Beta Testing Research Articles

Creation and beta testing of a "choose your own adventure" digital simulation to reinforce motivational interviewing skills in genetic counseling.

Standardized patients and/or role-playing are commonly used for practicing genetic counseling (GC) skills. Use of digital simulation, incorporating gamification elements, would require fewer resources to sustain than standardized patients. This manuscript reports steps taken and the lessons learned from creating a digital "Choose your own adventure" simulation in which students select preferred dialog for a genetic counselor who is seeing an adult patient to discuss genetic testing for the known pathogenic variant that caused familial adenomatous polyposis (FAP) in their father. The case has three endings, one of which is attained by selecting options that are mostly consistent with motivational interviewing counseling techniques. We conducted a preliminary evaluation of our beta version among nine GC students and one educator using a survey to assess acceptability and appropriateness as well as to elicit open-ended feedback. All participants agreed or strongly agreed with statements indicating the case was acceptable, appropriate, and fun. Users particularly appreciated the immediate feedback given throughout the case simulation. Many users wanted more options to select from and listed various other recommendations, including several which would require substantial resources to implement.

DEVELOPMENT OF E-LEARNING-BASED EDUCATION IN THE PAI STUDY PROGRAM, TARBIYAH DEPARTMENT, STAI AL-QODIRI JEMBER

This study aims to produce an e-learning product in PAI Study Program, Tarbiyah Department, STAI Al-Qodiri Jember. The research method used in this research is using the R&D method. The R&D model in this study uses the Alessi & Trollip model. In the model, there are three phases of the development procedure, namely planning, design and development. The results showed that educational psychology E-learning was developed using Moodle LMS. The development stage includes making modules, presentation materials and quizzes, hosting, installing Moodle, determining the chosen theme, compiling, uploading and managing e-learning materials or content into Moodle and product revisions (results from alpha test, beta test).
 

Lessons Learned from Nanbar Health: Developing a Multi-System Software Suite for Predictive Algorithms and Remote Monitoring for People Living with Sickle Cell Disease

Background: Sickle cell disease (SCD) is a genetic disorder that alters the shape of red blood cells, leading to significant complications and requiring highly complex care. Efforts often focus on prevention and early diagnosis of pain to improve outcomes for those with SCD. Remote monitoring (RPM) and predictive algorithms has grown exponentially in the last decade as a support tool for managing chronic diseases like heart failure and diabetes. Implementing similar technology for SCD care could improve patient outcomes through early detection of complications and providing physicians with longitudinal data to support clinical decisions. Our team previously used mobile health (mHealth) as RPM in this population and developed a machine learning algorithm to predict pain scores with 86% accuracy. Here, we describe the development process for the Nanbar Health software alongside the lessons learned from its development. Objectives: Describe the methods necessary to build a comprehensive mHealth remote monitoring system (Nanbar Health) that facilitates SCD health management. Develop a set of lessons for other developers when building a remote monitoring software suite. Methods: Nanbar Health's development process has taken 2 years. First, our team reviewed feedback and “bug” reports from patients and providers of other mobile applications our team built at Duke University. Using the feedback collected an user-interface (UI) interface (mock-ups) was created for the Nanbar Health mobile app using Figma. These mock-ups were then shown to healthcare providers with expertise in caring for individuals with SCD for feedback. Upon approval of mock-ups, our team developed the mobile application using Swift and Apple HealthKit. The team also built a physician-facing dashboard using React, NodeJS, and Python. The backend software for this system utilized Docker containers mounted on AWS EC2 instances, a Parse server, MongoDB and PostgreSQL databases, and Nginx for deployment and load balancing. Next, the dashboard was reviewed by medical providers for feedback. The analytics portion of the dashboard processed data in Python backend scripts and interactive visualizations were built using the Plotly library in NodeJS. The analytics portion of the tool is currently being reviewed for feedback. Throughout the process of developing and piloting the Nanbar Health Software, our team identified several challenges. These challenges were collected into a comprehensive index named, “Lessons Learned”. Results: The lessons learned include: 1. Overall Gain user feedback and place yourself in the shoes of the user: At every step of your software's development ensure you are continuously getting feedback from your users. 2. Mobile Application Engagement is key to acquiring good data: Ensure your team uses a variety of methods methods to engage your users.No mobile app is one size fits all, but one app can customize to all: The development team should create re-usable, dynamic components wherever possible. 3. Provider Dashboard Testing to build: Developers should build a user interface that is easy to run and test as a “pseudo-user” while they are building it, making it easier for the developer to understand the user experience and build a user-friendly application.Building to test: Plan for beta testers from the beginning and ensure that they have access to continuously-updated and fake but realistic data. 4. Network Analysis Complex analytics are computationally demanding - Advanced analytical tools incur more complications when incorporated into a High-Usage SystemFor heavy data processing, go serverless - Isolating heavy data processing from the rest of the application saves tremendous time and money. 5. Research and Operations Don't cry over spilt code: Mistakes and bugs are part of the process when developing any software, and part of the research process.Lack of engagement is not a reason for disappointment, but rather an opportunity for growth and improvement: Our tool has continuously experienced changes and improvements to increase patient engagement. Conclusion: Our team was successfully able to create and deploy a SCD care-focused Nanbar Health. These tools show promise of improving care for people living with SCD through the usage of RPM and predictive models. Further research should be conducted to determine methods to increase user engagement, and maintain large predictive models in cloud-based systems.

