Net Promoter Research Articles

Collection and use of patient-reported experience measures: approach to improve health care

Abstract Background Patient experience is one of the fundamental determinants of healthcare quality. There is progress in the collection of PREM in national level for hospitalized patients since 2020 in Latvia. Aim Analyze (2020.-2022.) in-patients Top-box rates about communication, share-decision making, patient safety and Net Promoter Score (NPS). Methods Project starting point was 2019. Agreement with EC, Sant’Anna School, Ministry of Health and Centre for Disease Prevention and Control of Latvia. Since 2020, the collection of PREM has been taking place regularly in hospitals (around 40% from all hospitals) and on average 20% response rate of those who agreed to participate in the survey. PREM questionnaire according to HCAHPS (Consumer Assessment of Healthcare Providers and Systems) standards, including Picker Institute patient experience questions. In line with OECD (Organization for Economic Co-operation and Development) recommendations, patient safety issues are also included. Top-box rates (most positive response) and percentiles (25th - 75th) were calculated. Results Totally 17019 adult (18 years and more) patient responses were analyzed with response rate 20.3% (n = 83983). 74.6% (67.5-78.2) during hospital stay doctors always explain things in a way you could understand and sufficiently involved in the decision-making process of treatment - 75.0% (70.1-81.4). During hospital stay 4.1% (n = 601) experienced patient safety incidents which were patient-reported. The most common groups were wrong patients, medication errors, incl. adverse drug reactions and falls. Hospitals achieved a NPS of 61 for 3 year period (2020.-2022.). Conclusions Collecting information about the patient experience may be the starting point for engaging patients and moving to more patient-centered health care. The results of these in-patient PREM data can be used to identify areas of improvement and make changes to better meet the needs and expectations of their patients. Key messages • It is a good practice for the implementation of new health care quality data - patient experience reported measures at the national level. • Feedback about the patient experience on regular basis provides insight into patient needs, preferences and values, which can help to improve the quality and safety of care.

Usability Testing of the Metadata Management of Audio Archive

The aim of this research is to test the usability of the audio archive metadata management application. This application is used to record all song collection data in the form of cassettes and vinyl and is also used to search for collection data easily and quickly. This research used System Usage Scale (SUS) method to test the application usability. The SUS Testing was carried out by distributing a questionnaire which consists of 10 statements to 30 respondents to determine the assessment scale based on percentile rank, grade, adjective rating, acceptability, and net promoter score. The result of the system usage scale testing showed an average total score of 83. By detail, this result explained that the percentile range assessment scale is between 90-95%, grade is A, adjective rating is in the Excellent category, acceptability is in the acceptable category, and net promoter is in the promoter category. Thus, it can be concluded that the audio archive metadata management application is suitable for use as a search and retrieval tool for song collections in the form of cassettes and vinyl. However, in order to increase the application’s usefulness, the application can be more developed in the future by adding additional features to meet the criteria as a better metadata management tool.

Analytics-based service perspective on customer value and business process management: evidence from transportation service

ABSTRACT This paper investigates customer value and business process management from the analytics-based service (ABS) view. ABS uses business analytics to support better-informed decision-making, which benefits service customers and providers. Applying descriptive/diagnostic analytics to service encounters and predictive/prescriptive analytics to post-service may improve business process management. This paper conducted predictive analytics (e.g. regression) and diagnostic analytics (e.g. bigram natural language processing), examining the mechanism to create customer value (e.g. net promoter score) and assessing customer-frontline employee interactions in business processes. This approach helps contextualize diverse and plural relationships between the service customer and provider as an enabler for design thinking. ABS may inform problem exploration with predictive analytics to identify predictors for outperforming or underperforming customer value metrics, problem definition and practice analysis with diagnostic analytics on business process scripts, and developing remedies based on prescriptive analytics powered by simulations and optimizations.

