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Article ; Online: Patient compliance with the implementation of a decolonization strategy for Staphylococcus aureus in hip and knee replacements.

Whelan, Lindsay / Leal, Jenine / Leslie, Myles / Barkema, Herman W / Ocampo, Wrechelle / May, Elissa R

2023 Volume 52, Issue 2, Page(s) 207–213

Abstract: Background: A preoperative, in-community antimicrobial decolonization protocol combining chlorohexidine gluconate (CHG) sponges and mupirocin ointment to reduce surgical site infections amongst hip and knee replacement patients has been adopted in ... ...

Abstract	Background: A preoperative, in-community antimicrobial decolonization protocol combining chlorohexidine gluconate (CHG) sponges and mupirocin ointment to reduce surgical site infections amongst hip and knee replacement patients has been adopted in Alberta, Canada. Patient compliance with the protocol is essential for effectiveness. It is, therefore, important to understand patterns, and reasons why, patients do, and do not, comply. Methods: A descriptive survey of patients having elective total hip or knee replacement at seven clinics in Alberta was conducted to determine patient compliance and reasons for noncompliance. Descriptive statistics and multivariate logistic regression were computed. Results: Patient compliance was assessed in 3,427 patients. There were no differences in compliance based on the baseline protocols and enhanced protocols, but there was a difference based on clinic location. The odds of compliance with three CHG sponges were 4.47 times higher in rural versus urban clinics (P < .001). The most common reason for noncompliance for patients instructed to use 3 CHG sponges was "patient forgot". Conclusions: Compliance did not change when enhanced protocols were introduced; however, compliance differed by clinic location. Reasons for noncompliance included "sponges not provided", "patient forgot", and "surgery date moved". Results may inform clinics on areas where improvements could be made to increase patient compliance.
MeSH term(s)	Humans ; Staphylococcus aureus ; Chlorhexidine ; Mupirocin/therapeutic use ; Staphylococcal Infections/drug therapy ; Staphylococcal Infections/prevention & control ; Patient Compliance ; Surgical Wound Infection/prevention & control ; Surgical Wound Infection/drug therapy ; Alberta ; Anti-Bacterial Agents/therapeutic use
Chemical Substances	Chlorhexidine (R4KO0DY52L) ; Mupirocin (D0GX863OA5) ; Anti-Bacterial Agents
Language	English
Publishing date	2023-06-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	392362-9
ISSN	1527-3296 ; 0196-6553
ISSN (online)	1527-3296
ISSN	0196-6553
DOI	10.1016/j.ajic.2023.06.016
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Article ; Online: Deployment of a human-centred clinical decision support system for pulmonary embolism: evaluation of impact on quality of diagnostic decisions.

Altabbaa, Ghazwan / Flemons, Ward / Ocampo, Wrechelle / Babione, Julie Nathalie / Kaufman, Jamie / Murphy, Sydney / Lamont, Nicole / Schaefer, Jeffrey / Boscan, Alejandra / Stelfox, Henry T / Conly, John / Ghali, William A

BMJ open quality

2024 Volume 13, Issue 1

Abstract: Pulmonary embolism (PE) is a serious condition that presents a diagnostic challenge for which diagnostic errors often happen. The literature suggests that a gap remains between PE diagnostic guidelines and adherence in healthcare practice. While system- ... ...