1 The Mobile Toolbox for Monitoring Cognitive Change

Objective:To present the Mobile Toolbox (MTB), comprised of an expandable library of cognitive and other tests, including adapted versions of NIH Toolbox® measures. The MTB provides a complete research platform for app creation, study management, data collection, and data management. We will describe the MTB project and MTB research platform and demonstrate examples of assessments.Participants and Methods:MTB is the product of an NIH-funded, multi-institutional effort involving Northwestern University, Sage Bionetworks, Penn State, University of California San Francisco, University of California San Diego, Emory University, and Washington University. The MTB assessment library is a dynamic repository built upon Sage Bionetworks mobile health platform. All MTB measures are created or adapted for a mobile interface using iOS and Android smartphones. Guided by the principles of open science, many components are open source to allow researchers and developers to integrate externally developed tests, including supplemental scales (e.g., passively collected contextual factors) assessing variables such as mood and fatigue that might influence cognitive test performance.Results:The current MTB library includes eight core cognitive tests based on well-established neuropsychological measures: two language tasks (Spelling and Word Meaning), two executive functioning tasks (Arrow Matching and Shape-Color Sorting), an associative memory task (Faces and Names), an episodic memory task (Arranging Pictures), a working memory task (Sequences) and a processing speed task (Numbers and Symbols). Additional cognitive assessments from other popular test libraries including the International Cognitive Ability Resource (ICAR), Cognitive Neuroscience Test Reliability and Clinical Applications for Schizophrenia (CNTRACS) and Test My Brain are currently being implemented, as are non-cognitive measures from the NIH Toolbox Emotion Battery and the Patient-Reported Outcomes Measurement Information System (PROMIS). The MTB library includes measures suitable for use in research studies incorporating point-in-time and burst designs as well as ecological momentary assessment (EMA).Conclusions:The MTB was created to address many of the scientific, practical, and technical challenges to cognitive assessment by capitalizing on advances in technology measurement and cognitive research. Initial psychometric evaluation of measures has been performed, and additional clinical validation is underway in studies with persons at risk for cognitive impairment or Alzheimer’s disease (AD), diagnosed with mild cognitive impairment (MCI) or AD, Parkinson’s disease, and HIV-associated Neurocognitive Disorders. Calculation of norms and reliable change indicators is in progress. The MTB is currently available to beta testers with public release planned for Summer, 2023. Clinical researchers will be able to use the MTB system to design smartphone-based test batteries, deploy and manage mobile data collection in their research studies, and aggregate and analyze results in the context of large-scale norming data.

Dungeon Code: Educational Game For Algorithm and Data Structure Courses by Applying The Game Development Life Cycle Method

Algorithm and Data Structure is a basic course in Informatics Study Program, at Khairun University. This subject needs to be mastered because it becomes the foundation that can support the learning process in the future. However, from the results of a survey conducted, as many as 40% of students felt bored with the teaching methods used by Algorithm and Data Structure lecturers in class. In addition, there were also 73.33% of students that even though they paid attention to the material presented in class, they still found it difficult to understand the material. To overcome this problem, new learning media is needed in the classroom, such as games. This study aims to design educational games that teach algorithms and data structures using the Game Development Life Cycle (GDLC) method. The GDLC is a game development method that is widely used to create educational games. The GDLC method has several development stages, namely initiation, pre-production, production, testing, beta, and release. Alpha test results show that all functionality is appropriate. While the results of beta testing show the number 3.43 of the total respondents' answers to the questionnaire related to game evaluation so they are included in the very good criteria.