An Investigation of the Test-Retest Reliability of the miniPXI

Repeated measurements of player experience are crucial in games user research, assessing how different designs evolve over time. However, this necessitates lightweight measurement instruments that are fit for the purpose. In this study, we conduct an examination of the test-retest reliability of the miniPXI -a short variant of the Player Experience Inventory (PXI) , an established measure for measuring player experience. We analyzed test-retest reliability by leveraging four games involving 100 participants, comparing it with four established multi-item measures and single-item indicators such as the Net Promoter Score ( NPS ) and overall enjoyment. The findings show mixed outcomes; the miniPXI demonstrated varying levels of test-retest reliability. Some constructs showed good to moderate reliability, while others were less consistent. On the other hand, multi-item measures exhibited moderate to good test-retest reliability, demonstrating their effectiveness in measuring player experiences over time. Additionally, the employed single-item indicators ( NPS and overall enjoyment) demonstrated good reliability. The results of our study highlight the complexity of player experience evaluations over time, utilizing single and multiple items per construct measures. We conclude that single-item measures may not be appropriate for long-term investigations of more complex PX dimensions and provide practical considerations for the applicability of such measures in repeated measurements.

A novel approach to measure perceived customer centricity in the passenger airline industry: Index development and validation

This study addresses a significant gap in current research by developing and validating a comprehensive index for measuring perceived customer centricity in the passenger airline industry. The index was derived using a rigorous scale development methodology based on three surveys with a total of 963 participants. The process involved construct definition, item generation, and item validation through exploratory and confirmatory factor analyses. The final measurement index comprises 19 items across four dimensions (Customer Care & Experience, Communication & Product, Sustainability, and Value) and demonstrates strong discriminant and convergent validity, providing a reliable tool for assessing customer perceptions. Therefore, this research introduces the first validated measure of perceived customer centricity specifically designed for the airline industry and offers practical insights for airline managers, enabling them to identify specific areas where customer perceptions fall short and to make targeted improvements. Additionally, the index serves as an alternative to the industry-wide adopted Net Promoter Score (NPS). It extends current literature by providing an industry-specific scale and offers a practical instrument for enhancing customer-centric strategies in real-world applications, thereby fostering long-term, mutually beneficial relationships. Additionally, it provides empirical evidence of the multidimensional nature of customer centricity and offers a validated tool that can be applied in future research to explore customer perceptions and their impact on airline performance, thus satisfying both practical and academic needs.

Status of the Respiratory Therapy Profession in Ghana: A Cross-Sectional Study.

The respiratory therapy (RT) profession in Ghana is a new and emerging field. Therefore, the purpose of this study was to assess and evaluate the RT profession as a needs assessment to help policymakers and key stakeholders shape the profession in Ghana. We conducted a cross-sectional study approved by the Institutional Review Board at Loma Linda University. Participants included RTs, RT students, faculty, physicians, nurses, and midwives, who were recruited via email, WhatsApp, and snowball sampling. Data were collected through an anonymous survey consisting of demographic, professional, and attitudinal questions. We analyzed the data using descriptive statistics and inferential tests, employing IBM Corp. Released 2023. IBM SPSS Statistics for Windows, Version 29.0.2.0 Armonk, NY: IBM Corp. A total of 195 participants were involved in the study from Ghana, with 83 men (42.6%) and 112 women (57.4%), with an average age of 32.33 (SD ± 8.83) years. A majority (56.4%) held bachelor's degrees, with nurses (35.9%) and physicians (21.9%) forming the largest professional groups. The survey found that 64.2% of participants acknowledged a high demand for RTs, yet interaction with RTs was limited due to their limited availability in the region. Notably, 86.8% were familiar with nebulizers, and 80.6% with Ambu bags. The study also highlighted significant challenges in the profession, including overwhelming workloads (64.3%), lack of recognition (100%), and resource shortages. Asthma emerged as the top respiratory condition treated by RTs. The Net Promoter Score for the respiratory therapy profession, at 26.92, demonstrates a moderately positive response, suggesting an increasing need for enhanced interest among professionals in the field of respiratory therapy in Ghana. To our knowledge, this was the first needs assessment study that evaluated the field of the RT profession in Ghana. The findings indicate robust support for the necessity, development, and expansion of the RT field in the country. Future prospective studies are recommended to further evaluate the impact and effectiveness of the RT profession on patient care outcomes.

