Human-Computer Interaction Experts Research Articles

Bridging the Communication Gap Between People With Cognitive Impairments and Their Caregivers Using mHealth Apps: User-Centered Design and Evaluation Study With People With 22q11 Deletion Syndrome.

In families with children with cognitive impairments, both parents and children experience tension and have questions because of a lack of communication and adequate information. Therefore, there is a great need to develop tools that can help bridge the communication gap between patients and caregivers by stimulating conversations and providing psychoeducational tools. mHealth apps show great potential in this context. The objective of this research is to discover the specific ways young people with cognitive impairments and their families interact with mHealth apps in the context of bridging the communication gap. This newly discovered information leads to potentially more impactful mHealth interventions in the future. Therefore, this paper documents the design and development of a mHealth app for a specific group of people with cognitive impairments-people with 22q11 deletion syndrome (22q11 DS)-and their caregivers, as well as key learnings from the evaluation of this app. An iterative, user-centered design approach is used to design and develop the app. Design and evaluation happens in 2 phases. During the design phase, feedback is gathered from 2 medical experts and 3 human computer interaction (HCI) experts using a low-fidelity paper prototype. During the evaluation phase, feedback is gathered from 8 families with a child with 22q11 DS using a fully working proof of concept. This phase consists of a semistructured interview, a 2-4-week trial period, and a concluding semistructured interview. The evaluation results of the fully working proof of concept led to design recommendations related to four different topics: (1) overcoming usage barriers, (2) stimulating conversation through a mHealth app, (3) providing information, and (4) bringing continual added value. Results are presented according to six different categories obtained in a thematic analysis: (1) feedback about the app "as is," (2) difficulties, (3) comparison between physical and digital tool, (4) extensions, (5) intention, and (6) other. In this research, the need for apps that help bridge the communication gap between a person with cognitive impairment and their caregiver is confirmed. All participating families express their gratitude and mention the added value for other families. Therefore, it is highly encouraged for clinics and institutions to take action and develop an app to be used in practice. Furthermore, considerations when developing for people with 22q11 DS, or more broadly, people with cognitive impairments, are proposed. First, one should keep design principles in mind to overcome usage barriers. Next, recognition is a key concept when stimulating conversations through mobile apps. Third, information should be provided by a trusted source, and more than just clinical information can be considered valuable. Finally, having the possibility of using a digital tool that can be personalized brings continual added value.

Dimensions of Diversity, Equity, and Inclusion

This paper reports on the ACM SPLASH 2022 conference panel on the Software Profession Dimensions of DEI [Diversity, Equity, and Inclusion]. The panelists observed that increased awareness for the dimensions of DEI will help reduce inequity in systems and technologies. The panel further observed that there are dimensions of diversity to consider beyond age, color, gender, and physical ability. As technologists, we need to leverage diverse talents and perspectives, including by those who may not have in-depth domain knowledge or a university education specific to computer science or engineering. Panelists included academic researchers and industry practitioners: experts in human-computer interaction, teamwork, AI applications, systems design, and gender diversity issues. The hybrid organization of the panel enabled participants from Taiwan and North America to join the in-room Australian and New Zealand panelists. Panelists explored a variety of related topics, ranging from how software can cause harm to the risks of "unconscious bias" in R&D and the challenges of building diverse teams. Panelists shared observations that AI and ML systems can be negatively impacted by the bias inherent with inadequate or incomplete training data used to tune algorithms. The panel discussed and summarized questions to foster increased DEI awareness by software professionals, researchers, and community leaders.

