JMIR Publications

ABSTRACT

Background:

Multifaceted factors need to be addressed to improve the health and quality of life of people with Type 2 Diabetes (T2D). Therefore, we developed a web-based decision support tool that comprises a more holistic diagnosis (including four domains: body, thinking and feeling, behavior, and environment) and personalized advice. This 360° diagnostic tool enables persons with T2D and healthcare professionals at the general practice to get an overview of the most important T2D-related issues and, subsequently, to determine the most suitable intervention for the person with T2D.

Objective:

The aim of this paper is to describe the systematic, iterative development, and evaluation of the online 360° diagnostic tool.

Methods:

We defined the requirements for the online 360° diagnostic tool based on previously developed tools, a literature review and a multidisciplinary team of experts. As part of the conceptualization we defined three requirements of the tool: 1) diagnostic requirements, 2) feedback requirements, and 3) advice, communication and referral requirements. Next, we developed and designed the instruments for each of these requirements. The diagnostic part of the tool (i.e., instruments and visualization) was evaluated, in a usability study, among 8 people with T2D at a Dutch general practice.

Results:

For each of the four domains specific aspects and underlying elements were selected, and measurement instruments (including clinical data and questionnaires) were chosen. Cut-off values were defined to identify high-, middle- and low-ranking scores and decision-rules were developed and implemented using R-scripts and algorithms. A visual design was created (the Profile wheel) to provide an overview of scores per domain which were communicated through traffic light colors. We mapped an inventory of interventions that could be added to the tool, and we developed a protocol which was designed as a card deck with intervention mapping steps. Furthermore, the usability study showed that people with T2D perceived the tool as easy to use, useful, easy to understand and insightful.

Conclusions:

Preliminary evaluation of 360° diagnostic tool by experts, healthcare professionals and people with T2D showed that the tool was considered relevant, clear, and practical. The iterative process provided insights in areas for improvement, and which were implemented. The strengths, shortcomings, future usage and its challenges are discussed.