Outcomes of Arthroscopic Cortical-Button Latarjet Procedure with Minimum Five Year Follow-Up

IntroductionThe surgical treatment of anterior shoulder instability with arthroscopic cortical-button Latarjet procedure has been the subject of very few medium and long-term studies. The aim of this study was to analyze the clinical and radiological results of arthroscopic cortical-button Latarjet procedure with minimum 5 years follow-up. MethodThis is a monocentric retrospective study including 40 patients who have undergone shoulder stabilization with primary arthroscopic cortical-button Latarjet procedure and been reviewed with minimum 5 years follow-up. The average age at the time of surgery was 26.6 years (16 – 59; ± 10) and 92.5% were sporty individuals. The average ISI score was 6 points (2- 9; ± 1,6). The clinical evaluation involved active range of motion measurement, apprehension test, Rowe and Walch-Duplay scores, SSV and Net Promoter Score. Radiologically, evolution of the bone graft and degenerative arthritis of the shoulder joint were analyzed at the last follow-up. ResultsAt an average follow-up of 71 months (60 – 97; ± 12), 3 patients (7.5%) experienced recurrence as a dislocation or subluxation, which was responsible for revision in 1 case. Moreover, apprehension persisted in 6 (16%) patients. There were no significant restrictions in recovery of active ranges of motion, including external rotation. Return to sports was effective in 94.6% of cases. The average Rowe and Walch-Duplay scores were 87 points (15 - 100; ± 20) and 88 points (15 - 100; ± 19) respectively. SSV was 91% (10 – 100; ± 16) and NET Promoter Score was 9.3 points (5 – 10; ± 1,3). Radiologically, degenerative arthritis occurred in 18.7% of patients, mainly asymptomatic stage 1 (9.4%). Bone healing was acquired in 72% of cases and partial lysis of the bone block in 41%. ConclusionAt an average follow-up of 6 years, arthroscopic cortical-button Latarjet procedure effective, enabling return to sport in 95% of cases. Onset of asymptomatic arthritis seems similar to conventional techniques but justifies a more long-term follow-up.

Teamwork enhances patient experience: linking TEAM and Net Promoter Scores.

We previously described a 6-item teamwork index (TEAM) with a strong relationship to provider experience, lower burnout, and intent to stay. We now sought to determine whether (1) TEAM relates to higher patient Net Promoter Score (NPS, or likelihood of patient referring to the organization) and (2) teamwork mediates a provider experience-NPS relationship. A provider wellness survey was administered in the fall of 2019 in 6 care delivery organizations (CDOs) with patient NPS data. Measures included a validated burnout item, 6-item TEAM measure, provider experience metric, standard intent-to-stay question, and NPS data from 79,254 patients matched to CDO. Regression analyses modeled relationships among TEAM, provider experience, and NPS. Open-ended comments were reviewed to confirm patient NPS findings. There were 1386 provider respondents (53% physicians, 47% advanced practice clinicians, 58% female, 62% White, 58% in primary care; response rate, 55.7%). Median NPS was 83%. TEAM was associated with patient NPS greater than the median (53% with high TEAM and high NPS vs 44% with low TEAM and high NPS; P < .001), as was provider experience (52% vs 45%; P < .05). In regression analyses, patient NPS was strongly related to TEAM (adjusted OR, 1.41; 95% CI, 1.25-1.60; P < .001). The provider experience-patient NPS relationship was partly mediated by TEAM. Open-ended comments confirmed positive or negative sentiments related to NPS. Teamwork and provider experience relate to patient NPS, and the provider experience-NPS relationship appears to be mediated by teamwork.

