Rheumatic? A diagnostic decision support tool for individuals suspecting rheumatic diseases: Mixed-methods usability and acceptability study

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Abstract
Background: The early diagnosis of inflammatory rheumatic diseases (IRDs) is of paramount importance in order to prevent irreversible damage to joints and to optimize treatment outcomes. Nevertheless, conventional care pathways frequently entail diagnostic delays spanning several months. Symptom checkers (SCs) have the potential to provide a solution by offering validated symptom assessments, improving triage systems and expediting diagnostic evaluations. The objective of this mixed-methods study is to assess the usability and acceptability of the SC Rheumatic? among individuals with suspected rheumatic diseases. Methods: A total of 105 individuals with suspected IRDs who were newly presenting at an outpatient rheumatology clinic completed the Rheumatic? symptom checker and an evaluation questionnaire. The questionnaire comprised the System Usability Scale (SUS) and Net Promoter Score (NPS). Additionally, 14 participants were interviewed by telephone in order to gain further insights through the qualitative method. Results: The Rheumatic? symptom checker received a “good” usability score, with an average SUS of 78 ± 16 (range 0-100). Younger participants reported significantly higher usability scores (p < 0.03). However, the NPS was − 15 (range − 100 to 100), indicating lower acceptability. Qualitative data supported the positive usability ratings but emphasized the need for enhancements to increase user engagement and perceived value, such as a current perceived lack of immediate benefit for many users. Their experience varied in terms of impact, with some patients suggesting an increased awareness of their symptoms while others did not notice any difference. Conclusion: Rheumatic? demonstrates good usability, particularly among younger users. Interviews revealed valuable suggestions for improvements, which could enhance overall acceptability and user satisfaction. Implementing Rheumatic? could lead to more efficient triage, potentially reducing diagnostic delays and an optimized allocation of resources. Future iterations should prioritize implementation strategies to maximize user impact and benefit. Clinical trial number: Not applicable.
Funding Information
  • Universitätsklinikum Erlangen

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