title: Automatic system testing of a decision support system for insulin dosing using Google Android.
abstract: Hyperglycaemia in hospitalized patients is a common and costly health care problem. The GlucoTab system is a mobile workflow and decision support system, aiming to facilitate efficient and safe glycemic control of non-critically ill patients. Being a medical device, the GlucoTab requires extensive and reproducible testing. A framework for high-volume, reproducible and automated system testing of the GlucoTab system was set up applying several Open Source tools for test automation and system time handling. The REACTION insulin titration protocol was investigated in a paper-based clinical trial (PBCT). In order to validate the GlucoTab system, data from this trial was used for simulation and system tests. In total, 1190 decision support action points were identified and simulated. Four data points (0.3%) resulted in a GlucoTab system error caused by a defective implementation. In 144 data points (12.1%), calculation errors of physicians and nurses in the PBCT were detected. The test framework was able to verify manual calculation of insulin doses and detect relatively many user errors and workflow anomalies in the PBCT data. This shows the high potential of the electronic decision support application to improve safety of implementation of an insulin titration protocol and workflow management system in clinical wards.
authors.affiliation: Institute for Biomedicine and Health Sciences, Graz, Austria.
authors.forename: Stephan
authors.initials: S
authors.lastname: Spat
authors.forename: Bernhard
authors.initials: B
authors.lastname: Höll
authors.forename: Georg
authors.initials: G
authors.lastname: Petritsch
authors.forename: Lukas
authors.initials: L
authors.lastname: Schaupp
authors.forename: Peter
authors.initials: P
authors.lastname: Beck
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Pieber
mesh_terms: D003198:Computer Simulation; D020000:Decision Support Systems, Clinical; D004360:Drug Therapy, Computer-Assisted / Q000379:methods*; D006801:Humans; D006943:Hyperglycemia / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy*; D007328:Insulin / Q000008:administration & dosage*; D008962:Models, Theoretical; D011381:Programming Languages; D012984:Software; D012986:Software Validation; D014584:User-Computer Interface
chemical_list: D007328:Insulin