Browsing by Author "Otero, Carlos"
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ponencia en congreso.listelement.badge Impact of participatory design for drug-drug interaction alerts: a comparison study between two interfaces(2017) Luna, Daniel; Otero, Carlos; Risk, Marcelo; Stanziola, Enrique; González Bernaldo de Quirós, Fernán"Decision support systems for alert drug-drug interactions have been shown as valid strategy to reduce medical error. Even so the use of these systems has not been as expected, probably due to the lack of a suitable design. This study compares two interfaces, one of them developed using participatory design techniques (based on user centered design processes). This work showed that the use of these techniques improves satisfaction, effectiveness and efficiency in an alert system for drug-drug interactions, a fact that was evident in specific situations such as the decrease of errors to meet the specified task, the time, the workload optimization and users overall satisfaction with the system."proyecto final de grado.listelement.badge Sistema de soporte a la decisión clínica para evaluación cuantitativa de riesgo de cáncer de mama(2017) Tajerian, Matías Nazareth; Otero, Carlos; Rubin, Luciana"El cáncer es la segunda causa de muerte en el mundo, siendo responsable de 1 de cada 6 muertes. En particular, el cáncer de mama es el más frecuente entre las mujeres y es el de mayor incidencia y mortalidad en Argentina. Es sabido que una detección temprana es crucial para el tratamiento de la enfermedad. En este sentido, la evaluación de riesgo es una herramienta de gran utilidad. Este proyecto se secciona en dos partes. En la primera se estudian cuatro modelos de evaluación de riesgo de cáncer de mama: los modelos de Gail, Claus, BRCAPRO y Tyrer-Cuzick. Se analizan sus métodos, factores de riesgo, limitaciones, entre otros aspectos. Finalmente, se procede a seleccionar uno de ellos para su implementación. La segunda parte consta del desarrollo de un sistema de soporte a la decisión clínica para evaluación cuantitativa de riesgo. En ésta se incorpora el modelo seleccionado, y se lleva a cabo un software para realizar el cálculo de riesgo, a partir del método en cascada. El trabajo realizado bajo la dirección de profesionales del Hospital Italiano de Buenos Aires, tiene una concreta proyección para ser aplicado en la historia clínica electrónica, con el objetivo de asistir a los profesionales de salud de atención primaria para la detección de pacientes de alto riesgo."ponencia en congreso.listelement.badge User-centered design improves the usability of drug-drug interaction alerts: a validation study in the real scenario(2017-08) Luna, Daniel; Rizzato Lede, Daniel; Rubin, Luciana; Otero, Carlos; Ortiz, Juan M.; García, Mónica G.; Rapisarda, Romina P.; Risk, Marcelo; González Bernaldo de Quirós, Fernán"Decision support systems can alert physicians to the existence of drug interactions. The Hospital Italiano de Buenos Aires, Argentina, has an in-house electronic health record with computerized physician order entry and clinical decision support. It includes a drug-drug interaction alert system, initially developed under traditional engineering techniques. As we detected a high alert override rate, we rebuilt the knowledge database and redesigned the alert interface with User-Centered Design techniques. A laboratory crossover study using clinical vignettes showed that new alerts were more usable than traditional ones. This paper aimed to validate these results through a controlled and randomized experimental study with two branches (old vs. new design) in a real setting. We analyzed, quantitatively, every fired alert between April 2015 and September 2016. Finally, we performed user surveys and qualitative interviews to inquire about their satisfaction and perceptions. In real scenarios, user-centered design alerts were more usable, being more effective and satisfactory, but less efficient than traditional alerts. "Safe omission", as a new concept, emerged from our stratified analyses and interviews."artículo de publicación periódica.listelement.badge User-centered design improves the usability of drug-drug interaction alerts: experimental comparison of interfaces(2017) Luna, Daniel; Rizzato Lede, Daniel; Otero, Carlos; Risk, Marcelo; González Bernaldo de Quirós, Fernán"Clinical Decision Support Systems can alert health professionals about drug interactions when they prescribe medications. The Hospital Italiano de Buenos Aires in Argentina developed an electronic health record with drug-drug interaction alerts, using traditional software engineering techniques and requirements. Despite enhancing the drug-drug interaction knowledge database, the alert override rate of this system was very high. We redesigned the alert system using user-centered design (UCD) and participatory design techniques to enhance the drug-drug interaction alert interface. This paper describes the methodology of our UCD. We used crossover method with realistic, clinical vignettes to compare usability of the standard and new software versions in terms of efficiency, effectiveness, and user satisfaction. Our study showed that, compared to the traditional alert system, the UCD alert system was more efficient (alerts faster resolution), more effective (tasks completed with fewer errors), and more satisfying. These results indicate that UCD techniques that follow ISO 9241-210 can generate more usable alerts than traditional design."