Accepted for/Published in: JMIR Formative Research
Date Submitted: Aug 29, 2023
Date Accepted: Mar 6, 2024
Development of a Digital Patient Assistant for the Management of Cyclic Vomiting Syndrome: A Patient-Centric Design Study
ABSTRACT
Background:
Cyclic vomiting syndrome (CVS) is a debilitating disorder of gut-brain interaction characterized by recurrent, stereotypical emetic episodes with idiopathic etiology, and associated with frequent medical encounters and significant negative impacts on patients' quality of life. Diagnosis of CVS is often made by review of medical history, physical exam, and tests to exclude other diseases, which may result in un-diagnosis for years. There is no approved prophylaxis or acute therapy for CVS. These factors contribute to high unmet needs in patients with CVS and the demand for innovative support to improve the management of CVS.
Objective:
To develop an artificial intelligence (AI)-powered digital patient assistant (DPA) for patients with CVS to address their unique needs, and iteratively enhance the technical features and user experience on the initial DPA versions.
Methods:
A patient-centric, design thinking approach was used to develop the DPA, which included multiple steps (i.e., targeted literature review, patient advisory board, and a design thinking session to incorporate feedback from patients, caregivers, and healthcare providers). The DPA prototype was then enhanced through iterative development and user feedback. The DPA's usability, relevance and user satisfaction were assessed by patients via the System Usability Scale (SUS) and additional feedback questions.
Results:
The DPA includes an introductory bot and daily and weekly check-in bots combined with a knowledge hub, which are reflected in a patient dashboard. These features address important CVS-related unmet needs: 1) an efficient way to track symptoms, episode triggers, and impacts, 2) CVS diagnosis and management information, and 3) an evidence-based digital health solution to aid with disease management. This development study demonstrated the potential for the DPA to address these unique unmet needs of patients. The SUS score was 80 out of 100, and further user feedback on the DPA showed a high level of ease of use and relevance, as well as suggestions for further application, such as having healthcare providers prescribe the DPA to patients with suspected or confirmed CVS.
Conclusions:
The development of this DPA for patients with CVS, via an iterative design thinking approach, offers a patient-centric solution on disease management. The DPA development framework may also serve to guide future patient digital support and research scenarios.
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