) and analyzed them. RESULTS 77 study protocols were identified for the analysis, including 102 outcomes related to usability in total. The most frequently assessed outcomes were satisfaction (53/102) and ease of use (33/102). The questionnaire was the most frequently planned technique (85/102) followed by interviews (24/102). Other methods were used, such as observation (9/102), mostly when the end users was a healthcare professional, and diary (6/102), mostly with patients. CONCLUSION Our study results showed that the collection of usability data can be included in a clinical investigation, with various levels of investment. Resource-light, rapid integration via a questionnaire will enable the collection of subjective data on the users' perceptions. When more resources are available, observation in accessible environments can be set up (especially during use by healthcare professionals in hospital) or interviews and/or diaries for home-based environments (especially by patients).
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Affiliation(s)
- Laura Douze
- Évaluation des technologies de santé et des pratiques médicales, University Lille, CHU Lille, ULR 2694 - METRICS, Lille, France
- Inserm, CIC-IT 1403, Lille, France
| | - Jessica Schiro
- Évaluation des technologies de santé et des pratiques médicales, University Lille, CHU Lille, ULR 2694 - METRICS, Lille, France
- Inserm, CIC-IT 1403, Lille, France
| | | | - Lionel Pazart
- INSERM CIC 1431, Centre d'Investigation Clinique, Centre Hospitalier Universitaire de Besançon, Besancon, France
| | - Sylvia Pelayo
- Évaluation des technologies de santé et des pratiques médicales, University Lille, CHU Lille, ULR 2694 - METRICS, Lille, France
- Inserm, CIC-IT 1403, Lille, France
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Optimal Usability Test Procedure Generation for Medical Devices. Healthcare (Basel) 2023; 11:healthcare11030296. [PMID: 36766871 PMCID: PMC9914048 DOI: 10.3390/healthcare11030296] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/10/2023] [Accepted: 01/14/2023] [Indexed: 01/20/2023] Open
Abstract
Medical device usability testing offers many benefits, including finding medical device usage errors and providing safety to users. As usability testing becomes mandatory for medical devices, manufacturers are increasing the cost burden. In order to perform a high-quality usability test, it is important to implement a usability test procedure, but guidelines for this are lacking. In this paper, we propose a method to systematically design and implement a usability test procedure. We propose methods to reduce test time-costs and apply them to implement the final procedure. Next, by applying the proposed method to sinus surgical navigation system, it is shown that the total time was reduced by 21% compared to the usability summative test procedure previously used in the same system.
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Kierkegaard P, Micocci M, McLister A, Tulloch JSP, Parvulescu P, Gordon AL, Buckle P. Implementing lateral flow devices in long-term care facilities: experiences from the Liverpool COVID-19 community testing pilot in care homes- a qualitative study. BMC Health Serv Res 2021; 21:1153. [PMID: 34696803 PMCID: PMC8544628 DOI: 10.1186/s12913-021-07191-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 09/30/2021] [Indexed: 01/01/2023] Open
Abstract
Introduction Antigen-based lateral flow devices (LFDs) offer the potential of widespread rapid testing. The scientific literature has primarily focused on mathematical modelling of their use and test performance characteristics. For these tests to be implemented successfully, an understanding of the real-world contextual factors that allow them to be integrated into the workplace is vital. To address this gap in knowledge, we aimed to explore staff’s experiences of integrating LFDs into routine practice for visitors and staff testing with a view to understand implementation facilitators and barriers. Methods Semi-structured interviews and thematic analysis. Results We identified two main themes and five subthemes. The main themes included: visitor-related testing factors and staff-related testing factors. Subthemes included: restoring a sense of normality, visitor-related testing challenges, staff-related testing challenges, and pre-pilot antecedent factors. Conclusion Our study demonstrates that the real-world implementation of LFDs to test visitors and staff faces significant challenges as a result of several contextual factors negatively affecting the work practice and environment. More comprehensive studies are needed to identify and inform effective implementation strategies to ensure that LFDs can be adopted in an agile way that better supports an already exhausted and morally depleted workforce.