Integrative Oncology Leadership Collaborative (IOLC): Making tools (and a new PRO) for whole person cancer care to be routine and regular.

355 Background: Nearly two-thirds (62%) of people with cancer want to know about non-tumor directed therapies such as exercise, nutrition counseling, massage, and meditation before starting conventional treatment, but only 33% of oncologists agree with that timeline, according to a 2022 online survey . In 2021-2022, Samueli Integrative Health Programs (now Healing Works Foundation) funded a two-year integrative oncology leadership collaborative (IOLC) with a goal to further whole person cancer care, also called integrative oncology. The IOLC adapted a new patient reported outcome (PRO), and patient education and workflow resources used in whole person primary care for use in cancer care. The Personal Health Inventory (PHI), a person-focused PRO intake tool to elicit “what matters”, was made oncology-specific and deployed at several centers including a VA Medical Center. The IOLC created or adapted additional resources, resulting in a set of open-source tools for use in mainstream oncology practice. Methods: 13 cancer care organizations met monthly in 90-min virtual format from April-Dec 2021. From Jan-Dec 2022 sessions were held twice monthly over 1-hr. Year One allowed group cohesion in discussion-based review of the current state of whole person cancer care and covered foundational topics to include guideline-based supportive care and group medical visits. IOLC members suggested changes to the primary care PHI along with development of new oncology-specific whole person care resources. In Year Two, IOLC members were encouraged to beta test the PHI and related-resources in their practice settings and a Patient Empowerment and Advocacy Collaborative (PAEC) was developed as part of the group to bring in direct patient experience. The oncology-specific PHI was trialed within the Dayton VA Whole Health Oncology clinic from Oct 2021-June 2023. It proved feasible for use at any stage of the cancer care experience in 25 intake encounters. Results: PHI oncology-specific adaptations included replacing “Healthy Days” with FACT-G7 and the Patient Dignity Question (PDQ). Nineteen “pocket guides” were created and posted free online to support whole person cancer care. The patient voice was expanded through the formation of the PAEC in Year Two, and the group led two joint sessions where advocates provided input on IOLC tools’ development. Conclusions: A group of cancer care professionals and patients, working together in a sponsored community of practice, created no-cost resources, including a new PRO called the PHI, to further whole person integrative cancer care. The PHI demonstrated feasibility in a veteran population with cancer and can be offered at any time in the oncology trajectory, from diagnosis to end of life, surviving to thriving. Next steps are to formally test these tools in various oncology practice settings.

Quality Assurance in Investment Banking Domain

Investment Banking applications are complex applications supporting different trading platforms, risk management systems, compliance, and regulatory requirements. Different Investment Banking applications have different software testing and QA requirements, depending on the domain function they are supporting, complexity of the flows and external applications they are integrating with. Investment Banking is a huge domain, and everything cannot be summarized in a single white paper. In this paper we will study the commonly used terminologies in Investment banking domain, especially around trade life cycle, and what quality assurance activities need to be performed in complex Investment Banking applications, covering majorly around the trade flows

Migration of Data from RDBMS to NOSQL and Possibility of Implementing a Single Query Language for NOSQL Databases

Abstract: The migration of data from RDBMS to NoSQL database systems gains increasing popularity nowadays. This research assesses the possibility of implementing an application that would function with all NoSQL databases. Furthermore, it dives into the ways of developing a Single Query Language for all NoSQL databases. Findings suggest that the potential for specialized frameworks within such a language would simplify the usage of this language by programmers. Research also suggests that the language could be bolstered by collaborative efforts between database corporations and beta testing of the language to set a pathway towards achieving this unified language. This literature signifies how important it is to consider user feedback to achieve the expected result. As we can see from previous methods explored, UnQL ceased its existence.

Club convergence analysis of fossil fuels material footprint at the global level.

Material footprint is vital for playing a role in increasing the pace of climate change and the sustainability of development efforts. Fossil fuels material footprint (FFMF) remains a critical indicator of environment-friendly economic development. Fossil fuels have also retained their dominance as prominent drivers of global growth since the Industrial Revolution. FFMF levels show considerable variations in economic growth worldwide as awareness of sustainability and climate change propagates. Although biomass/carbon emission convergence have been discussed extensively in the existing literature, FFMF convergence is still scanty despite its vital role in climate change. Hence, this study adds to the existing literature by examining the convergence of FFMF for 154 countries for the period from 1970 to 2019 using club convergence analysis. The results show that FFMF converges to a single steady state, stating a symmetric decline in FFMF growth. Further, the findings from sigma and beta tests are consistent with the main results. Thus, the demonstrated convergence of FFMF directs that global efforts regarding FFMF control should be continued. Moreover, future climate change policies should also be formulated to enhance the awareness of FFMF and long-term sustainability.