Integrating Fairness in the Software Design Process: An Interview Study With HCI and ML Experts

The term Fairness is used in the field of Machine Learning to refer to a suite of evaluation techniques, measures, and process adjustments focused on the reduction of bias in statistical models. With many different potential definitions and methodologies for implementing fairness, some contradictory in goal or incompatible in approach, there are challenges in the selection of the most appropriate definition(s) to meet the ethical expectations society or end users may have for a model. This is further confounded by the potentially complex engineering challenges in applying the selected definition. The goal of designing and developing a fair system requires interdisciplinary collaboration between user experience researchers, focused on the socio-technical challenges of application usage and adoption, and data scientists and machine learning software developers, directly involved in the technical engineering and optimisation of such models. How these two groups interact and how their areas of specialisation can support and influence the other when developing fair AI is unknown. This leaves open questions about how these stakeholders view fairness, how it can be operationalised in their current work, and what are the obstacles/opportunities for improving the treatment of fairness in practice. In order to answer these questions, 18 subject matter experts from the fields of human-computer interaction (HCI) or Machine Learning (ML) were interviewed about their experience with fairness, their perception of current fairness adoption, and the challenges they would anticipate in a set of example scenarios. This work identifies some of the current challenges to developing fair artificial intelligence (AI). In dealing with these challenges, we propose approaches that include expanding the responsibilities of HCI and ML specialists, and identifying areas where joint responsibility is required.

A Methodological Study of Human-Computer Interaction: A Review

Abstract: The concept of human-computer interaction has emerged as a result of advancements in computer technology. As emerging technologies in the fields of mobile and cloud computing, as well as the internet of things (IoT), become more and more ingrained in our daily lives, they have started to pose a serious challenge for professionals in human-computer interaction (HCI). These technologies call for greater dedication from HCI experts in terms of systems interface design. A comprehensive study of human-computer interaction (HCI) has been presented in the current study. The design process of human-computer interaction and the current state-of-art of the same is explained in brief along with the applications of HCI. Based on the results of the review, the study recommended combining human-centred design with agile interface design methodologies. It also encouraged future research using a qualitative or quantitative approach to further explore HCI interface design methodologies, with a focus on cloud-based, AR, VR technologies and other organizational information systems.

A device and an app for the diagnosis and self-management of tinnitus.

Tinnitus is an annoying ringing in the ears, in varying shades and intensities. Tinnitus can affect a person’s overall health and social well-being (e.g., sleep problems, trouble concentrating, anxiety, depression and inability to work). The diagnostic procedure of tinnitus usually consists of three steps: an audiological examination, psychoacoustic measurement, and a disability evaluation. All steps are performed by physicians, who use specialised hardware/software and administer questionnaires. This paper presents a system, to be used by patients, for the diagnosis and self-management of tinnitus. The system is made up of an app and a device. The app is responsible for executing – through the device – a part of the required audiological and psychoacoustic examinations, as well as administering questionnaires that evaluate disability. The paper reviews the quality of the automated audiometric reporting and the user experience provided by the app. Descriptive and inferential statistics were used to support the findings. The results show that automated reporting is comparable with that of physicians and that user experience was improved by re-designing and re-developing the acufenometry of the app. As for the user experience, two experts in Human-Computer Interaction evaluated the first version of the app: their agreement was good (Cohen’s K = 0.639) and the average rating of the app was 1.43/2. Also patients evaluated the app in its initial version: the satisfactory tasks (audiometry and questionnaires) were rated as 4.31/5 and 4.65/5. The unsatisfactory task (acufenometry) was improved and the average rating increased from 2.86/5 to 3.96/5 (p = 0.0005). Finally, the general usability of the app was increased from the initial value of 73.6/100 to 85.4/100 (p = 0.0003). The strengths of the project are twofold. Firstly, the automated reporting feature, which – to the best of our knowledge – is the first attempt in this area. Secondly, the overall app usability, which was evaluated and improved during its development. In summary, the conclusion drawn from the conducted project is that the system works as expected, and despite some weaknesses, also the replication of the device would not be expensive, and it can be used in different scenarios.

Assessing the Usability of a Clinical Decision Support System: Heuristic Evaluation.