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Affiliation(s)
- Patrick Kierkegaard
- NIHR London In Vitro Diagnostics Co-operative, Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, Praed Street, London, W2 1NY, UK. .,CRUK Convergence Science Centre, Institute for Cancer Research & Imperial College London, Roderic Hill Building, South Kensington Campus, Exhibition Road, London, SW7 2AZ, UK.
| | - Massimo Micocci
- NIHR London In Vitro Diagnostics Co-operative, Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, Praed Street, London, W2 1NY, UK
| | - Anna McLister
- NIHR London In Vitro Diagnostics Co-operative, Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, Praed Street, London, W2 1NY, UK
| | - John S P Tulloch
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, CH64 7TE, UK
| | - Paula Parvulescu
- Public Health Department, Liverpool City Council, Liverpool, Cunard Building, Water Street, Liverpool, L3 1DS, UK
| | - Adam L Gordon
- Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Nottingham, UK.,NIHR Applied Research Collaboration East Midlands (ARC-EM), Nottingham, UK
| | - Peter Buckle
- NIHR London In Vitro Diagnostics Co-operative, Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, Praed Street, London, W2 1NY, UK
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Kierkegaard P, McLister A, Buckle P. Rapid point-of-care testing for COVID-19: quality of supportive information for lateral flow serology assays. BMJ Open 2021; 11:e047163. [PMID: 33741675 PMCID: PMC7985936 DOI: 10.1136/bmjopen-2020-047163] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 02/16/2021] [Accepted: 02/18/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE There is a lack of evidence addressing several important human factors questions pertaining to the quality of supportive information provided by commercial manufacturers that can affect the adoption and use of lateral flow serology assays in practice. We aimed to: (1) identify and assess the quality of information that commercial manufacturers provided for their point-of-care tests (POCTs) and (2) examine the implications of these findings on real-world settings. DESIGN We used a content analysis methodology in two stages to systematically, code and analyse textual data from documents of commercial manufacturers. A deductive approach was applied using a coding guide based on the validated Point-of-Care Key Evidence Tool (POCKET) multidimensional checklist. An inductive approach was used to identify new patterns or themes generated from our textual analysis. SETTING Publicly available supportive information documents by commercial manufacturers for lateral flow serology, were identified and gathered from online searches. PARTICIPANTS Supportive information documents retrieved from online searches over 3 months (March 2020 to June 2020). RESULTS A total of 79 POCTs were identified that met the study inclusion criteria. Using the POCKET coding guide, we found that the quality of information varied significantly between the manufacturers and was often lacking in detail. Our inductive approach further examined these topics and found that several statements were vague and that significant variations in the level of details existed between manufacturers. CONCLUSIONS This study revealed significant concerns surrounding the supportive information reported by manufacturers for lateral flow serology assays. Information transparency was poor and human factor issues were not properly addressed to mitigate the risk of improper device use, although it should be noted that the results of our study are limited by the data that manufactures were prepared to disclose. Overall, commercial manufacturers should improve the quality and value of information presented in their supporting documentation.
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Affiliation(s)
- Patrick Kierkegaard
- NIHR London In Vitro Diagnostics Co-operative, Department of Surgery and Cancer, Imperial College London, London, UK
- CRUK Convergence Science Centre, Institute of Cancer Research & Imperial College London, London, UK
| | - Anna McLister
- NIHR London In Vitro Diagnostics Co-operative, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Peter Buckle
- NIHR London In Vitro Diagnostics Co-operative, Department of Surgery and Cancer, Imperial College London, London, UK
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Borsci S, Buckle P, Walne S. Is the LITE version of the usability metric for user experience (UMUX-LITE) a reliable tool to support rapid assessment of new healthcare technology? APPLIED ERGONOMICS 2020; 84:103007. [PMID: 31785449 DOI: 10.1016/j.apergo.2019.103007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 08/27/2019] [Accepted: 11/21/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To ascertain the reliability of a standardised, short-scale measure of satisfaction in the use of new healthcare technology i.e., the LITE version of the usability metric for user experience (UMUX-LITE). Whilst previous studies have demonstrated the reliability of UMUX-LITE, and its relationship with measures of likelihood to recommend a product, such as the Net Promoter Score (NPS) in other sectors no such testing has been undertaken with healthcare technology. MATERIALS AND METHODS Six point-of-care products at different stages of development were assessed by 120 healthcare professionals. UMUX-LITE was used to gather their satisfaction in use, and NPS to declare their intention to promote the product. Inferential statistics were used to: i) ascertain the reliability of UMUX-LITE, and ii) assess the relationship between UMUX-LITE and NPS at different stages of products development. RESULTS UMUX-LITE showed an acceptable reliability (α = 0.7) and a strong positive correlation with NPS (r = 0.455, p < .001). This is similar to findings in other fields of application. The level of product development did not affect the UMUX-LITE scores, while the stage of development was a significant predictor (R2 = 0.49) of the intention to promote. DISCUSSION AND CONCLUSION Practitioners may apply UMUX-LITE alone, or in combination with the NPS, to complement interview and 'homemade' scales to investigate the quality of new products at different stages of development. This shortened scale is appropriate for use in the context of healthcare in which busy professionals have a minimal amount of time to support innovation.