Adapting an evidence-based mindfulness-based intervention for sheltered youth experiencing homelessness

ObjectivesYouth experiencing homelessness (YEH) face challenges that impact their physical, mental, and social wellbeing, emotion regulation, and coping. Mindfulness reduces stress and improves resilience, emotion regulation, and executive functioning. Mindfulness-based interventions (MBI) teach the practice of mindfulness to foster present-moment attention without judgement and enhance self-observation and self-regulation, resulting in greater awareness of thoughts and emotions and improved interpersonal relationships. One such intervention, .b, has been shown to lower stress among youth. While a pilot study of .b among sheltered youth found the intervention to be feasible, the need for modifications was identified to improve its relevance, accessibility, and incorporate a trauma-informed approach.MethodsWe used the ADAPT-ITT (Assessment, Decisions, Administration, Production, Topical experts, Integration, Training staff, and Testing) framework to adapt the .b mindfulness intervention to YEH living in an emergency shelter. Nine focus group discussions (n = 56), key informant interviews (n = 8), and beta testing with five youth working group sessions (n = 10) identified needed modifications.ResultsAdaptations to the curriculum and delivery modality were made to approximate the average length of stay in the shelter; integrate trauma-informed care approaches; increase diversity of images by race, ethnicity, age, sexual orientation, and gender identity; and increase the relevance of the audio-visual components.ConclusionsYouth and the health and social services providers who care for youth generally liked the core concepts and presentation of the curriculum. Using the ADAPT-ITT framework, minor, yet important, changes were made to increase the relevance, acceptability, and feasibility of the intervention. Next steps are to conduct a randomized attention control pilot study to assess feasibility and acceptability.

Innovation of Pedagogy: Development of Digital Classroom to Increasing Student’s In Foreign Language Profiency

This study aims to develop a digital classroom to improve the foreign language skills of MA MUQ Langsa students in facing digital-based learning challenges according to the demands of the 21st century. To find out the effectiveness of using digital classes in foreign language learning. The method in this study is the research and development (R&D) method. The results of this study were testing foreign language learning materials with a score of 4.00 (good category) and media testing with media experts obtained a score of 4.00 (good category). Meanwhile, for random testing of students, a score of 4.00 (good category) was obtained. The average score obtained at the pretest was 38.88 and the posttest was 39.00. So that it can be explained from the results of alpha and beta testing and seeing the effectiveness of product development, it can be concluded that the product is feasible and effective for learning foreign languages. This of course will be very beneficial for teachers in transferring teaching materials and providing innovation in student learning spaces.

Pengaruh Kualitas Pelayanan dan Keragaman Produk Tabungan terhadap Minat Menabung Masyarakat Bondowoso pada Bank Muamalat

The aim of this research is to find and examine the relationship between service quality and the diversity of savings products in attracting Bondowoso people's interest in saving at Bank Muamalat. Quantitative research is the type now used. The Bondowoso community was the target of this research, which included a sample of 100 respondents from each of the five sub-districts of Sukosari, Tapen, Wonosari, Tenggarang and Bondowoso. Multiple linear regression is the analysis tool used. The following are the findings from the multiple linear regression analysis coefficient assessment: 1) With a beta test coefficient of 0.249, service quality has a good and significant effect on the Bondowoso people's desire to save at Muamalat Bank; 2) With a beta test coefficient of 0.446, the diversity of savings products has a good and significant effect on the Bondowoso people's desire to save at Bank Muamalat; 3) With the beta test coefficient, service quality and diversity of savings products have a good and significant effect on the Bondowoso people's desire to save at Bank Muamalat.

Digital Literacy in Learning Media in the Vocational Education of Serving Dishes

The strengthening of the education system launched by the government is a new literacy movement, namely digital literacy. Digital literacy in culinary vocational education is still lacking in system and integration. One of them is web processing to support the learning process that has not been maximized. Therefore this study aims to develop web-based digital literacy that can guide independent learning. The approach taken is through R&D of digital media through WIX with the ADDIE model. The subjects of this study were students of the Culinary Education study program. Descriptive data analysis techniques on alpha and beta testing. The results obtained by media experts were 93.64% and material experts were 95% in the "very decent" category. The gain value of 0.72 is in the range G> 0.7 which means an increase in knowledge before and after using digital media for web-based F&B service dishes with a high category. Thus the website product in the F&B service course is appropriate to be used as a form of learning innovation in supporting the 4.0 era. and a digital literacy-based education system, especially vocational education.

