Development and evaluation of a prototype personal digital assistant-decision support system for the management of obesity

The purpose of this study was to develop a prototype personal digit assistant-decision support system (PDA-DSS) based on a clinical practice guideline (CPG) for the management of obesity and to evaluate the prototype. The study was composed of seven phases: (1) Analysis of advanced practice nurses (APN) students' documentation related to the management of obesity using the Clinical Log-APN (CL-APN), (2) Identification of functional requirements and data modeling through Use Case Analysis and Unified Modeling Language (UML), (3) Evaluation of representation of obesity-related concepts with standardized terminologies, (4) Design of a web-based prototype user interface, (5) Usability inspection of the prototype with usability experts, (6) User testing of the PDA-DSS with APN students and (7) Comparison of data of APN students randomized to PDA-DSS vs. CL-APN.;The analysis revealed the documentation rate of obesity as an assessment diagnosis and adherence to the CPG for obesity was low. Through Use Case Analysis and UML modeling, the functional requirements---screening, assessment, and planning treatment for obesity---were identified and a data model was built. Overall, the standardized terminologies that are used in the database for the CL-APN could represent about 80% of the obesity-related concepts. However, the terms of these standardized terminologies were not specific enough to represent all the concepts. The Systematized Nomenclature of Medicine-Clinical Terms (SNOMED CT) could represent 83% of the concepts and was used to extend the knowledge base. Heuristic evaluation and user testing revealed that prototypes for the management of obesity followed heuristic principles and that the system was perceived as easy to use and useful. The proportion of encounters with an obesity diagnosis was significantly higher in the PDA-DSS group than in the CL-APN group.;The PDA-DSS for the management of obesity has potential uses for education, nursing practice, and research. As an educational tool, it can be used to improve APN students' adherence to the CPG's recommendations and to enhance informatics competencies. The PDA-DSS has the potential to improve APN students' clinical decision making at the point-of-care and delivery of CPG-based care, thereby improving patients' outcomes related to the management of obesity.