Analisis Produk UMKM Sektor Makanan Kota Mataram Pada Aspek Loyalitas Pelanggan (Studi Pada Produk Tahu Abian Tubuh)

This study aims to assess customer loyalty toward Abian Tubuh tofu, one of Mataram City's flagship products. Using a descriptive research approach, the study seeks to provide insights into customer loyalty, a key aspect of consumer behavior theory. A sample survey method was employed, selecting several tofu markets in Mataram City as research locations. The population includes all customers who purchase tofu at these markets, with purposive sampling used to select respondents based on the research objectives. Given the unknown total population, a sample of 100 respondents was determined. The analysis utilized the Net Promoter Score (NPS) model to measure and understand customer loyalty levels. This study builds upon previous research focusing on the same product, Abian Tubuh tofu, in Mataram. Customer loyalty, a critical aspect of consumer behavior, needs periodic evaluation to ensure continued purchases and customer retention. Findings indicate that customers are highly loyal to Abian Tubuh tofu, based on various product attributes such as taste, price, aroma, texture, and nutritional content. The strong perception of product quality leads customers to recommend it to friends and colleagues. Marketers should maintain and enhance this level of loyalty to ensure business sustainability in the future.

Carpal tunnel release under local anesthesia with or without distal median nerve block: Double-blind randomized clinical trial

Background: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy of the upper extremity, and its surgical treatment is carpal tunnel release (CTR). It is mostly performed in local anesthesia. There are no clinical randomized controlled trials (RCTs) comparing local infiltration anesthesia with or without a distal median nerve block in CTR. The aim of the PERSONNEL trial (carPal tunnEl ReleaSe lOcal iNfiltratioN mEdian bLockade) is to assess whether a distal median nerve block reduces pain during and after the procedure in addition to local anesthesia. Methods: This is a single-center randomized clinical superiority trial comparing local anesthesia alone and local anesthesia with a distal median nerve block for CTR in patients with CTS. Adult patients will be randomized in one university hospital in Finland, and the intended sample size is 118. The primary outcome is the mean pain level after the procedure during 72 h using a visual analogue scale (VAS). The secondary outcomes include expected pain; pain during the injection of the anesthetic solution caused by pressure, burning, needle sting, and total pain; worst pain during the surgery; duration of anesthesia; number of experienced needle stings; Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ); pain killer consumption;, patient satisfaction using Net Promoter Score (NPS); and complications. Discussion: Patient satisfaction is a crucial factor in modern healthcare. A distal median nerve block may reduce pain during and after CTR, potentially increasing patient satisfaction with the given treatment. It can also be hypothesized that better postoperative pain control may prevent complications, for example, complex regional pain syndrome. However, we lack adequate evidence to justify the use of distal median nerve block, which can itself predispose patients to complications, for example, median nerve injury. Therefore, there is a need for adequate RCTs to assess its efficacy. The results of this study can be used to optimize anesthesia for carpal tunnel surgery, improve patient satisfaction, and possibly prevent complications. Registration: ClinicalTrials.gov NCT05372393.

Augmented Reality Gaming Experience: Assessing Satisfaction Level Towards Post Event Behavior for MARA 1.0

The proliferation of Augmented Reality (AR) technology has significantly transformed the gaming industry by merging digital content with the physical environment. This study focuses on assessing player satisfaction and subsequent behaviors in response to Mission AR Apocalypse (MARA) 1.0, an AR game designed to enhance educational engagement for Universiti Teknologi MARA (UiTM) students. Developed amidst the COVID-19 pandemic by UnBound Malaysia, this game aims to provide an enriching experience through the integration of educational content within an AR framework. This research investigates four primary factors influencing player satisfaction: immersion and visual experience, ease of use and controls, game content and storyline and technical performance. Utilizing a correlational research design, data were collected from 503 students across 15 UiTM branches via structured questionnaires. The study employs Net Promoter Score (NPS) to measure satisfaction levels and their impact on post-event behaviors, such as the intent to recommend and continue using the game. Findings indicate a high level of satisfaction with immersion and visual experience, ease of use, and game content, though technical performance showed mixed results. These results support the hypotheses that immersive, visually rich AR games with user-friendly controls and engaging content enhance player satisfaction and recommendation intentions. The study concludes that while the majority of players are satisfied, there are areas for improvement, particularly in technical performance, to ensure a more seamless and enjoyable gaming experience. These insights are crucial for developers and educators aiming to optimize AR applications for educational purposes.

