Accepted for/Published in: JMIR Formative Research
Date Submitted: Jun 26, 2025
Date Accepted: Nov 26, 2025
Usability and Acceptance Testing of an Electronic Patient-Reported Outcome (ePRO) Symptom Monitoring System for People Receiving Immune Checkpoint Inhibitors
ABSTRACT
Background:
Electronic patient-reported outcomes (ePRO) symptom monitoring systems may help detect immune-related adverse events (irAEs). Usability testing is critical to the development of ePRO systems but there are no published examples.
Objective:
To assess the usability and acceptance of a co-designed ePRO symptom monitoring prototype for irAEs.
Methods:
Participants were patients who had received/were receiving immune checkpoint inhibitors, their caregivers, oncologists, or nurse specialists, at an Australian quaternary cancer centre. The Mobile Device Proficiency Questionnaire (MDPQ-16) and the Computer Proficiency Questionnaire (CPQ-12) assessed digital literacy pre-session. Sessions involved a patient/caregiver, oncologist, and nurse specialist who performed a series of tasks reflecting their roles. Semi-structured interview and two questionnaires assessed usability (System Usability Scale, SUS) and acceptance (Unified Theory of Acceptance and Use of Technology, UTAUT).
Results:
30 people (7 patients, 3 caregivers, 10 oncologists, 10 nurse specialists) participated in 10 testing sessions. Median MDPQ-16 and CPQ-12 scores were higher for oncologists and nurse specialists compared to patients/caregivers. Median SUS scores for patients/ caregivers, oncologists and nurse specialists were 77.5%, 82.5%, 80.0% (70.0%-86.3%, 80.0%-90.0%, 75.6%-94.4%) respectively, indicating high levels of usability. Median UTAUT scores for patients/caregivers, oncologists and nurse specialists were all 4.0 (4.0-5.0) respectively, indicating high levels of user acceptance. Qualitative feedback around usability and acceptance identified system strengths and areas for improvement.
Conclusions:
The ePRO prototype demonstrated high levels of usability and acceptance on qualitative and quantitative assessments. Feedback will inform ePRO prototype updates prior to implementation in routine care. Clinical Trial: Not applicable
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.