Development of a Website for a Living Network Meta-analysis of Atopic Dermatitis Treatments Using a User-Centered Design: Multimethod Study

Karen P L Lau; Payal Agarwal; Laura Parente; Olivia Marcello; Mike Lovas; Jason Van; Simone N Vigod; Trevor Champagne; Tanya Mohan; Bernd Wm Arents; Tim Burton; Carsten Flohr; Aaron M Drucker

doi:10.2196/41201

Development of a Website for a Living Network Meta-analysis of Atopic Dermatitis Treatments Using a User-Centered Design: Multimethod Study

JMIR Dermatol. 2022 Sep 26;5(3):e41201. doi: 10.2196/41201.

Authors

Karen P L Lau¹, Payal Agarwal^{1

2}, Laura Parente³, Olivia Marcello³, Mike Lovas⁴, Jason Van⁵, Simone N Vigod^{1

6

7}, Trevor Champagne^{1

8}, Tanya Mohan⁹, Bernd Wm Arents¹⁰, Tim Burton, Carsten Flohr¹¹, Aaron M Drucker^{1

12}

Affiliations

¹ Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.
² Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
³ Healthcare Human Factors, University Health Network, Toronto, ON, Canada.
⁴ Cancer Digital Intelligence, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
⁵ Thousand Plus, Toronto, ON, Canada.
⁶ Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
⁷ Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
⁸ Dermatology Division, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
⁹ Specialty Health Network, Shoppers Drug Mart, Toronto, ON, Canada.
¹⁰ Dutch Association for People with Atopic Dermatitis, Nijkerk, Netherlands.
¹¹ Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, Guy's & St Thomas' NHS Foundation Trust and King's College London, London, United Kingdom.
¹² Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada.

PMID: 37632894
PMCID: PMC10334921
DOI: 10.2196/41201

Abstract

Background: A rapid expansion of systemic immunological treatment options for atopic dermatitis (AD) has created a need for clinically relevant and understandable comparative efficacy and safety information for patients and clinicians. Given the scarcity of head-to-head trials, network meta-analysis (NMA) is an alternative way to enable robust comparisons among treatment options; however, NMA results are often complex and difficult to directly implement in shared decision-making.

Objective: The aim of this study is to develop a website that effectively presents the results of a living systematic review and NMA on AD treatments to patient and clinician users.

Methods: We conducted a multimethod study using iterative feedback from adults with AD, adult caregivers of children with AD, dermatologists, and allergists within a user-centered design framework. We used questionnaires followed by workshops among patients and clinicians to develop and improve the website interface. Usability testing was done with a caregiver of a patient with eczema.

Results: Questionnaires were completed by 31 adults with AD or caregivers and 94 clinicians. Patients and caregivers felt it was very important to know about new treatments (20/31, 65%). Clinicians felt the lack of evidence-based comparisons between treatments was a barrier to care (55/93, 59%). "Avoiding dangerous side effects" was ranked as the most important priority for patients (weighted ranking 5.2/7, with higher ranking being more important), and "improving patients' overall symptoms" was the most important priority for clinicians (weighted ranking 5.0/6). A total of 4 patients and 7 clinicians participated in workshops; they appreciated visualizations of the NMA results and found the website valuable for comparing different treatments. The patients suggested changes to simplify the interface and clarify terminology related to comparative efficacy. The user in the usability testing found the website intuitive to navigate.

Conclusions: We developed a website, "eczematherapies.com," with a user-centered design approach. Visualizations of NMA results enable users to compare treatments as part of their shared decision-making process.

Keywords: allergist; atopic dermatitis; decision-making; dermatitis; dermatology; eczema; education material; health information; health literacy; information seeking; interface; knowledge translation; network meta-analysis; online resource; patient education; skin; usability; user experience; user-centered design; visualization; web design; web development; website design; website development.

©Karen P L Lau, Payal Agarwal, Laura Parente, Olivia Marcello, Mike Lovas, Jason Van, Simone N Vigod, Trevor Champagne, Tanya Mohan, Bernd WM Arents, Tim Burton, Carsten Flohr, Aaron M Drucker. Originally published in JMIR Dermatology (http://derma.jmir.org), 26.09.2022.