A Web-Based Application to Communicate Benefits and Risks of Surgical Treatments
Fabienne E. Stubenrouch, MSc, PhD Candidate, Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands, Marwin Baumann, MSc, System and Network Engineer, Department of Medical Informatics, Academic Medical Center, Amsterdam, The Netherlands, Dink A. Legemate, MD, PhD, Professor of Surgery, Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands, Dirk T. Ubbink, MD, PhD, Principal Investigator, Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands
Background: In general, communication is an important aspect during surgeon-patient consultations. However, clear communication of the benefits and risks of the possible treatment options can be challenging. Visual presentation of information may increase patient comprehension. We developed and piloted a web-based application that provides graphical representations of the numerical benefits and risks of surgical treatment options.
Materials and Methods: The app was developed by assessing functional requirements, developing a prototype, pilot-testing and adjusting the prototype, and evaluating the final app. In the app, the surgeon enters the benefits and risks of the surgical treatment options as percentages. The app shows the possible outcomes ad libitum as bar charts, icon arrays, or natural frequency trees. Subsequently, we investigated clinicians’ and patients’ satisfaction with the prototype by means of questionnaires, semi-structured interviews, and by observing their conversations.
Results: The MAPPING app (“Mapping All Patient Probabilities In Numerical Graphs”) was pilot-tested among five surgeons and 12 patients with various surgical disorders. Nine patients welcomed the app and were eager to understand the risks and benefits involved when presented as graphs. The surgeons judged the app as simple to use and valuable. The prototype was improved based on their suggestions.
Conclusion: The MAPPING app was developed successfully and has the potential to facilitate surgical risk communication in a more structured and uniform manner. Future research will focus on its validation and promotion of SDM in different types of patients and disorders.