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Affiliation(s)
- Simone Borsci
- Department of Cognitive Psychology and Ergonomics, Faculty of Behavioural, Management and Social Sciences, University of Twente, Enschede, the Netherlands; The NIHR MIC London IVD Diagnostics, Department of Surgery and Cancer, Faculty of Medicine, Imperial College of London, United Kingdom.
| | - Peter Buckle
- The NIHR MIC London IVD Diagnostics, Department of Surgery and Cancer, Faculty of Medicine, Imperial College of London, United Kingdom
| | - Simon Walne
- The NIHR MIC London IVD Diagnostics, Department of Surgery and Cancer, Faculty of Medicine, Imperial College of London, United Kingdom
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Fettner S, Mela C, Wildenhahn F, Tavanti M, Wells C, Douglass W, Mallalieu NL. Evidence of bioequivalence and positive patient user handling of a tocilizumab autoinjector. Expert Opin Drug Deliv 2019; 16:551-561. [PMID: 31043095 DOI: 10.1080/17425247.2019.1604678] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND The anti-interleukin-6 receptor antibody tocilizumab is approved for subcutaneous injection using a prefilled syringe (PFS). We report results from a bioequivalence study in healthy subjects and a user-handling study in patients with rheumatoid arthritis (RA) using an autoinjector (AI) for tocilizumab. METHODS A randomized crossover study in healthy subjects (N = 161) examined the bioequivalence, safety, and tolerability of tocilizumab after a single subcutaneous injection by AI versus PFS. A nonrandomized observational, real-life human factors study in RA patients (N = 54) assessed user (RA patients, caregivers, health care providers) ability to administer tocilizumab effectively by AI. RESULTS Bioequivalence criteria for tocilizumab AI versus PFS were met for key pharmacokinetic parameters. Safety was comparable between devices and consistent with the established tocilizumab profile. In the real-life human factors study, the proportion of users who successfully performed all essential tasks required to operate the AI to deliver the full dose was 92.3% at first assessment and 98.1% at second assessment, with no safety concerns. CONCLUSIONS Tocilizumab administration by AI was bioequivalent to administration by PFS. Intended users were successful in performing the tasks required to administer tocilizumab by AI. No new safety signals were observed in either study. CLINICAL TRIAL REGISTRATION NCT02678988, NCT02682823.