Surviving & Thriving; a healthy lifestyle app for new US firefighters: usability and pilot study protocol.

In the United States (US), new firefighters' fitness and health behaviors deteriorate rapidly after fire academy graduation. Over the long-term, this increases their risks for chronic diseases. This study protocol describes the proposed usability testing and pilot study of a newly designed and developed healthy lifestyle smartphone app, "Surviving & Thriving", tailored towards young US firefighters. "Surviving & Thriving" will provide interactive educational content on four lifestyle factors; nutrition, sleep, physical activity, and resilience, and include a personalized journey, habit tracker, and elements of gamification to promote engagement and long-term healthy behavior change. The first phase of the app development entails alpha testing by the research team and pre-beta testing by a fire service expert panel which will help refine the app into a pre-consumer version. Upon completion of the full app prototype, beta 'usability' testing will be conducted among new fire academy graduates from two New England fire academies to collect qualitative and quantitative feedback via focus groups and satisfaction surveys, respectively. A last phase of piloting the app will evaluate the app's efficacy at maintaining/improving healthy lifestyle behaviors, mental health metrics, and physical fitness metrics. We will also evaluate whether firefighters' perceived "health cultures" scores (ratings of each fire station's/fire department's environments as to encouraging/discouraging healthy behaviors) modify the changes in health metrics after utilizing the app for three to six months. This novel user-friendly app seeks to help new firefighters maintain/improve their health and fitness more effectively, reducing their risk of lifestyle-related chronic disease. Firefighters who can establish healthy habits early in their careers are more likely to sustain them throughout their lives.

Media edukasi kerohanian Kristen tentang gembala dan domba tersesat berbasis game 3D

It is hoped that this Shepherd and Sheep Game can provide insight and knowledge about the depiction of God's love through the parable of sheep and shepherds and help Christian youths learn and understand Christianity. The making of this game uses the Unity 3D game engine and uses the C# programming language. This research uses the waterfall method as a system development method. The data collection methods used in this research are observation, interviews, and literature study. In the Shepherd and the Lost Sheep Game, there are four levels which have missions that must be completed by the player. The testing method uses Blackbox and Beta Testing. Based on the results of blackbox testing, overall this game has been successfully created and functions well. Based on the results of beta testing using a questionnaire distributed to 30 users, a score of 951 was obtained with a percentage value of 79.25%. It can be concluded that overall users feel satisfied after playing the Shepherd and the Lost Sheep game both in terms of system and material, and users feel quite helped in understanding Christian spiritual material by playing this game.

Expert System for Diagnosing Metabolic Syndrome at The Tembilahan Regional General Hospital

Metabolic syndrome is a disease that is considered trivial and common in society. When sufferers feel the effects of the disease, it will make treatment and healing difficult. To detect this disease early, an expert system application with the forward chaining method is needed so that this application makes it easier to detect disease early. The method for developing this system uses the waterfall method. System analysis and design using UML. System testing uses a black box where system test results are received. Application user testing, using statistical tests with Beta testing with a 95% confidence level, the system can be accepted and trusted. Based on these results, this system can be a solution for early detection of metabolic syndrome.

Digitalization of Web-Based Employee Selection System at Bank Woori Saudara Diponegoro Branch Bandung City

Employee selection is an activity to select workers according to the needs of the company, to select employees according to the needs there must be prior selection. In the selection of employees, the problem that is felt by the company is that managing application files requires a long time of about 2-3 weeks, limited storage capacity in the archive space so that there is a buildup of application files and a lack of transparency to applicants regarding information on passing the selection stage. As for the applicants themselves, they must wait for information to pass the selection stage with a long time of about 1-2 months, so that applicants feel there is no certainty. To overcome these problems, namely by making a digitization project for an employee selection system in order to solve problems. The goal for the company is to make it easier for companies to find the required human resources, to make it easier for HRD to manage files, as well as transparency of information for applicants regarding each passing selection stage. As for the applicants themselves, namely to make it easier to find out information on job vacancies in the company, make it easier for applicants to collect files, and make it easier to find out information on passing the selection stage. The web-based selection system digitization project was created using XAMPP and Wordpress CMS which is supported by the results of the project's trial with alpha and beta testing. The HRD staff is expected to be able to understand the use of the project and can be operated by the manual book so that it can be carried out according to the procedure.
 