Solid Organ Donation Process: Correlation between Pro!le, Learning and Course Indication

Objectives: To understand the pro!le of professionals trained in the solid organ donation process, to analyze the result of their learning before and after the course, and to correlate the pro!le and the performance of the professional with the learning and indication of the course. Methods: Retrospective, quantitative, analytical-descriptive study with participants of the course Processo de Doação de Órgãos Sólidos para Pro!ssionais de Saúde. Online questionnaires were used on professional pro!le, performance in the area of organ donation, knowledge assessment, and course indication. "e analyses and correlations were veri!ed with the McNemar test, Spearman's rank, and the bisserial point. Results: Of the 130 professionals, 62% were nurses, 38% physicians, 35% emergency physicians, 26% intensivists, and 42% had more than 10 years of training. For the pro!le of work in the area of organ donation, the professionals report having participated in up to !ve cases in each of the following stages: 44% were involved in the brain death protocol, 56% in the family interview, and 60% in the organ donation process. "e class knowledge retention rate was 26.7%, with 29.5% for physicians and 24.8% for nurses. "e indication of the course was evaluated following the Net Promoter Score (NPS), being in the promoters zone. "e correlation between the groups was positive and statistically signi!cant for those working in the emergency room, with more than 5 years since graduation and with more than !ve cases reported on the questioned stages of organ donation. No signi!cant correlation was identi!ed between these variables and the indication of the course. Conclusion: "e course contributed to the learning of professionals with more training time, greater previous experience in the stages of the organ donation process, and working in the emergency sector.

Patients’ experiences with ‘sludge’ (administrative burden) in the cancer screening process and its relationship with screening completion, experience and health system distrust

Objective‘Sludge’ refers to administrative burdens or frictions that preclude people from getting what they want or need (eg, duplicative forms, complicated instructions, long waiting times). This mixed methods study evaluated...

Abstract P337: Impact of a population health approach using smartphone-enabled home albuminuria testing to improve screening in patients with hypertension or diabetes

Background: Screening for albuminuria with urine albumin/creatinine ratio (ACR) testing among at risk patients is critical as guideline-based therapies can be used to decrease the risk of cardiovascular and kidney disease. However, adherence to testing remains very low, especially for hypertension. Here, we report the results from a prospective pilot study involving a smartphone-enabled home albuminuria testing quality improvement. Methods: We randomly selected 4000 adult individuals (50% with hypertension but no diabetes and 50% with diabetes +/- hypertension) receiving primary care at a large healthcare system in Central and Northeastern Pennsylvania who had not undergone ACR testing in the past 12 months to receive Minuteful Kidney, an FDA-cleared, smartphone-enabled home urine albuminuria screening kit using the vendor’s (Healthy.io) standard workflow. The home testing group was matched 1:1 to 4000 controls who received usual care using propensity score matching addressing imbalances in sociodemographics and comorbidities. The primary outcome was completion of ACR test (either laboratory based ACR or Minuteful Kidney) within 100 days of the index date. Results shown are as of May 1, 2024 (86 days after the index date). Results: Overall, completion of any ACR test was higher in the home testing group than matched controls (50.2% vs. 19.1%; p&lt;0.001). The impact on ACR testing was higher for the hypertension subgroup (50.4% vs. 11.2%; p&lt;0.001) than the diabetes subgroup (49.9% vs. 26.9%; p&lt;0.001). Among the home testing group, 1542/4000 (38.7%) completed the smartphone ACR test, with a higher proportion of completions in non-diabetic hypertension (848/2000 [42.4%] than the diabetes subgroup (663/2000 [33.2%]). Adherence rates were similar across age groups and geographic location. Satisfaction was high among individuals in the home testing group (53+ Net Promoter Score; 94% rated the test as easy or very easy to complete; 88% stated preference for at home testing). Home-based albuminuria screening detected mild to moderate albuminuria (30-300 mg/g) in 33.2% and severe albuminuria (&gt;300 mg/g) in 8.1%. Abnormal results were fairly similar for the diabetes subgroup (33.8% 30-300 mg/g, 10.8% &gt;300 mg/g) and the hypertension subgroup (32.6% 30-300 mg/g, 5.9% &gt;300 mg/g). Conclusions: A population health approach using smartphone-enabled home albuminuria testing is effective in increasing albuminuria screening among individuals with hypertension or diabetes.