BackgroundPoor usability is a primary cause of unintended consequences related to the use of electronic health record (EHR) systems, which negatively impacts patient safety. Due to the cost and time needed to carry out iterative evaluations, many EHR components, such as clinical decision support systems (CDSSs), have not undergone rigorous usability testing prior to their deployment in clinical practice. Usability testing in the predeployment phase is crucial to eliminating usability issues and preventing costly fixes that will be needed if these issues are found after the system’s implementation.ObjectiveThis study presents an example application of a systematic evaluation method that uses clinician experts with human-computer interaction (HCI) expertise to evaluate the usability of an electronic clinical decision support (CDS) intervention prior to its deployment in a randomized controlled trial.MethodsWe invited 6 HCI experts to participate in a heuristic evaluation of our CDS intervention. Each expert was asked to independently explore the intervention at least twice. After completing the assigned tasks using patient scenarios, each expert completed a heuristic evaluation checklist developed by Bright et al based on Nielsen’s 10 heuristics. The experts also rated the overall severity of each identified heuristic violation on a scale of 0 to 4, where 0 indicates no problems and 4 indicates a usability catastrophe. Data from the experts’ coded comments were synthesized, and the severity of each identified usability heuristic was analyzed.ResultsThe 6 HCI experts included professionals from the fields of nursing (n=4), pharmaceutical science (n=1), and systems engineering (n=1). The mean overall severity scores of the identified heuristic violations ranged from 0.66 (flexibility and efficiency of use) to 2.00 (user control and freedom and error prevention), in which scores closer to 0 indicate a more usable system. The heuristic principle user control and freedom was identified as the most in need of refinement and, particularly by nonnursing HCI experts, considered as having major usability problems. In response to the heuristic match between system and the real world, the experts pointed to the reversed direction of our system’s pain scale scores (1=severe pain) compared to those commonly used in clinical practice (typically 1=mild pain); although this was identified as a minor usability problem, its refinement was repeatedly emphasized by nursing HCI experts.ConclusionsOur heuristic evaluation process is simple and systematic and can be used at multiple stages of system development to reduce the time and cost needed to establish the usability of a system before its widespread implementation. Furthermore, heuristic evaluations can help organizations develop transparent reporting protocols for usability, as required by Title IV of the 21st Century Cures Act. Testing of EHRs and CDSSs by clinicians with HCI expertise in heuristic evaluation processes has the potential to reduce the frequency of testing while increasing its quality, which may reduce clinicians’ cognitive workload and errors and enhance the adoption of EHRs and CDSSs.

Complex, but in a good way? How to represent encryption to non-experts through text and visuals – Evidence from expert co-creation and a vignette experiment

An ongoing discussion in the field of usable privacy and security debates whether security mechanisms should be visible to end-users during interactions with technology, or hidden away. This paper addresses this question using a mixed-methods approach, focusing on encryption as a mechanism for confidentiality during data transmission on a smartphone application. In study 1, we conducted a qualitative co-creation study with security and Human-Computer Interaction (HCI) experts (N = 9) to create appropriate textual and visual representations of the security mechanism encryption in data transmission. We investigated this question in two contexts: online banking and e-voting. In study 2, we put these ideas to the test by presenting these visual and textual representations to non-expert users in an online vignette experiment (N = 2180). We found a statistically significant and positive effect of the textual representation of encryption on perceived security and understanding, but not on user experience (UX). More complex text describing encryption resulted in higher perceived security and more accurate understanding. The visual representation of encryption had no statistically significant effect on perceived security, UX or understanding. Our study contributes to the larger discussion regarding visible instances of security and their impact on user perceptions.

