Abstract

Abstract Study question Is a digital platform for remote pre-treatment assessment perceived as useful and able to fulfil the needs of patients and clinicians? Summary answer The digital platform was found to be of high quality, useful, and answer the expressed needs of the targeted audiences in cross-cultural samples. What is known already Infertility is a life crisis. It takes on average 3.2 years to be diagnosed, 1.6 years to access a specialist, and 2.2 years to complete treatment. The pre-assessment phase is time-consuming, costly, often disruptive to the patient’s life, and may require traveling abroad. Patients need organized care where they can schedule/order tests, access information about their specific health conditions, and reach out to professionals. On the other hand, clinicians find themselves trying to assess a large number of patients before initiating treatment abroad without having a unified platform where they can review the patient’s clinical history and treatment plan. Study design, size, duration Study I explored patients’ experience with pre-treatment care and their perceived usefulness of the Patient’s Portal. An online questionnaire of 25 questions was used. Study II explored clinicians’ perceived usefulness and quality of the Doctor’s Portal. A semi-structured interview was conducted and an online questionnaire of 17 items was used. Both questionnaires had multiple options, Likert-scale, and open-ended items. The studies followed a cross-sectional design. The data were analyzed using IBM SPSS Statistics, Version 28.0. Participants/materials, setting, methods Study I had a cross-cultural sample of 59 women (M = 37.2, SD = 4.9 years). 41% are trying to conceive for more than 24 months, 89.8% were in a heterosexual relationship, and all were undergoing treatment/pursuing a clinic. The internal consistency of the questionnaire is α=.97. Study II had a cross-cultural sample (N = 8) of clinic leaders, all from different clinics. The interview questions were open-ended to capture unprompted opinions. The internal consistency of the questionnaire is α=.94. Main results and the role of chance Study I: People who took >4 weeks to have tests done/get the results scored significantly higher values than people who took less time in terms of how much they had to pay, struggled to find where to have the tests done, had difficulty managing emotions, and would’ve preferred their clinic had scheduled the testing for them. Overall, 61.02% reported the testing had been disruptive to their lives. Regarding the perceived usefulness of the platform, means >4 and a mode of 5 on a scale of 1-5 were obtained. We also found that regardless of the woman’s age or how long she’s been trying to conceive, she’d benefit from having this platform available. Study II: 75% made mention the high-quality of the platform, 50% said it would improve their current practice, covered information comprehensively, and was user-friendly, and 37.5% said it would make the process of diagnosing patients faster. Suggestions were used to adapt the platform. Regarding the quality questionnaire, the means varied between 7.86 and 9.14 (SD between .69 and 1.11) and the mode between 8 and 9 on a scale of 1-10. The inter-rater reliability coefficient was .94. This means the perceived high-quality and usefulness of the platform were consensual. Limitations, reasons for caution Small sample sizes condition the extrapolation of the findings. Further studies of the perceived usefulness and quality of the Patients’ Portal and Doctors’ Portal after the implementation of the digital platform are required. Wider implications of the findings The digital platform for remote pre-treatment assessment is currently available and being used by clinicians and patients. In the future it, can be further developed to develop and train an Artificial Intelligence algorithm to Diagnose & Predict Fertility Treatment Outcomes with Personalised Patient Pathways. Trial registration number not applicable

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