title: A Clinical Decision Support System for Chronic Pain Management in Primary Care: Usability testing and its relevance.
abstract: BACKGROUND
  Clinical decision support systems (CDSSs) that are integrated into electronic medical records may be useful for encouraging practice change compliant with clinical practice guidelines.
  
  
  OBJECTIVE
  To engage end users to inform early phase CDSS development through a process of usability testing.
  
  
  METHODS
  A sequential exploratory mixed method approach was used. Interprofessional clinician participants (seven in iteration 1 and six in iteration 2) were asked to 'think aloud' while performing various tasks on the CDSS and then complete the System Usability Scale (SUS). Changes were made to the CDSS after each iteration.Results Barriers and facilitators were identified: systemic; user interface (most numerous barriers); content (most numerous facilitators) and technical. The mean SUS score was 81.1 (SD = 12.02) in iteration 1 and 70.40 (SD = 6.78) in iteration 2 (p &gt; 0.05).
  
  
  CONCLUSIONS
  Qualitative data from usability testing were valuable in the CDSS development process. SUS scores were of limited value at this development stage.
authors.affiliation: Department of Family Medicine, McMaster University, Canada. nairk@mcmaster.ca.
authors.forename: Kalpana Maria
authors.initials: KM
authors.lastname: Nair
authors.affiliation: Department of Family Medicine, McMaster University, Canada. Raheleh.mal@gmail.com.
authors.forename: Raheleh
authors.initials: R
authors.lastname: Malaeekeh
authors.affiliation: Department of Family Medicine, McMaster University, Canada. ischabo@mcmaster.ca.
authors.forename: Inge
authors.initials: I
authors.lastname: Schabort
authors.affiliation: Department of Psychiatry, University of Calgary, Canada. ptaenzer@gmail.com.
authors.forename: Paul
authors.initials: P
authors.lastname: Taenzer
authors.affiliation: Family and Community Medicine, University of Toronto, Canada. arun98@gmail.com.
authors.forename: Arun
authors.initials: A
authors.lastname: Radhakrishnan
authors.affiliation: Department of Family Medicine, McMaster University, Canada. guentd@mcmaster.ca.
authors.forename: Dale
authors.initials: D
authors.lastname: Guenter
mesh_terms: D059350:Chronic Pain / Q000628:therapy*; D020000:Decision Support Systems, Clinical / Q000458:organization & administration*; D057286:Electronic Health Records; D006801:Humans; D059408:Pain Management / Q000379:methods*; D011320:Primary Health Care / Q000379:methods*; D012985:Software Design; D014584:User-Computer Interface