Improving Children's Cultural Heritage Experience Using Game-based Learning at a Living Museum

This empirical study was conducted to design, develop, and evaluate children's experiences with a game-based mobile guide (GBMG) application at Sarawak Cultural Village (SCV). The Interaction Design lifecycle model was used for the systematic development of the GBMG application. A total of 45 children took part in this study who were divided into two groups: a paper-based pamphlet and GBMG application group. The Museum Experience Scale were used to evaluate the overall experience with the GBMG application in this study. Results showed that the children in the mobile-based groups have a higher mean for the four dimensions of MES, although the difference is only significant for the emotional connection dimension. This study shows that the game-based mobile guide application did not significantly improve children's museum experience at SCV except for their emotional connection. Additional findings from the Heuristic Evaluation with six Human-Computer Interaction experts offered a deeper understanding of why the GBMG did not improve the children's visitor experience at SCV. The outcome of this study contributes to the research field of game-based mobile applications to enhance children's experiences at living museums with several issues raised for further research.

A Review of Human-Computer Interaction Design Approaches towards Information Systems Development

Nowadays modern information systems (emerging technologies) are increasingly becoming an integral part of our daily lives and has begun to pose a serious challenge for human-computer interaction (HCI) professionals, as emerging technologies in the area of mobile and cloud computing, and internet of things (IoT), are calling for more devotion from HCI experts in terms of systems interface design. As the number of mobile platforms users, nowadays comprises of children’s, elderly people, and people with disabilities or disorders, all demanding for an effective user interface that can meet their diverse needs, even on the move, at anytime and anywhere. This paper, review current articles (43) related to HCI interface design approaches to modern information systems design with the aim of identifying and determining the effectiveness of these methods. The study found that the current HCI design approaches were based on desktop paradigm which falls short of providing location-based services to mobile platforms users. The study also discovered that almost all the current interface design standard used by HCI experts for the design of user’s interface were not effective & supportive of emerging technologies due to the flexibility nature of these technologies. Based on the review findings, the study suggested the combination of Human-centred design with agile methodologies for interface design, and call on future works to use qualitative or quantitative approach to further investigate HCI methods of interface design with much emphasis on cloud-based technologies and other organizational information systems.

HEURISTICS FOR AWARENESS SUPPORT IN GROUPWARE SYSTEMS

ABSTRACT: Groupware Systems (GS) or collaborative systems are software systems that support the development of activities in which a group of users interacts to combine their skills, abilities, and work to achieve a common goal. In this area, an important concept is awareness, which is the information that helps people be aware of events beyond their current tasks. This information makes smoother the use of a collaborative system, so it is a fundamental element in this kind of software. In the design and construction of these types of systems, heuristics are used as design guidelines that serve as a useful evaluation tool for product designers and usability professionals. The current heuristics and guidelines for the design of awareness support focus on supporting the awareness of the team in the shared workspace, without considering elements to support the information needs of the user's own and individual interaction within the workspace. To address this problem and to facilitate the design and integration of awareness support, we developed 13 heuristics that integrate principles of Human-Computer Interaction and Computer Supported Cooperative Work to help groupware designers meet individual and team awareness needs. For evaluating the validity of the proposed heuristics, a structured and iterative consultation process was carried out with experts in Human-Computer Interaction and Computer-Supported Cooperative Work. The proposed heuristics can help software engineers develop collaborative systems that integrate awareness information and satisfy users' contextual information needs. Keywords: Awareness, virtual groups, collaborative work, heuristics.

Developmental research on an interactive application for language speaking practice using speech recognition technology

This developmental research aims to (1) examine the design and developmental process, (2) investigate the nature and structure of the application, and (3) analyze the results of expert reviews and usability tests. Twenty-five participants, including a developer, an instructional designer, Korean language educators, educational technology researchers, human–computer interaction experts, and language learners, were involved in this study. This study was conducted in the following steps: (1) formulated design principles through the literature review of language instruction and learning theories, computer-assisted language learning, speech recognition technology, human–computer interaction, and scaffolding, (2) developed a functional software prototype that adopted the formulated design principles, (3) conducted expert reviews and learner usability tests, (4) revised and updated the application through the repetitive expert reviews and learner usability tests, (5) analyzed the results of the final expert review, usability test, and log data analysis, and (6) clarified the implications of the development research. The developed application shows an approach to addressing the challenges of second language classrooms that might cause a low-level of learner’s language speaking performance. This study specifically delivers knowledge about the design and developmental process of computer-assisted language learning software. This provides guidelines for educational technology researchers and practitioners who work on similar projects.