Abstract	Pulmonary embolism (PE) is a serious condition that presents a diagnostic challenge for which diagnostic errors often happen. The literature suggests that a gap remains between PE diagnostic guidelines and adherence in healthcare practice. While system-level decision support tools exist, the clinical impact of a human-centred design (HCD) approach of PE diagnostic tool design is unknown. Design: Before-after (with a preintervention period as non-concurrent control) design study. Setting: Inpatient units at two tertiary care hospitals. Participants: General internal medicine physicians and their patients who underwent PE workups. Intervention: After a 6-month preintervention period, a clinical decision support system (CDSS) for diagnosis of PE was deployed and evaluated over 6 months. A CDSS technical testing phase separated the two time periods. Measurements: PE workups were identified in both the preintervention and CDSS intervention phases, and data were collected from medical charts. Physician reviewers assessed workup summaries (blinded to the study period) to determine adherence to evidence-based recommendations. Adherence to recommendations was quantified with a score ranging from 0 to 1.0 (the primary study outcome). Diagnostic tests ordered for PE workups were the secondary outcomes of interest. Results: Overall adherence to diagnostic pathways was 0.63 in the CDSS intervention phase versus 0.60 in the preintervention phase (p=0.18), with fewer workups in the CDSS intervention phase having very low adherence scores. Further, adherence was significantly higher when PE workups included the Wells prediction rule (median adherence score=0.76 vs 0.59, p=0.002). This difference was even more pronounced when the analysis was limited to the CDSS intervention phase only (median adherence score=0.80 when Wells was used vs 0.60 when Wells was not used, p=0.001). For secondary outcomes, using both the D-dimer blood test (42.9% vs 55.7%, p=0.014) and CT pulmonary angiogram imaging (61.9% vs 75.4%, p=0.005) was lower during the CDSS intervention phase. Conclusion: A clinical decision support intervention with an HCD improves some aspects of the diagnostic decision, such as the selection of diagnostic tests and the use of the Wells probabilistic prediction rule for PE.
MeSH term(s)	Humans ; Decision Support Systems, Clinical ; Pulmonary Embolism/diagnosis ; Health Facilities
Language	English
Publishing date	2024-02-12
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2399-6641
ISSN (online)	2399-6641
DOI	10.1136/bmjoq-2023-002574
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Article ; Online: Erratum to "Human-centred design processes for clinical decision support: A pulmonary embolism case study" [Int. J. Med. Inf. (2020) 104196].

Babione, Julie N / Ocampo, Wrechelle / Haubrich, Sydney / Yang, Connie / Zuk, Torre / Kaufman, Jaime / Carpendale, Sheelagh / Ghali, William / Altabbaa, Ghazwan

International journal of medical informatics

2021 Volume 148, Page(s) 104417

Language	English
Publishing date	2021-02-23
Publishing country	Ireland
Document type	Published Erratum
ZDB-ID	1466296-6
ISSN	1872-8243 ; 1386-5056
ISSN (online)	1872-8243
ISSN	1386-5056
DOI	10.1016/j.ijmedinf.2021.104417
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Article ; Online: Exploring data reduction strategies in the analysis of continuous pressure imaging technology.

Peng, Mingkai / Southern, Danielle A / Ocampo, Wrechelle / Kaufman, Jaime / Hogan, David B / Conly, John / Baylis, Barry W / Stelfox, Henry T / Ho, Chester / Ghali, William A

BMC medical research methodology

2023 Volume 23, Issue 1, Page(s) 56

Abstract: Background: Science is becoming increasingly data intensive as digital innovations bring new capacity for continuous data generation and storage. This progress also brings challenges, as many scientific initiatives are challenged by the shear volumes of ...

Abstract	Background: Science is becoming increasingly data intensive as digital innovations bring new capacity for continuous data generation and storage. This progress also brings challenges, as many scientific initiatives are challenged by the shear volumes of data produced. Here we present a case study of a data intensive randomized clinical trial assessing the utility of continuous pressure imaging (CPI) for reducing pressure injuries. Objective: To explore an approach to reducing the amount of CPI data required for analyses to a manageable size without loss of critical information using a nested subset of pressure data. Methods: Data from four enrolled study participants excluded from the analytical phase of the study were used to develop an approach to data reduction. A two-step data strategy was used. First, raw data were sampled at different frequencies (5, 30, 60, 120, and 240 s) to identify optimal measurement frequency. Second, similarity between adjacent frames was evaluated using correlation coefficients to identify position changes of enrolled study participants. Data strategy performance was evaluated through visual inspection using heat maps and time series plots. Results: A sampling frequency of every 60 s provided reasonable representation of changes in interface pressure over time. This approach translated to using only 1.7% of the collected data in analyses. In the second step it was found that 160 frames within 24 h represented the pressure states of study participants. In total, only 480 frames from the 72 h of collected data would be needed for analyses without loss of information. Only ~ 0.2% of the raw data collected would be required for assessment of the primary trial outcome. Conclusions: Data reduction is an important component of big data analytics. Our two-step strategy markedly reduced the amount of data required for analyses without loss of information. This data reduction strategy, if validated, could be used in other CPI and other settings where large amounts of both temporal and spatial data must be analysed.
MeSH term(s)	Humans ; Data Collection ; Technology ; Time Factors ; Signal Processing, Computer-Assisted
Language	English
Publishing date	2023-03-01
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	2041362-2
ISSN	1471-2288 ; 1471-2288
ISSN (online)	1471-2288
ISSN	1471-2288
DOI	10.1186/s12874-023-01875-y
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Article ; Online: Effect of a Continuous Bedside Pressure Mapping System for Reducing Interface Pressures: A Randomized Clinical Trial.

