title: Knowledge translation of an online tool to determine candidacy for epilepsy surgery evaluation.
abstract: BACKGROUND
  Guidelines recommend that surgery be considered in patients with drug-resistant epilepsy, yet delays to epilepsy surgery still exist. A Web-based, evidence-informed clinical decision tool (www.toolsforepilepsy.com) was developed to help physicians determine which patients are appropriate for an epilepsy surgery evaluation. We evaluated the usability and feasibility of the tool with the intended end users in order to improve implementation into practice.
  
  
  METHODS
  Usability testing was conducted with relevant end users. After the tool was modified based on usability results, another group of end users trialed the tool in their clinical practice. This latter group of end users then participated in focus groups and semi-structured interviews to address barriers and facilitators to tool implementation. Finally, a stakeholder meeting was held with domain experts and end users to discuss further changes to the tool and implementation strategies.
  
  
  RESULTS
  Six overall themes were identified through usability testing, and an additional 11 themes were identified through the focus groups and interviews. The tool was modified based on these findings, which were then presented at the stakeholder meeting of experts and end users for further refinement. The findings were also used to guide discussions of potential implementation strategies at the meeting.
  
  
  CONCLUSIONS
  This study provides guidance on how to improve the usability of clinical decision tools by engaging end users, experts, and other key stakeholders. The modifications to the tool should facilitate its implementation in clinical practice and ultimately enhance the quality of care persons with epilepsy receive.
authors: Department of Clinical Neurosciences & Hotchkiss Brain Institute (KMS, SW, LC, NJ), Department of Community Health Sciences & O'Brien Institute for Public Health (KMS, JH-L, SW, HQ, NJ), Department of Medicine (JH-L), Department of Family Medicine (HA), and Ward of the 21st Century (JS), Cumming School of Medicine, University of Calgary, Alberta, Canada; UCL Institute of Child Health & Great Ormond Street Hospital for Children (JHC), London, UK; and Department of Neurosurgery, Ronald Reagan UCLA Medical Center, University of California (GWM), Los Angeles.
authors: Khara M
authors: KM
authors: Sauro
authors: Department of Clinical Neurosciences & Hotchkiss Brain Institute (KMS, SW, LC, NJ), Department of Community Health Sciences & O'Brien Institute for Public Health (KMS, JH-L, SW, HQ, NJ), Department of Medicine (JH-L), Department of Family Medicine (HA), and Ward of the 21st Century (JS), Cumming School of Medicine, University of Calgary, Alberta, Canada; UCL Institute of Child Health & Great Ormond Street Hospital for Children (JHC), London, UK; and Department of Neurosurgery, Ronald Reagan UCLA Medical Center, University of California (GWM), Los Angeles.
authors: Jayna
authors: J
authors: Holroyd-Leduc
authors: Department of Clinical Neurosciences & Hotchkiss Brain Institute (KMS, SW, LC, NJ), Department of Community Health Sciences & O'Brien Institute for Public Health (KMS, JH-L, SW, HQ, NJ), Department of Medicine (JH-L), Department of Family Medicine (HA), and Ward of the 21st Century (JS), Cumming School of Medicine, University of Calgary, Alberta, Canada; UCL Institute of Child Health & Great Ormond Street Hospital for Children (JHC), London, UK; and Department of Neurosurgery, Ronald Reagan UCLA Medical Center, University of California (GWM), Los Angeles.
authors: Samuel
authors: S
authors: Wiebe
authors: Department of Clinical Neurosciences & Hotchkiss Brain Institute (KMS, SW, LC, NJ), Department of Community Health Sciences & O'Brien Institute for Public Health (KMS, JH-L, SW, HQ, NJ), Department of Medicine (JH-L), Department of Family Medicine (HA), and Ward of the 21st Century (JS), Cumming School of Medicine, University of Calgary, Alberta, Canada; UCL Institute of Child Health & Great Ormond Street Hospital for Children (JHC), London, UK; and Department of Neurosurgery, Ronald Reagan UCLA Medical Center, University of California (GWM), Los Angeles.