 Keywords: Employee Selection, Selection System, Applicant Files, Digitalization.

JavaScript SBST Heuristics to Enable Effective Fuzzing of NodeJS Web APIs

JavaScript is one of the most popular programming languages. However, its dynamic nature poses several challenges to automated testing techniques. In this paper, we propose an approach and open-source tool support to enable white-box testing of JavaScript applications using Search-Based Software Testing (SBST) techniques. We provide an automated approach to collect search-based heuristics like the common Branch Distance and to enable Testability Transformations . To empirically evaluate our results, we integrated our technique into the EvoMaster test generation tool, and carried out analyses on the automated system testing of RESTful and GraphQL APIs. Experiments on eight Web APIs running on NodeJS show that our technique leads to significantly better results than existing black-box and grey-box testing tools, in terms of code coverage and fault detection.

User-Centered Development of a Mobile App to Assess the Quality of Life of Patients With Cancer: Iterative Investigation and Usability Testing.

The treatment for cancer can have a negative impact not only on physical well-being but also on mental health and the quality of life (QoL). Health apps enable the monitoring of different parameters, but to date, there are only few that support patients with cancer and none that focuses on the assessment of QoL. Furthermore, patients as stakeholders are often only integrated at the late stage of the development process, if at all. The aim of this research was to develop and evaluate a smartphone app (Lion-App) to enable patients with cancer to autonomously measure the QoL with an iterative, user-centered approach. Patients with cancer were involved in a 3-stage process from conceptualization to the point when the app was available on the tester's private device. First, focus groups with members (N=21) of cancer support groups were conducted to understand their expectations and needs. Thereafter, individual tests were performed. After developing a prototype that incorporated findings from the focus groups, a second test cycle was conducted, followed by a beta test lasting 2 months. In our app, the QoL can be assessed via a patient diary and an integrated questionnaire. Through all stages, usability was evaluated using the modular extended version of the User Experience Questionnaire (UEQ+), including the calculation of a key performance indicator (KPI). If possible, the impact of sex on the results was evaluated. As part of the beta test, usage rates as well as age-dependent differences were also assessed. A total of 21 participants took part in the initial 3 focus groups. In the subsequent usability testing (N=18), 17 (94%) participants rated their impression through the UEQ+, with a mean KPI of 2.12 (SD 0.64, range: -3 to 3). In the second usability test (N=14), the mean KPI increased to 2.28 (SD=0.49). In the beta test, the usage rate of 19 participants was evaluated, of whom 14 (74%) also answered the UEQ+ (mean KPI 1.78, SD 0.84). An influence of age on the number of questionnaire responses in Lion-App was observed, with a decrease in responses with increasing age (P=.02). Sex-dependent analyses were only possible for the first usability test and the beta test. The main adjustments based on user feedback were a restructuring of the diary as well as integration of a shorter questionnaire to assess the QoL. The iterative, user-centered approach for development and usability testing resulted in positive evaluations of Lion-App. Our app was rated as suitable for everyday use to monitor the QoL of patients with cancer. Initial results indicated that the sex and age of participants seem to play only a minor role.

Development and usability of a decision aid to initiate anti-osteoporosis medication treatment in patients visiting the fracture liaison service with a recent fracture.

At fracture liaison services (FLS), patients with a recent fracture ánd osteoporosis or a prevalent vertebral fracture are advised to start anti-osteoporosis medication (AOM). This study describes the development of a decision aid (DA) to support patients and healthcare providers (HCPs) in their decision about whether to start AOM. The DA was developed according to International Patient Decision Aid Standards (IPDAS). A systematic procedure was chosen including scope, design, prototype development, and alpha testing. A previously developed DA for women with osteoporosis was used as a basis. Furthermore, input from literature searches, the Dutch guideline on management of osteoporosis, and from people with a fracture or osteoporosis was used. The updated DA was evaluated during alpha testing. The DA facilitates the decision of patients whether to initiate AOM treatment and provides information on fractures and osteoporosis, general risk factors that increase the likelihood of a subsequent fracture, the role of lifestyle, personalized risk considerations of a subsequent fracture with and without AOM treatment, and AOM options and their characteristics in an option grid. Alpha testing with 15 patients revealed that patient preferences and needs were adequately presented, and several suggestions for improvement (e.g. adding more specific information, simplifying terminology, improving icon use) were accounted for. Participants from the alpha testing recommended use of the DA during outpatient visits. Professionals and persons with osteoporosis were supportive of the proposed DA and its usability. The DA could help in a shared decision-making process between patients and HCPs.