Ho, Chester / Ocampo, Wrechelle / Southern, Danielle A / Sola, Darlene / Baylis, Barry / Conly, John M / Hogan, David B / Kaufman, Jaime / Stelfox, Henry Thomas / Ghali, William A

JAMA network open

2023 Volume 6, Issue 6, Page(s) e2316480

Abstract: Importance: Continuous bedside pressure mapping (CBPM) technology can assist in detecting skin areas with excessive interface pressure and inform efficient patient repositioning to prevent the development of pressure injuries (PI).: Objective: To ... ...

Abstract	Importance: Continuous bedside pressure mapping (CBPM) technology can assist in detecting skin areas with excessive interface pressure and inform efficient patient repositioning to prevent the development of pressure injuries (PI). Objective: To evaluate the efficacy of CBPM technology in reducing interface pressure and the incidence of PIs. Design, setting, and participants: This parallel, 2-group randomized clinical trial was performed at a tertiary acute care center. The study started to enroll participants in December 2014 and was completed in May 2018. Participants included adults partially or completely dependent for bed mobility. Statistical analysis was performed from September 2018 to December 2022. Intervention: Nursing staff using visual feedback from CBPM technology for 72 hours. Main outcomes and measures: Absolute number of sensing points with pressure readings greater than 40 mm Hg, mean interface pressure across all sensing points under a patient's body, proportion of participants who had pressure readings greater than 40 mm Hg, and pressure-related skin and soft tissue changes. Results: There were 678 patients recruited. After attrition, 260 allocated to the control group (151 [58.1%] male; mean [SD] age, 61.9 [18.5] years) and 247 in the intervention group (147 [59.5%] male; mean [SD] age, 63.6 [18.1] years) were included in analyses. The absolute number of sensing points with pressures greater than 40 mm Hg were 11 033 in the control group vs 9314 in the intervention group (P = .16). The mean (SD) interface pressure was 6.80 (1.63) mm Hg in the control group vs 6.62 (1.51) mm Hg in the intervention group (P = .18). The proportion of participants who had pressure readings greater than 40 mm Hg was 99.6% in both the control and intervention groups. Conclusions and relevance: In this randomized clinical trial to evaluate the efficacy of CBPM technology in the reduction of interface pressure and the incidence of PIs in a tertiary acute care center, no statistically significant benefit was seen for any of the primary outcomes. These results suggest that longer duration of monitoring and adequately powered studies where CBPM feedback is integrated into a multifaceted intervention to prevent PI are needed. Trial registration: ClinicalTrials.gov Identifier: NCT02325388.
MeSH term(s)	Adult ; Female ; Humans ; Male ; Middle Aged ; Pressure ; Pressure Ulcer/prevention & control ; Point-of-Care Systems
Language	English
Publishing date	2023-06-01
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2023.16480
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Article ; Online: Implementation strategies for hospital-based probiotic administration in a stepped-wedge cluster randomized trial design for preventing hospital-acquired Clostridioides difficile infection.

Bresee, Lauren C / Lamont, Nicole / Ocampo, Wrechelle / Holroyd-Leduc, Jayna / Sabuda, Deana / Leal, Jenine / Dalton, Bruce / Kaufman, Jaime / Missaghi, Bayan / Kim, Joseph / Larios, Oscar E / Henderson, Elizabeth / Raman, Maitreyi / Fletcher, Jared R / Faris, Peter / Kraft, Scott / Shen, Ye / Louie, Thomas / Conly, John M

BMC health services research

2023 Volume 23, Issue 1, Page(s) 1386

Abstract: Background: Clostridioides difficile infection (CDI) is associated with considerable morbidity and mortality in hospitalized patients, especially among older adults. Probiotics have been evaluated to prevent hospital-acquired (HA) CDI in patients who ... ...

