Development of an Electronic Healthcare Tool to Elicit Patient Preferences in Older Adults Diagnosed with Hematologic Malignancies

The objective of this study was to develop and evaluate iterative prototypes for an electronic healthcare tool (EHT) using three versions of a discrete choice experiment (DCE) designed to elicit the treatment preferences of older adults with hematologic malignancies. We used a mixed-methods approach including qualitative assessments (think-aloud sessions and semi-structured interviews) to develop an affinity diagram for thematic analysis, and questionnaires (Post-Study System Usability and the National Aeronautical and Space administration's Task Load Index [NASA-TLX]) to evaluate human-computer interaction, human factors and ergonomics standards on the perceived usability of, and the cognitive workload (CWL) required to perform tasks within the prototypes. DCEs included object case, profile case and multi-profile case. Iterative changes to the prototype were planned after each 5 participants. Overall, 15 healthy volunteers completed all assessments with 3 prototypes. Participants reported the prototypeswere easy to complete and straightforward but usability issues around definitions, instructions, information overload, and navigation were revealed. Participants also reported feeling overwhelmed at the information presented in the DCEs and having difficulty understanding definitions. Usability and CWL levels were acceptable for all prototypes. The profile case DCE had higher frustration scores than the other versions (NASA-TLX subscale, p = 0.04). Iterative improvements were guided by usability principles and included easier access to definitions, the addition of instructive videos and the inclusion of a more straightforward DCE (object case). This process should improve the validity of results from the DCE and the feasibility of clinical implementation of the EHT.