Usability of Rehabilitation Technologies Aimed at Supporting Shared Decision Making: A Scoping Review (Preprint)

BACKGROUND The field of rehabilitation has seen a recent rise in technologies to support shared decision-making (SDM), though it is unclear how usability testing is integrated into the design process. OBJECTIVE This scoping review aimed to answer the following research questions: (1) Which methods and measures have been used to produce knowledge about the usability of rehabilitation technologies aimed at supporting SDM at the different phases of development and implementation? (2) Which parameters of usability have been measured and reported? METHODS This review was followed the Arksey and O’Malley framework. An electronic search was performed in Ovid MEDLINE, EMBASE, CINAHL and PsycINFO databases from 2005 up to November 2020. Two independent reviewers screened all retrieved titles, abstracts and full texts according to the inclusion criteria and extracted the data. The characteristics of studies were outlined in a descriptive summary. Findings were categorized based the usability parameters, technology interventions and measures of usability. RESULTS A total of 38 articles were included. Technologies for SDM included clinical decision support systems (26%), mobile health apps (26%), web-based aids (47%), and electronic patient-reported outcome systems (11%). The usability of SDM technologies was assessed during development, pre-implementation, or implementation through 14 different methods, most frequently through usability questionnaires (28%), largely mapped to the parameter of satisfaction (83%). CONCLUSIONS The reported methods, measures and usability parameters demonstrated limitations in the evaluation of usability of SDM technologies for rehabilitation. A comprehensive approach to usability evaluation should be used to reflect the complicated concept of usability, involving inspection and empirical methods that span multiple usability parameters (effectiveness, efficiency, memorability, productivity, security and satisfaction). As the process of SDM aims to improve patient-centered care, the involvement of patients and clinicians in the development process through comprehensive usability testing may assist in developing health technologies that reflect their needs and priorities.