Abstract	Background: Clostridioides difficile infection (CDI) is associated with considerable morbidity and mortality in hospitalized patients, especially among older adults. Probiotics have been evaluated to prevent hospital-acquired (HA) CDI in patients who are receiving systemic antibiotics, but the implementation of timely probiotic administration remains a challenge. We evaluated methods for effective probiotic implementation across a large health region as part of a study to assess the real-world effectiveness of a probiotic to prevent HA-CDI (Prevent CDI-55 +). Methods: We used a stepped-wedge cluster-randomized controlled trial across four acute-care adult hospitals (n = 2,490 beds) to implement the use of the probiotic Bio-K + ® (Lactobacillus acidophilus CL1285®, L. casei LBC80R® and L. rhamnosus CLR2®; Laval, Quebec, Canada) in patients 55 years and older receiving systemic antimicrobials. The multifaceted probiotic implementation strategy included electronic clinical decision support, local site champions, and both health care provider and patient educational interventions. Focus groups were conducted during study implementation to identify ongoing barriers and facilitators to probiotic implementation, guiding needed adaptations of the implementation strategy. Focus groups were thematically analyzed using the Theoretical Domains Framework and the Consolidated Framework of Implementation Research. Results: A total of 340 education sessions with over 1,800 key partners and participants occurred before and during implementation in each of the four hospitals. Site champions were identified for each included hospital, and both electronic clinical decision support and printed educational resources were available to health care providers and patients. A total of 15 individuals participated in 2 focus group and 7 interviews. Key barriers identified from the focus groups resulted in adaptation of the electronic clinical decision support and the addition of nursing education related to probiotic administration. As a result of modifying implementation strategies for identified behaviour change barriers, probiotic adherence rates were from 66.7 to 75.8% at 72 h of starting antibiotic therapy across the four participating acute care hospitals. Conclusions: Use of a barrier-targeted multifaceted approach, including electronic clinical decision support, education, focus groups to guide the adaptation of the implementation plan, and local site champions, resulted in a high probiotic adherence rate in the Prevent CDI-55 + study.
MeSH term(s)	Humans ; Aged ; Clostridioides difficile ; Lactobacillus acidophilus ; Clostridium Infections/prevention & control ; Probiotics/therapeutic use ; Anti-Bacterial Agents/therapeutic use ; Cross Infection/prevention & control ; Cross Infection/drug therapy ; Hospitals
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2023-12-11
Publishing country	England
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	2050434-2
ISSN	1472-6963 ; 1472-6963
ISSN (online)	1472-6963
ISSN	1472-6963
DOI	10.1186/s12913-023-10350-9
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Article ; Online: Healthcare provider and patient/family perceptions of continuous pressure imaging technology for prevention of pressure injuries: A secondary analysis of patients enrolled in a randomized control trial.

Ocampo, Wrechelle / Sola, Darlene Y / Baylis, Barry W / Conly, John M / Hogan, David B / Kaufman, Jaime / Kiplagat, Linet / Stelfox, Henry T / Ghali, William A / Ho, Chester

PloS one

2022 Volume 17, Issue 11, Page(s) e0278019

Abstract: Introduction: Despite the availability of various pressure injury (PI) prevention strategies (e.g., risk identification, use of pressure re-distribution surfaces, frequent repositioning), they persist as a significant issue for healthcare systems ... ...

