Abstract: |
The work describes FHCatScreen©, a web-based Familial Hypercholesterolemia (FH) data collection cum screening application. It facilitates automatic scoring and categorisation of patients by medical practitioners based on the four well-known FH diagnostic criteria used to screen Malaysian patients at risk of FH, namely Dutch Lipid Clinic Network (DLCC), Simon Broome (SB), Japanese FH Management Criteria (JFHMC) and US-Make Early Diagnosis to Prevent Early Deaths (US-MEDPED). The development of FHCatScreen© is motivated by the need to establish a FH diagnostic criterion specific for the Malaysian population. For this purpose, data has to be collected to help medical practitioners understand the concordance and discordance in the data. Also, to learn about the performance and correlation among the four FH diagnostic criteria. The digitalisation of the screening process can help to overcome the shortcomings of the current paper-based method. It resolves issues associated with inefficiencies in form filling, dealing with different and redundant input variables and outcome of each diagnostic criteria, mistakes in the score calculation that leads to incorrect determination of FH severity, and storage and handling of the used forms.
We applied an iterative, participatory, adaptive software development approach comprising planning, development and validation phases to develop the application. Subsequently, in the first of several planned user studies, we involved thirty medical practitioners, clinicians and researchers affiliated with the UiTM Sg. Buloh hospital to evaluate the effectiveness and usability of FHCatScreen©. The study showed that FHCatScreen© was able to provide a more correct, faster and better-informed assessment compared to the traditional paper-based method. The study further showed that FHCatScreen© has a good degree of performance and acceptance by the participants, i.e., around 90% of the participants agreed or strongly agreed on the usefulness, satisfiability and learnability of FHCatScreen©, while a slightly lower 84% of them agreed or strongly agreed on its ease of use. The participants indicated that the simultaneous use of the DLCC, SB, JFHMC and US-MEDPED diagnostic criteria in FHCatScreen© has assisted them to compare the outcome of each of the criteria side-by-side. It allowed corroborative comparison of the results of the different diagnostic criteria to decide on the severity of the patient’s condition with high confidence.
We believe FHCatScreen© can expedite the collection of data on FH incidence and prevalence in Malaysia. Due to its convenience, FHCatScreen© can enhance FH detection by encouraging more FH screening programmes in the community and cascade screening for relatives of index cases. The cloud data-sharing feature of FHCatScreen© cases allows centralised collection of FH data from the screening conducted on patients in hospitals, medical centres and multiple field-testing sites. |