Student Satisfaction With Learning Experience and Its Impact on Likelihood Recommending University: Net Promotor Score Approach

Like any business, universities realize the importance and relevance of customer satisfaction that leads to customer recommendations, which is vital to their long-term success, survival, and growth. This study examines university students’ satisfaction with various aspects of their college learning experience, recommending a university as measured by Net Promoter Score (NPS), and the influence of factors related to student satisfaction on the likelihood of recommending the university. The survey results, based on 220 responses from current students, identify students’ satisfaction with the factors included in the study, where students had the highest satisfaction with the attribute ‘feeling support by faculty and staff.’ The study also found that the NPS is -0.40, indicating that students are not likely to recommend this university to other potential students, where NPS varies by gender, class level, and major. In addition, a regression analysis identifies factors to predict the likelihood of recommending this university. These findings offer insights to university administrators for designing strategies to improve student satisfaction and procure recommendations.

Cryo-Pneumatic Compression Results in a Significant Decrease in Opioid Consumption After Shoulder Surgery: A Multicenter Randomized Controlled Trial.

The management of pain after shoulder surgery typically includes the use of cryotherapy and the prescription of opioid analgesics. Much focus has been placed lately on the opioid epidemic, which in part is fueled by excessive prescription of opioid medication. Previous studies have found a combination of cryotherapy and compression effective at reducing analgesic consumption and increasing recovery in patients undergoing knee and spine surgery; however, efficacy in patients undergoing shoulder surgery has not been evaluated. To evaluate the effectiveness of a cryo-pneumatic compression device on postoperative shoulder pain, narcotic use, and quality of life when compared with standard care cryotherapy. Randomized controlled trial; Level of evidence, 2. In total, 200 patients older than 18 years scheduled for unilateral shoulder surgery were enrolled. Patients were randomized to receive either postoperative cryo-pneumatic compression or standard care. The intervention group received a cryo-pneumatic device, while the standard care group received the treating surgeon's preferred method of postoperative care, including standard cryotherapy. Narcotic use was evaluated by the number of oral morphine milligram equivalents consumed during the postoperative period, as well as the time to cessation of narcotic use. Patient-reported outcome measures consisted of a numeric rating scale pain score, 36-item Short Form Survey, patient experience assessed using the net promoter score, and adverse events. Outcomes were evaluated at 2, 6, and 12 weeks postoperatively. Patients receiving cryo-pneumatic compression reported a significant decrease in opioid consumption when compared with standard care (oral morphine milligram equivalents median, 56.1 vs 112; P = .02468). A significant increase in self-reported function was seen in the cryo-pneumatic compression group at 2 weeks when compared with standard care (mean, 61.2 vs 54.2; P = .0412). In patients undergoing unilateral shoulder surgery, the use of cryotherapy with pneumatic compression, when compared with standard care, resulted in significantly decreased opioid consumption as well as increased function at 2 weeks. NCT04185064 (ClinicalTrials.gov identifier).

Comparison of Two Symptom Checkers (Ada and Symptoma) in the Emergency Department: Randomized, Crossover, Head-to-Head, Double-Blinded Study.

