Acceptability and utility of an online patient-completed clinical decision aid for the differential diagnosis of transient loss of consciousness: a qualitative interview study

Background:

Online patient-completed clinical decision aids (CDAs) have the potential to reduce inefficient resource use and patient risk in acute and emergency settings while minimising additional clinician time burden. However, such interventions must be acceptable for use by their target audience - patients.

Objective:

To assess acceptability and utility to patients of a novel online patient-completed CDA for the differential diagnosis of transient loss of consciousness (TLOC).

Methods:

Within a larger validation study of a patient-completed CDA, we conducted nested qualitative semi-structured interviews with a purposive sample of 20 patients who used the CDA in the study, and performed thematic analysis of interview transcripts.

Results:

We identified 6 themes within the data: 3 addressing the content of the CDA; 3 addressing the online implementation; and 4 addressing usability and acceptability of the CDA. Respondents generally felt an online CDA was easy to complete and acceptable, though felt that increased options to personalise descriptions of their experience would be helpful, and offered guidance on how to make it a more useful resource for patients as well as clinicians. We present good practice points for the design of patient-completed online CDAs on the basis of our thematic analysis.

Conclusions:

Patient-completed CDAs can be accessible and feasible for patients to use in acute and emergency settings. In designing such tools, clinicians should endeavour to maintain their accessibility for all relevant patient groups, and to utilise them to provide direct patient benefit, as well as to support clinical decision-making, e.g. through simultaneous patient-directed outputs. Clinical Trial: We pre-registered the study protocol on clinicaltrials.gov (ID: NCT05367999).