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Nazari M, Gargari SLM, Sahebghadam Lotfi A, Rassaee MJ, Taheri RA. Aptamer-Based Sandwich Assay for Measurement of Thymidine Kinase 1 in Serum of Cancerous Patients. Biochemistry 2019; 58:2373-2383. [PMID: 30900869 DOI: 10.1021/acs.biochem.8b01284] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Thymidine kinase 1 (TK1) is traditionally a serum biomarker that is elevated in the early stages of malignancies. The diagnostic and prognostic role of TK1 for screening and monitoring human malignancies has recently been investigated. Anti-human TK1 aptamers were selected through 12 iterative rounds of systematic evolution of ligands by exponential enrichment from a DNA library. The aptamer pool of round 12 was amplified, and the polymerase chain reaction product was cloned on the TA vector. Of the 85 colonies obtained, 52 were identified as positive clones. These aptamers were screened for TK1 with surface plasmon resonance, where apta37 and apta69 showed the highest affinity for TK1. The TK1_apta37 and TK1_apta69 aptamers were used in a sandwich assay platform and successfully detected TK1 in the concentration range of 54-3500 pg mL-1. Clinical samples from 60 cancerous patients were also tested with this assay system and compared using the conventional antibody-based enzyme-linked immunosorbent assay kit. The aptamer sandwich assay demonstrated a dynamic range for TK1 at clinically relevant serum levels, covering subpicogram per milliliter concentrations. The new approach offers a simple and robust method for detecting serum biomarkers that have low and moderate abundance. The results of this study demonstrate the screening capability of the aptamer sandwich assay platform and its potential applicability to the point-of-care testing system.
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Affiliation(s)
- Mahmood Nazari
- Department of Clinical Biochemistry, Faculty of Medicine , Tarbiat Modares University , Tehran , Iran
| | | | - Abbas Sahebghadam Lotfi
- Department of Clinical Biochemistry, Faculty of Medicine , Tarbiat Modares University , Tehran , Iran
| | - Mohammad Javad Rassaee
- Department of Clinical Biochemistry, Faculty of Medicine , Tarbiat Modares University , Tehran , Iran
| | - Ramezan Ali Taheri
- Nanobiotechnology Research Center , Baqiyatallah University of Medical Sciences , Tehran , Iran
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Borsci S, Uchegbu I, Buckle P, Ni Z, Walne S, Hanna GB. Designing medical technology for resilience: integrating health economics and human factors approaches. Expert Rev Med Devices 2017; 15:15-26. [PMID: 29243500 DOI: 10.1080/17434440.2018.1418661] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
INTRODUCTION The slow adoption of innovation into healthcare calls into question the manner of evidence generation for medical technology. This paper identifies potential reasons for this including a lack of attention to human factors, poor evaluation of economic benefits, lack of understanding of the existing healthcare system and a failure to recognise the need to generate resilient products. Areas covered: Recognising a cross-disciplinary need to enhance evidence generation early in a technology's life cycle, the present paper proposes a new approach that integrates human factors and health economic evaluation as part of a wider systems approach to the design of technology. This approach (Human and Economic Resilience Design for Medical Technology or HERD MedTech) supports early stages of product development and is based on the recent experiences of the National Institute for Health Research London Diagnostic Evidence Co-operative in the UK. Expert commentary: HERD MedTech i) proposes a shift from design for usability to design for resilience, ii) aspires to reduce the need for service adaptation to technological constraints iii) ensures value of innovation at the time of product development, and iv) aims to stimulate discussion around the integration of pre- and post-market methods of assessment of medical technology.
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Affiliation(s)
- Simone Borsci
- a Surgery and Cancer , National Institute for Health Research Diagnostic Evidence Cooperative of London, Imperial College London, St Mary's Hospital , London , UK
| | - Ijeoma Uchegbu
- a Surgery and Cancer , National Institute for Health Research Diagnostic Evidence Cooperative of London, Imperial College London, St Mary's Hospital , London , UK
| | - Peter Buckle
- a Surgery and Cancer , National Institute for Health Research Diagnostic Evidence Cooperative of London, Imperial College London, St Mary's Hospital , London , UK
| | - Zhifang Ni
- a Surgery and Cancer , National Institute for Health Research Diagnostic Evidence Cooperative of London, Imperial College London, St Mary's Hospital , London , UK
| | - Simon Walne
- a Surgery and Cancer , National Institute for Health Research Diagnostic Evidence Cooperative of London, Imperial College London, St Mary's Hospital , London , UK
| | - George B Hanna
- a Surgery and Cancer , National Institute for Health Research Diagnostic Evidence Cooperative of London, Imperial College London, St Mary's Hospital , London , UK
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Integrating human factors and health economics to inform the design of medical device: a conceptual framework. ACTA ACUST UNITED AC 2017. [DOI: 10.1007/978-981-10-5122-7_13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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