Emergency departments (EDs) are frequently overcrowded and increasingly used by nonurgent patients. Symptom checkers (SCs) offer on-demand access to disease suggestions and recommended actions, potentially improving overall patient flow. Contrary to the increasing use of SCs, there is a lack of supporting evidence based on direct patient use. This study aimed to compare the diagnostic accuracy, safety, usability, and acceptance of 2 SCs, Ada and Symptoma. A randomized, crossover, head-to-head, double-blinded study including consecutive adult patients presenting to the ED at University Hospital Erlangen. Patients completed both SCs, Ada and Symptoma. The primary outcome was the diagnostic accuracy of SCs. In total, 6 blinded independent expert raters classified diagnostic concordance of SC suggestions with the final discharge diagnosis as (1) identical, (2) plausible, or (3) diagnostically different. SC suggestions per patient were additionally classified as safe or potentially life-threatening, and the concordance of Ada's and physician-based triage category was assessed. Secondary outcomes were SC usability (5-point Likert-scale: 1=very easy to use to 5=very difficult to use) and SC acceptance net promoter score (NPS). A total of 450 patients completed the study between April and November 2021. The most common chief complaint was chest pain (160/437, 37%). The identical diagnosis was ranked first (or within the top 5 diagnoses) by Ada and Symptoma in 14% (59/437; 27%, 117/437) and 4% (16/437; 13%, 55/437) of patients, respectively. An identical or plausible diagnosis was ranked first (or within the top 5 diagnoses) by Ada and Symptoma in 58% (253/437; 75%, 329/437) and 38% (164/437; 64%, 281/437) of patients, respectively. Ada and Symptoma did not suggest potentially life-threatening diagnoses in 13% (56/437) and 14% (61/437) of patients, respectively. Ada correctly triaged, undertriaged, and overtriaged 34% (149/437), 13% (58/437), and 53% (230/437) of patients, respectively. A total of 88% (385/437) and 78% (342/437) of participants rated Ada and Symptoma as very easy or easy to use, respectively. Ada's NPS was -34 (55% [239/437] detractors; 21% [93/437] promoters) and Symptoma's NPS was -47 (63% [275/437] detractors and 16% [70/437]) promoters. Ada demonstrated a higher diagnostic accuracy than Symptoma, and substantially more patients would recommend Ada and assessed Ada as easy to use. The high number of unrecognized potentially life-threatening diagnoses by both SCs and inappropriate triage advice by Ada was alarming. Overall, the trustworthiness of SC recommendations appears questionable. SC authorization should necessitate rigorous clinical evaluation studies to prevent misdiagnoses, fatal triage advice, and misuse of scarce medical resources. German Register of Clinical Trials DRKS00024830; https://drks.de/search/en/trial/DRKS00024830.

Effects of a Digital Care Pathway for Multiple Sclerosis: Observational Study.