Communicating cosmology with multisensory metaphorical experiences

We present a novel approach to communicating abstract concepts in cosmology and astrophysics in a more accessible and inclusive manner. We describe an exhibit aiming at creating an immersive, multisensory metaphorical experience of an otherwise imperceptible physical phenomenon — dark matter. Human-Computer Interaction experts and physicists co-created a multisensory journey through dark matter by exploiting the latest advances in haptic and olfactory technology. We present the concept design of a pilot and a second, improved event, both held at the London Science Museum, including the practical setup of the multisensory dark matter experience, the delivery of sensory stimulation and preliminary insights from users' feedback.

A Gesture-based Recognition System for Augmented Reality

With the geometrical improvement in Information Technology, current conventional input devices are becoming increasingly obsolete and lacking. Experts in Human Computer Interaction (HCI) are convinced that input devices remain the bottleneck of information acquisition specifically in when using Augmented Reality (AR) technology. Current input mechanisms are unable to compete with this trend towards naturalness and expressivity which allows users to perform natural gestures or operations and convert them as input. Hence, a more natural and intuitive input device is imperative, specifically gestural inputs that have been widely perceived by HCI experts as the next big input device. To address this gap, this project is set to develop a prototype of hand gesture recognition system based on computer vision in modeling basic human-computer interactions. The main motivation in this work is a technology that requires no outfitting of additional equipment whatsoever by the users. The gesture-based had recognition system was implemented using the Rapid Application Development (RAD) methodology and was evaluated in terms of its usability and performance through five levels of testing, which are unit testing, integration testing, system testing, recognition accuracy testing, and user acceptance testing. The test results of unit, integration, system testing as well as user acceptance testing produced favorable results. In conclusion, current conventional input devices will continue to bottleneck this advancement in technology; therefore, a better alternative input technique should be looked into, in particularly, gesture-based input technique which offers user a more natural and intuitive control.

GOFlow: Smartwatch app to deliver laboratory results in emergency departments – A feasibility study

PurposeInformation Technology (IT) plays a critical role in supporting emergency physicians’ (EPs) routines. Pagers, personal computers, and smartphones offer fast access to patient data, such as laboratory results. However, due to the inherent features of specimen processing and laboratory instruments, the turnaround time from test ordering to availability of results can be long. Lack of follow-up of abnormal results can lead to missed information that could impact patient care and safety. Despite the increasing use of ubiquitous technologies, a third of physicians remains devoid of reliable methods for ensuring that results have been received. In this feasibility study, we report the potential of using a smartwatch to deliver laboratory results to EPs at the point-of-care and to support efficiency in emergency care. Unlike mobile devices that are increasingly used by EPs, smartwatches are always accessible, even during hands-on procedures. MethodTwo EPs and four experts in human-computer interaction designed the smartwatch application following the Design Science Research Methodology (DSRM). The application was then evaluated in a pediatric emergency department through semi-simulated scenarios by eleven EPs. The primary outcome was to measure both the app perceived usability and satisfaction scores by the aim of the System Usability Scale (SUS), and the perceived usefulness and intention of its use by the aim of the Unified Theory of Acceptance and Use of Technology (UTAUT) scale. Secondary outcomes were to assess the application’s efficiency by measuring the delay between the reception of the notification and 1) the access to its details and 2) the visit to the patient. Finally, open questions about the positive and negative aspects of the prototype as well as potential improvements were asked and evaluated qualitatively. ResultsThe prototype obtained a score of 81.4 out of 100 (good) on the SUS and a score of 5.96 out of 7 on the UTAUT scale. EPs using the smartwatch visited patients within 30 seconds receiving the laboratory results. ConclusionsThis study demonstrates the capacity of smartwatches to speed up the point-of-care delivery of laboratory results in the ED.