Abstract	Introduction: Despite the availability of various pressure injury (PI) prevention strategies (e.g., risk identification, use of pressure re-distribution surfaces, frequent repositioning), they persist as a significant issue for healthcare systems worldwide. Continuous pressure imaging (CPI) is a novel technology that could be integrated within a comprehensive approach to the prevention of PIs. We studied the perceptions of healthcare providers and patients/families to identify facilitators and barriers to the use of this technology. Methods: Hospitalized patients/family members from a randomized controlled trial assessing the efficacy of CPI in preventing PIs completed a survey after 72 hours (or upon discharge from hospital) of CPI monitoring. They were asked questions about prior and current experience with CPI technology. For healthcare providers, perceptions on the use of the device and its impact on care were explored through a survey distributed by email or hard copies. Results: A total of 125 healthcare providers and 525 patients/family members completed the surveys. Of the healthcare providers, 95% either agreed/strongly agreed that the CPI technology was easy to use and 65% stated that the device improved how they provided pressure relief for patients. Identified issues with the device were cost, the fitting of the mattress cover, and the fixation of the patients/families on the device. Over a quarter of the patient/family respondents agreed/strongly agreed that the device influenced how pressure relief was provided. This response was statistically associated with whether the monitor was turned on (intervention arm; 52.7%) or off (control arm; 4.2%). Discussion and conclusion: CPI technology was positively perceived by healthcare providers. Most patients/families felt it influenced care when the CPI monitor was turned on. Concerns raised around cost and the ease of use of these devices by healthcare providers may affect the decisions of healthcare system administrators to adopt and implement this technology.
MeSH term(s)	Humans ; Crush Injuries ; Electronic Mail ; Family ; Health Personnel ; Pressure Ulcer ; Technology
Language	English
Publishing date	2022-11-29
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0278019
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Article ; Online: Healthcare provider and patient/family perceptions of continuous pressure imaging technology for prevention of pressure injuries

Wrechelle Ocampo / Darlene Y. Sola / Barry W. Baylis / John M. Conly / David B. Hogan / Jaime Kaufman / Linet Kiplagat / Henry T. Stelfox / William A. Ghali / Chester Ho

PLoS ONE, Vol 17, Iss

A secondary analysis of patients enrolled in a randomized control trial

2022 Volume 11

Abstract: Introduction Despite the availability of various pressure injury (PI) prevention strategies (e.g., risk identification, use of pressure re-distribution surfaces, frequent repositioning), they persist as a significant issue for healthcare systems ... ...

Abstract	Introduction Despite the availability of various pressure injury (PI) prevention strategies (e.g., risk identification, use of pressure re-distribution surfaces, frequent repositioning), they persist as a significant issue for healthcare systems worldwide. Continuous pressure imaging (CPI) is a novel technology that could be integrated within a comprehensive approach to the prevention of PIs. We studied the perceptions of healthcare providers and patients/families to identify facilitators and barriers to the use of this technology. Methods Hospitalized patients/family members from a randomized controlled trial assessing the efficacy of CPI in preventing PIs completed a survey after 72 hours (or upon discharge from hospital) of CPI monitoring. They were asked questions about prior and current experience with CPI technology. For healthcare providers, perceptions on the use of the device and its impact on care were explored through a survey distributed by email or hard copies. Results A total of 125 healthcare providers and 525 patients/family members completed the surveys. Of the healthcare providers, 95% either agreed/strongly agreed that the CPI technology was easy to use and 65% stated that the device improved how they provided pressure relief for patients. Identified issues with the device were cost, the fitting of the mattress cover, and the fixation of the patients/families on the device. Over a quarter of the patient/family respondents agreed/strongly agreed that the device influenced how pressure relief was provided. This response was statistically associated with whether the monitor was turned on (intervention arm; 52.7%) or off (control arm; 4.2%). Discussion and conclusion CPI technology was positively perceived by healthcare providers. Most patients/families felt it influenced care when the CPI monitor was turned on. Concerns raised around cost and the ease of use of these devices by healthcare providers may affect the decisions of healthcare system administrators to adopt and implement this technology.
Keywords	Medicine ; R ; Science ; Q
Subject code	360
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Effectiveness of Bio-K+ for the prevention of

Infection control and hospital epidemiology

2023 Volume 45, Issue 4, Page(s) 443–451

Abstract: Objective: To evaluate the impact of administering probiotics to prevent : Design: Stepped-wedge cluster-randomized trial between September 1, 2016, and August 31, 2019.: Setting: This study was conducted in 4 acute-care hospitals across an ... ...