Helsinki University Hospital has developed a digital care pathway (DCP) for people with multiple sclerosis (MS) to improve the care quality. DCP was designed for especially newly diagnosed patients to support adaptation to a chronic disease. This study investigated the MS DCP user behavior and its impact on patient education-mediated changes in health care use, patient-perceived impact of MS on psychological and physical functional health, and patient satisfaction. We collected data from the service launch in March 2020 until the end of 2022 (observation period). The number of users, user logins, and their timing and messages sent were collected. The association of the DCP on health care use was studied in a case-control setting in which patients were allowed to freely select whether they wanted to use the service (DCP group n=63) or not (control group n=112). The number of physical and remote appointments either to a doctor, nurse, or other services were considered in addition to emergency department visits and inpatient days. The follow-up time was 1 year (study period). Furthermore, a subgroup of 36 patients was recruited to fill out surveys on net promoter score (NPS) at 3, 6, and 12 months, and their physical and psychological functional health (Multiple Sclerosis Impact Scale) at 0, 3, 6, and 12 months. During the observation period, a total of 225 patients had the option to use the service, out of whom 79.1% (178/225) logged into the service. On average, a user of the DCP sent 6.8 messages and logged on 7.4 times, with 72.29% (1182/1635) of logins taking place within 1 year of initiating the service. In case-control cohorts, no statistically significant differences between the groups were found for physical doctors' appointments, remote doctors' contacts, physical nurse appointments, remote nurse contacts, emergency department visits, or inpatient days. However, the MS DCP was associated with a 2.05 (SD 0.48) visit increase in other services, within 1 year from diagnosis. In the prospective DCP-cohort, no clinically significant change was observed in the physical functional health between the 0 and 12-month marks, but psychological functional health was improved between 3 and 6 months. Patient satisfaction improved from the NPS index of 21 (favorable) at the 3-month mark to the NPS index of 63 (excellent) at the 12-month mark. The MS DCP has been used by a majority of the people with MS as a complementary service to regular operations, and we find high satisfaction with the service. Psychological health was enhanced during the use of MS DCP. Our results indicate that DCPs hold great promise for managing chronic conditions such as MS. Future studies should explore the potential of DCPs in different health care settings and patient subgroups.

Enhancing Customer Satisfaction Analysis Using Advanced Machine Learning Techniques in Fintech Industry

Customer satisfaction (CSAT) is vital in service and marketing, indicating how well products or services meet customer expectations. Traditional CSAT methods like the American Customer Satisfaction Index (ACSI) and Net Promoter Score (NPS) face challenges such as survey fatigue and low response rates. This study introduces a novel framework using advanced machine learning (ML) and deep learning (DL) techniques, specifically Bidirectional Encoder Representations from Transformers (BERT), to classify customer feedback into distinct CSAT drivers. Integrating term frequency-inverse document frequency (TF-IDF) methods with BERT-based embeddings, the framework significantly improves prediction accuracy. Using a proprietary dataset of 5,943 customer feedback responses from 39 companies across 13 industries, the fine-tuned BERT model achieved an F1 score of 0.84, surpassing traditional methods like TF-IDF and support vector machine (SVM) with an F1 score of 0.47, and TF-IDF with multi-layer perceptron (MLP) networks at 0.50. A hybrid approach combining BERT and TF-IDF embeddings with MLP networks yielded an F1 score of 0.71. The results show the transformative potential of DL techniques, particularly fine-tuned BERT models, in enhancing CSAT prediction accuracy. This research bridges the gap between traditional and advanced text mining methods, setting a new standard for CSAT modeling and offering a robust framework for extracting actionable insights from customer feedback. It highlights the importance of adopting advanced ML and DL models for strategic decision-making and improving customer satisfaction measurement.

Key characteristics of perceived customer centricity in the passenger airline industry: A systematic literature review

The airline industry is operating in a highly competitive and saturated market and is considered to be one of the most dynamic service industries in the world. Maintaining a high level of passenger satisfaction and incorporating customer centricity into an airline's strategy can be the key competitive advantage. Despite the growing interest of scholars and managers in customer centricity, research on this topic in the airline industry has just started. However, it is key to understand how a firm's intentions to become customer-centric finally translate into customer perceptions. For this purpose, the authors developed a perceived customer centricity framework which is tailored to the environment of the passenger airline industry. A systematic literature review was conducted to review and analyze key characteristics and measures of perceived customer centricity in the airline industry. The authors identified 15 distinct key characteristics (measures) in literature and conclude that airlines need to focus on various aspects to truly be customer-centric. Investing in sustainable practices, employee training, modern in-flight experiences, competitive pricing, technological infrastructure, and positive brand associations all contribute to customer centricity. Understanding how these elements are interconnected allows airlines to customize their efforts, meeting current and future passenger needs, and ultimately creating a standout customer-centric culture in the competitive airline industry. By formulating concrete measures this paper establishes a foundation for future perceived customer centricity research, such as surveys, and presents alternative measures to the widely adopted net promoter score (NPS).