Biomedical subjects

Monique W M Jaspers

Publications and source records attributed to Monique W M Jaspers.

4 recordsLinked to original sources

PubMed2006

The significance of a usability evaluation of an emerging laboratory order entry system.

OBJECTIVES: To assess the usability of an emerging POE system, OM/Lab, for the computer-supported ordering of laboratory tests. We were more specifically interested in the relation of the usability problems detected in the user testing sessions with the order behaviour in terms of efficiency and errors in ordering. METHODS: A cognitive walkthrough of the OM/Lab system was conducted by two analysts using four real-life scenarios for ordering laboratory tests, which were reviewed for comprehensiveness by an expert clinician. Thereafter, the OM/Lab system was evaluated on its usability in testing sessions with seven potential end-users of the system performing these same four scenarios. The results of these end-user testing sessions were used to analyze the effect of usability flaws on the quality of ordering in terms of omissions, errors in orders and cancelled orders. RESULTS: The analyses revealed a total of 33 usability problems, of which 25 problems were revealed both by the cognitive walkthrough and in the end-user sessions. These 25 usability problems indeed led to inefficient order behaviour, omissions and errors in orders and even to cancelled orders. DISCUSSION: Our results revealed that the OM/Lab system suffered from a high number of usability flaws. The interface design flaws were, among other things, related to misallocation of buttons on the screen, incomprehensibility of button labels and feedback containing no relevant information to the user about the cause of errors made and consequences of a user's action. Additionally, our user test session results indicated that the OM/Lab system also suffered from user interaction problems of a more socio-technical nature. These sessions revealed, among other things, that the more specific action sequences to be executed within the ordering model of the OM/Lab system did not correspond to the daily working routines of end-users and that the grouping of laboratory tests within clusters did not match the paper-based order forms. The seemingly negative effects of these usability flaws on the quality of ordering and the inefficiency of work processes during the pilot implementation finally lead to withdrawal of the OM/Lab system from clinical practice. Though the system implementation failed, our usability study brought research on (re)designing and evaluating clinical computer applications at a higher status in our institution. It is now recognized that usability evaluation studies that will support good quality of clinical practice are highly important.

Clinical Laboratory Information Systems↗

PubMed2006

The redesign of the Medical Informatics Master of Science course at the University of Amsterdam.

OBJECTIVES: To describe our new two years Master of Science (MSc) program starting in September 2006 at the University of Amsterdam- Academic Medical Center, The Netherlands. METHODS: We elaborate shortly on the mission, organizational structure and new contents of this new MSc course in medical informatics. RESULTS: Through the years, our medical informatics university program underwent some major revisions of which the transition from a four years course into a three years BSc program and a two years MSc program has been the most fundamental. The new MSc program is aimed at (international) baccalaureates in medical informatics, computer science, medicine, health sciences, and biology. Besides, health care professionals or professionals with a background in computer science may enter the program. The program length is two years, comprising four study semesters of 30 European Credits each (EC, 1 EC corresponding to 27 hours study load), equalizing 120 EC in total of which 48 EC are reserved for the master's thesis. CONCLUSIONS: With the new set up of the MSc program, that will be offered in English, we hope to both accommodate the learning needs of our own baccalaureates and to attract international baccalaureates and other professionals to this course. Our ultimate aim is to bring forth medical informatics specialists who are well equipped to make significant contributions to the field.

Curriculum↗

PubMed2004

The think aloud method: a guide to user interface design.

OBJECTIVES: Clinical use of computer systems has been hampered by their poorly designed user interfaces. The objective of this study was to design a user interface for a pediatric oncologists' computerized patient record with great consideration of their working behavior and of human computer interfacing principles so as to contribute to oncologists' efficiency and satisfaction in interaction with the system. METHODS: The think aloud method was used in combination with video recording to get a deep understanding of the way in which four pediatric oncologists searched through the paper-based patient record in preparing a patient visit. Protocol and video analyses was used to develop a cognitive task model reflecting pediatric oncologists' task behavior. This model was input for a prototype user interface, which was subsequently evaluated by eight other pediatric oncologists. RESULTS: The resulting computerized medical record system proved to meet pediatric oncologists' information needs and task behavior patterns. The design of the user interface minimized pediatric oncologists' work load and was highly efficient in supporting the pediatric oncologists in preparing their patient visits. The pediatric oncologists were very much satisfied with the computer system. CONCLUSIONS: It is argued that early involvement of cognitive engineering methods in the system design process may be of great help in designing systems that fully support health care professionals' work practices. The think aloud method, if applied under prescribed conditions, is a valuable information source of human task-behavior and as such a useful technique for requirements analysis in designing clinical computer systems.

Ambulatory Care Facilities↗

PubMed2003

No damaging effect of chemotherapy in addition to radiotherapy on the thyroid axis in young adult survivors of childhood cancer.

Late effects of treatment for childhood cancer on the thyroid axis are ascribed predominantly to radiotherapy. Whether chemotherapy has an additional detrimental effect is still unclear. Our aim was to evaluate this effect in young adult survivors of a broad spectrum of childhood cancers. The thyroid axis in 205 childhood cancer survivors was evaluated in relation to former use of chemotherapy and radiotherapy (cranial, cranio-spinal, cervical, mediastinal, or thoracic). The mean follow-up time was 17.5 yr. Damage to the thyroid axis was found in 55 patients (26.8%). Thirty-seven patients (18%) had thyroidal disease. Diagnoses varied from TSH elevation to papillary carcinoma. After multivariate analysis, high risk radiation field, irradiation dose, and the diagnosis of non-Hodgkin lymphoma/Hodgkin's disease were found to be significant risk factors for developing thyroid disease. Treatment with chemotherapy did not have an additional negative effect on the thyroid axis. For the development of central (pituitary or hypothalamic) thyroid dysfunction, patients with a brain tumor were at increased risk. Chemotherapy for childhood cancer does not contribute to the damage on the thyroid axis inflicted by radiotherapy during young adulthood.

Adolescent↗