JMIR Publications

ABSTRACT

Background:

Diagnosis about ventricular tachycardia (VT) is challenging due to similarity between VT and some forms of supraventricular tachycardia, complexity of clinical manifestations, heterogeneity of underlying diseases, and potential for life-threatening hemodynamic instability. Clinical Decision Support Systems (CDSS) have emerged as promising tools to augment the diagnostic capabilities of cardiologists. Requirements analysis is acknowledged to be vital for success of a CDSS, especially for complex clinical tasks like VT diagnosis.

Objective:

The study aims to analyze the requirements for a VT diagnosis CDSS within the framework of knowledge, practice and clinical decision support (CDS) needs.

Methods:

Our multidisciplinary team firstly conducted semi-structured interviews with seven cardiologists. The interviews were about VT challenges and expected decision supports. A questionnaire was designed by the multidisciplinary team based the results of interviews. The questionnaire was divided into four sections: demographic information, knowledge assessment, practice assessment and clinical decision support. The practice section consisted of two simulated cases and is worth 10 marks. Online questionnaires were disseminated to registered cardiologists across China from December 2022 to February 2023. The scores for the practice section are expressed as continuous variables, using mean, median and range. The knowledge and CDS sections were assessed using a 4-point Likert scale without a neutral option. We conducted Kruskal-Wallis tests to investigate the relationship between scores and practice years and specialty.

Results:

Of 687 cardiologists who completed the questionnaire, 567 were eligible for further analysis. The results of the knowledge assessment showed that 383 cardiologists (68.0 %) lacked knowledge in diagnostic evaluation. The overall average score of practice assessment was 6.11 ±0.55, the etiological diagnosis section has the highest overall score (6.74±1.75), however diagnostic evaluation section has the lowest scores (5.78±1.19). A majority of cardiologists reported needs for CDSS (60.7%). There was a significant difference in practice competency scores between general cardiologists and arrhythmia specialists (P= 0.017).

Conclusions:

There was a notable deficiency in the knowledge and practice of VT among Chinese cardiologists. Specific knowledge and practice support requirements were identified, which provide a foundation for further development and optimization of CDSS. Meanwhile, it is important to consider clinicians' specialization levels and years of practice for effective and personalized support.