A237 DEVELOPMENT AND EVALUATION OF A WEB-BASED EDUCATIONAL TOOL FOR THE HEPATOPULMONARY SYNDROME
Bibliographic record
Abstract
Hepatopulmonary syndrome (HPS) is a rare shunting lung disease that is caused by liver disease. This complex disease entails high informational needs for patients and their caregivers. We sought to analyze existing web resources for HPS patients, to assess patients’ and caregivers’ informational needs, and to develop and evaluate a tailored web-based educational resource for this population. We performed a GoogleTM search for existing web-based resources for HPS. We then administered an electronic needs assessment survey to patients with HPS [liver disease, intrapulmonary vascular dilatation (IPVD) and hypoxemia)/pre-HPS (liver disease, IPVD and normal oxygenation) in the Toronto HPS Clinic Database, and their caregivers. In response to these needs, we developed an HPS website, applying best practices in health website design. We administered electronic questionnaires to assess changes in self-efficacy (Likert-scale questions) and knowledge (standardized knowledge test) after website use, website quality (DISCERN score) and usability [System Usability Score (SUS)]. We identified 21 unique HPS websites, with a mean DISCERN score of 19.9 ± 5.2 (out of 45) and Flesch-Kincaid reading grade of 16.8 ± 4.2. We recruited 35 (15 HPS, 5 pre-HPS, 15 caregivers) of 59 (59.3%) eligible participants for the needs assessment. Of these, 27 (77.1%) had searched online for HPS information; 5/27 (18.5%) had found the information they sought and 8/27 (29.6%) had found the information easy to understand. Participant-reported self-efficacy (see Figure) improved after interaction with the website, as did knowledge scores [64.9% ± 16.8 to 72.7% ± 18.5 (n=30; p=0.015)]. A higher SUS score (p=0.048) and lower level of comfort browsing the Internet (p=0.020) predicted improvement in knowledge score in both univariate and multivariable models. The mean DISCERN score for our website was 38.5 ± 4.3 (out of 45); SUS score was 76.6 ± 16.2 (out of 100); and reading grade was 8.3. HPS patients often seek information on the internet, yet existing web resources were few, scored poorly on a validated test of health information quality, and had a reading level far above the 8th grade recommended threshold. A website designed through evidence-based criteria for health educational website design was able to improve self-efficacy and knowledge among patients and caregivers with HPS. The importance of user-centered design is demonstrated by the fact that users with a lower comfort level browsing the Internet were even more likely to experience knowledge gains. All patients/caregivers affected by HPS should be made aware of the availability of this beneficial resource. Figure. Participant Self-Efficacy Pre- and Post-Website Interaction. Responses were entered on a 5-point Likert scale labeled 1 (disagree); 3 (neutral); and 5 (agree). For the purposes of this figure, scores of 1 and 2 were considered “disagree,” and 4 and 5 were considered “agree.” Each bar demonstrates the proportion of participants with each response, for each statement. This includes 30 participants for the pre- and post- assessment (19 patients with hepatopulmonary syndrome and 11 caregivers). None
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.010 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".