Introduction to the special issue on the 50th anniversary of IJHCS

This special issue celebrates the 50th anniversary of the International Journal of Human-Computer Studies (IJHCS), which published its first volume in January 1969. The special issue comprises 15 contributions from a number of experts in Human-Computer Interaction (HCI) and other areas relevant to IJHCS. These contributions are best characterized as ‘landscape papers’, providing insightful analyses about the evolution (i.e., the past, the present and the future) of research areas relevant to IJHCS. The areas covered in this special issue include: the history and scope of the journal; foundational concerns in HCI; critical discussions about the issues surrounding digital living in a variety of areas, from healthcare and cybersecurity to digital games and art; the making of interactive products and services, as seen through the viewpoints defined by research in psychology of programming, end-user development and participatory design; and, finally, the issues associated with adapting to various novel emerging technologies, including automated systems, online personalisation, human augmentations, mixed reality, and sonic interfaces. In this short essay, we introduce the special issue, reflecting on the nature and evolution of the journal, before providing short outlines of each of the contributions to this special issue.

Evaluation of “The Seafarers”: A serious game on seaborne trade in the Mediterranean sea during the Classical period

Throughout the history of the Mediterranean region, seafaring and trading played a significant role in the interaction between the cultures and people in the area. In order to engage the general public in learning about maritime cultural heritage we have designed and developed a serious game incorporating geospatially analyzed data from open GIS archaeological maritime sources, and archaeological data resulting from shipwreck excavations. We present a second prototype of the seafaring serious game, and discuss the results of an evaluation which involved a large multi-site user study with participants from three continents.More specifically, we present the evaluation of “The Seafarers” a strategy-based game which integrates knowledge from multiple disciplines in order to educate the user through playing. A first prototype was reported in Philbin-Briscoe et al. (2017) where an expert-user evaluation of the usability and the effectiveness of the game in terms of the learning objectives was performed.In this paper, we present how the outcomes of the evaluation of the first prototype “The Seafarers – 1” by expert-users were used in the redesign and development of the game mechanics for the second prototype “The Seafarers-2”. We then present our methodology for evaluating the game with respect to the game objective of engagement in learning about maritime cultural heritage, seafaring and trading in particular. Specifically, the evaluation was to test the hypothesis that game playing allows for more engaged learning thus improving longer-term knowledge retention. The evaluation was conducted in two phases and includes a pilot study, followed by a multi-site, multi-continent user-study involving a large number of participants. We analyze the results of the user evaluation and discuss the outcomes.This work is part of the EU-funded project iMareCulture and involves truly multi-continental, multi-institutional and multi-disciplinary cooperation – civil engineers and archaeologists from Cyprus, Human Computer Interaction (HCI) experts and Educationists from Bosnia and Herzegovina, Canada, and cultural sociologists and computer scientists from Canada.

User experience design for mixed reality: a case study of HoloLens in museum

In recent years the applications of Mixed Reality (MR) processing has become highly apparent in academia and the manufacturing industry with the release of innovative technologies such as the Microsoft HoloLens. However, crucial design issues with the HoloLens’ restricted Field Of View (FOV) to a narrow window of 34 degrees inhibited the user's natural peripheral vision (Kress & Cummings, 2017). This visual limitation results in a loss of pre-set functions and projected visualisations in the AR application window. This paper presents an innovative methodology in designing a spatial User Interface (UI), to minimise the adverse effects associated with the HoloLens’ narrow FOV. The spatial UI is a crucial element towards developing a museum-based MR system, which was evaluated by nine experts in Human-Computer interaction (HCI), visual communication and museum studies. Results of this study indicate a positive user reaction towards the accessibility of the spatial UI system and enhancing the user experience. This approach can help current and future HoloLens developers to extend their application functions without visual restrictions or missing content.