authors: Hude
authors: H
authors: Quan
authors: Department of Clinical Neurosciences & Hotchkiss Brain Institute (KMS, SW, LC, NJ), Department of Community Health Sciences & O'Brien Institute for Public Health (KMS, JH-L, SW, HQ, NJ), Department of Medicine (JH-L), Department of Family Medicine (HA), and Ward of the 21st Century (JS), Cumming School of Medicine, University of Calgary, Alberta, Canada; UCL Institute of Child Health & Great Ormond Street Hospital for Children (JHC), London, UK; and Department of Neurosurgery, Ronald Reagan UCLA Medical Center, University of California (GWM), Los Angeles.
authors: Lara
authors: L
authors: Cooke
authors: Department of Clinical Neurosciences & Hotchkiss Brain Institute (KMS, SW, LC, NJ), Department of Community Health Sciences & O'Brien Institute for Public Health (KMS, JH-L, SW, HQ, NJ), Department of Medicine (JH-L), Department of Family Medicine (HA), and Ward of the 21st Century (JS), Cumming School of Medicine, University of Calgary, Alberta, Canada; UCL Institute of Child Health & Great Ormond Street Hospital for Children (JHC), London, UK; and Department of Neurosurgery, Ronald Reagan UCLA Medical Center, University of California (GWM), Los Angeles.
authors: J Helen
authors: JH
authors: Cross
authors: Department of Clinical Neurosciences & Hotchkiss Brain Institute (KMS, SW, LC, NJ), Department of Community Health Sciences & O'Brien Institute for Public Health (KMS, JH-L, SW, HQ, NJ), Department of Medicine (JH-L), Department of Family Medicine (HA), and Ward of the 21st Century (JS), Cumming School of Medicine, University of Calgary, Alberta, Canada; UCL Institute of Child Health & Great Ormond Street Hospital for Children (JHC), London, UK; and Department of Neurosurgery, Ronald Reagan UCLA Medical Center, University of California (GWM), Los Angeles.
authors: Gary W
authors: GW
authors: Mathern
authors: Department of Clinical Neurosciences & Hotchkiss Brain Institute (KMS, SW, LC, NJ), Department of Community Health Sciences & O'Brien Institute for Public Health (KMS, JH-L, SW, HQ, NJ), Department of Medicine (JH-L), Department of Family Medicine (HA), and Ward of the 21st Century (JS), Cumming School of Medicine, University of Calgary, Alberta, Canada; UCL Institute of Child Health & Great Ormond Street Hospital for Children (JHC), London, UK; and Department of Neurosurgery, Ronald Reagan UCLA Medical Center, University of California (GWM), Los Angeles.
authors: Heather
authors: H
authors: Armson
authors: Department of Clinical Neurosciences & Hotchkiss Brain Institute (KMS, SW, LC, NJ), Department of Community Health Sciences & O'Brien Institute for Public Health (KMS, JH-L, SW, HQ, NJ), Department of Medicine (JH-L), Department of Family Medicine (HA), and Ward of the 21st Century (JS), Cumming School of Medicine, University of Calgary, Alberta, Canada; UCL Institute of Child Health & Great Ormond Street Hospital for Children (JHC), London, UK; and Department of Neurosurgery, Ronald Reagan UCLA Medical Center, University of California (GWM), Los Angeles.
authors: Julie
authors: J
authors: Stromer
authors: Department of Clinical Neurosciences & Hotchkiss Brain Institute (KMS, SW, LC, NJ), Department of Community Health Sciences & O'Brien Institute for Public Health (KMS, JH-L, SW, HQ, NJ), Department of Medicine (JH-L), Department of Family Medicine (HA), and Ward of the 21st Century (JS), Cumming School of Medicine, University of Calgary, Alberta, Canada; UCL Institute of Child Health & Great Ormond Street Hospital for Children (JHC), London, UK; and Department of Neurosurgery, Ronald Reagan UCLA Medical Center, University of California (GWM), Los Angeles.
authors: Nathalie
authors: N
authors: Jetté