title: Improving access to clinical practice guidelines with an interactive graphical interface using an iconic language.
abstract: BACKGROUND
  Clinical practice guidelines are useful for physicians, and guidelines are available on the Internet from various websites such as Vidal Recos. However, these guidelines are long and difficult to read, especially during consultation. Similar difficulties have been encountered with drug summaries of product characteristics. In a previous work, we have proposed an iconic language (called VCM, for Visualization of Concepts in Medicine) for representing patient conditions, treatments and laboratory tests, and we have used these icons to design a user interface that graphically indexes summaries of product characteristics. In the current study, our objective was to design and evaluate an iconic user interface for the consultation of clinical practice guidelines by physicians.
  
  
  METHODS
  Focus groups of physicians were set up to identify the difficulties encountered when reading guidelines. Icons were integrated into Vidal Recos, taking human factors into account. The resulting interface includes a graphical summary and an iconic indexation of the guideline. The new interface was evaluated. We compared the response times and the number of errors recorded when physicians answered questions about two clinical scenarios using the interactive iconic interface or a textual interface. Users' perceived usability was evaluated with the System Usability Scale.
  
  
  RESULTS
  The main difficulties encountered by physicians when reading guidelines were obtaining an overview and finding recommendations for patients corresponding to "particular cases". We designed a graphical interface for guideline consultation, using icons to identify particular cases and providing a graphical summary of the icons organized by anatomy and etiology. The evaluation showed that physicians gave clinical responses more rapidly with the iconic interface than the textual interface (25.2 seconds versus 45.6, p < 0.05). The physicians appreciated the new interface, and the System Usability Scale score value was 75 (between good and excellent).
  
  
  CONCLUSIONS
  An interactive iconic interface can provide physicians with an overview of clinical practice guidelines, and can decrease the time required to access the content of such guidelines.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Pereira
authors.forename: Sylvain
authors.initials: S
authors.lastname: Hassler
authors.forename: Saliha
authors.initials: S
authors.lastname: Hamek
authors.forename: César
authors.initials: C
authors.lastname: Boog
authors.forename: Nicolas
authors.initials: N
authors.lastname: Leroy
authors.forename: Marie-Catherine
authors.initials: MC
authors.lastname: Beuscart-Zéphir
authors.forename: Madeleine
authors.initials: M
authors.lastname: Favre
authors.forename: Alain
authors.initials: A
authors.lastname: Venot
authors.forename: Catherine
authors.initials: C
authors.lastname: Duclos
authors.affiliation: , Laboratoire d'informatique médicale et d'ingénierie des connaissances en e-santé (LIMICS), Université Paris 13, Sorbonne Paris Cité, INSERM UMRS 1142, Université Paris 6, 74 rue Marcel Cachin, 93017 Bobigny, France. jean-baptiste.lamy@univ-paris13.fr.
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Lamy
mesh_terms: D003196:Computer Graphics; D006801:Humans; D008491:Medical Informatics Applications; D017410:Practice Guidelines as Topic; D014584:User-Computer Interface