User Experience Design for Mixed Reality: A Case Study of HoloLens in Museum

In recent years, the applications of mixed reality (MR) processing have become highly apparent in academia and the manufacturing industry with the release of innovative technologies such as the Microsoft HoloLens. However, crucial design issues with the HoloLens' restricted field of view (FOV) to a narrow window of 34 degrees inhibited the user's natural peripheral vision (Kress and Cummings, 2017). This visual limitation results in a loss of pre-set functions and projected visualisations in the AR application window. This paper presents an innovative methodology in designing a spatial user interface (UI), to minimise the adverse effects associated with the HoloLens' narrow FOV. The spatial UI is a crucial element towards developing a museum-based MR system, which was evaluated by nine experts in human-computer interaction (HCI), visual communication and museum studies. Results of this study indicate a positive user reaction towards the accessibility of the spatial UI system and enhancing the user experience. This approach can help current and future HoloLens developers to extend their application functions without visual restrictions and missing content.

Incorporating Multiple Perspectives Into the Development of an Electronic Survivorship Platform for Head and Neck Cancer.

To improve the care of survivors of head and neck cancer, we developed the Head and Neck Survivorship Tool: Assessment and Recommendations (HN-STAR). HN-STAR is an electronic platform that incorporates patient-reported outcomes into a clinical decision support tool for use at a survivorship visit. Selections in the clinical decision support tool automatically populate a survivorship care plan (SCP). We aimed to refine HN-STAR by eliciting and incorporating feedback on its ease of use and usefulness. Human-computer interaction (HCI) experts reviewed HN-STAR using think-aloud testing and the Nielsen Heuristic Checklist. Nurse practitioners (NPs) thought aloud while reviewing the clinical decision support tool and SCP and responded to an interview. Survivors used HN-STAR as part of a routine visit and were interviewed afterward. We analyzed themes from the feedback. We described how we addressed each theme to improve the usability of HN-STAR. Five HCI experts, 10 NPs, and 10 cancer survivors provided complementary usability insight that we categorized into themes of improvements. For ease of use, themes included technical design considerations to enhance user interface, ease of completion of a self-assessment, streamlining text, disruption of the clinic visit, and threshold for symptoms to appear on the SCP. The theme addressing usefulness was efficiency and comprehensiveness of the clinic visit. For each theme, we report revisions to HN-STAR in response to the feedback. HCI experts provided key technical design insights into HN-STAR, whereas NPs and survivors provided usability feedback and clinical perspectives. We incorporated the feedback into the preparation for additional testing of HN-STAR. This method can inform and improve the ease of use and usefulness of the survivorship applications.

A Decision Support Tool for Healthcare Professionals in the Management of Hyperphosphatemia in Hemodialysis.

Hyperphosphatemia is known as one of the more challenging conditions in end-stage renal disease patients. This study set out to present and evaluate a healthcare-oriented decision support tool in the management of hyperphosphatemia within hemodialysis therapy. A prototype module was designed to fit into the interface of a modern dialysis machine (Fresenius 5008). The prototype included three main functions: 1) immediate bedside blood sample access, 2) a model based prognosis tool with estimates of P-phosphate and 3) an overview of the user's phosphate related activities during dialysis treatments. The prototype was evaluated by a) heuristic evaluation with five human computer interaction experts and b) user testing with think-aloud by three users as (clinical) domain experts. The two evaluation procedures identified a total of 103 usability problems and led to some specific amendments to improve its practical potential. The overall results will guide further development of the decision support tool to ensure that the functions will support the user's needs. In conclusion, the prototype was evaluated to be relevant and potentially beneficial in the management of hyperphosphatemia in hemodialysis patients. Furthermore, it was found that some of the functions could be used for educational purposes or as decision support for some patient groups, e.g. for patient doing home-dialysis.