Abstract	Objective: To evaluate the impact of administering probiotics to prevent Design: Stepped-wedge cluster-randomized trial between September 1, 2016, and August 31, 2019. Setting: This study was conducted in 4 acute-care hospitals across an integrated health region. Patients: Hospitalized patients, aged ≥55 years. Methods: Patients were given 2 probiotic capsules daily (Bio-K+, Laval, Quebec, Canada), containing 50 billion colony-forming units of Results: Overall adherence of Bio-K+ administration ranged from 76.9% to 84.6% when stratified by facility and periods. Rates of adherence to administration within 48 and 72 hours of antibiotic treatment were 60.2% -71.4% and 66.7%-75.8%, respectively. In the adjusted analysis, there was no change in HA-CDI (incidence rate ratio [IRR], 0.92; 95% confidence interval [CI], 0.68-1.23) or Conclusions: Hospitals considering probiotics as a primary prevention strategy should consider the baseline incidence of HA-CDI in their population and timing of probiotics relative to the start of antimicrobial administration.
MeSH term(s)	Humans ; Clostridioides difficile ; Clostridium Infections/epidemiology ; Clostridium Infections/prevention & control ; Clostridium Infections/drug therapy ; Anti-Bacterial Agents/therapeutic use ; Anti-Infective Agents/therapeutic use ; Canada ; Cross Infection/epidemiology ; Probiotics/therapeutic use
Chemical Substances	Anti-Bacterial Agents ; Anti-Infective Agents
Language	English
Publishing date	2023-12-11
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	639378-0
ISSN	1559-6834 ; 0195-9417 ; 0899-823X
ISSN (online)	1559-6834
ISSN	0195-9417 ; 0899-823X
DOI	10.1017/ice.2023.169
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Article ; Online: Human-centred design processes for clinical decision support: A pulmonary embolism case study.

Babione, Julie N / Ocampo, Wrechelle / Haubrich, Sydney / Yang, Connie / Zuk, Torre / Kaufman, Jaime / Carpendale, Sheelagh / Ghali, William / Altabbaa, Ghazwan

International journal of medical informatics

2020 Volume 142, Page(s) 104196

Abstract: Background: Clinical Decision Support Systems (CDSS) can make patient care more efficient, cost-effective, and guideline-concordant. Many are created by clinicians who understand the challenges, but may publish concepts before considering subtle but ... ...

Abstract	Background: Clinical Decision Support Systems (CDSS) can make patient care more efficient, cost-effective, and guideline-concordant. Many are created by clinicians who understand the challenges, but may publish concepts before considering subtle but important design details. Human-Centred Design (HCD) approaches provide necessary methods ensuring solid CDSS design. This article highlights HCD approaches in a pulmonary embolism CDSS case study context. Methods: This pulmonary embolism CDSS results from collaborative work between computer science, psychology, and medicine. HCD methods used include: evaluations of pre-clinical prototype recordings, iterative usability expert reviews with software refinement, formative usability testing, and (separately-published) clinical pilot study. Results: HCD methods were instrumental in iteratively creating an easy to use and functionally-sound CDSS. Retrospective evaluations revealed that participants spent considerable time on items that were out of order from natural cognitive diagnostic workflows. Features missing between original and study version were noted, confusing interface elements reworked, and currently-active decision tree branches were visually emphasized. From iterative usability reviews, positioning of information within the decision tree was radically reworked, information separated into levels of support for different user groups, and supportive versus directive language issues addressed. Formative studies identified issues such as interface adjustments and hospital workflow integration. Conclusions: Human-centred design approaches provide methods for integrating the skills and knowledge of many disciplines, illustrated by example in this pulmonary embolism CDSS creation. Advantages of leveraging many design guidelines as well as revealing new design considerations that would otherwise have remained hidden are described. The findings reported here support future CDSS design through HCD inclusion.
MeSH term(s)	Decision Support Systems, Clinical ; Humans ; Pilot Projects ; Pulmonary Embolism/diagnosis ; Retrospective Studies ; Workflow
Language	English
Publishing date	2020-06-07
Publishing country	Ireland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1466296-6
ISSN	1872-8243 ; 1386-5056
ISSN (online)	1872-8243
ISSN	1386-5056
DOI	10.1016/j.ijmedinf.2020.104196
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