Feasibility and Acceptability of Using an Electronic Patient-Reported Outcome Measure via a Patient Portal in HIV care
Bibliographic record
Abstract
Context: Adherence to antiretrovirals (ART) is essential for people with HIV (PWH), but many face barriers. The I-Score is a new electronic patient-reported outcome measure (ePROM) of ART adherence barriers to be used in HIV care. Objective: To assess the feasibility and acceptability of administering the I-Score on a patient portal. Study Design Analysis: 6-month one-arm implementation pilot study. Setting: A large hospital-based clinic in Montreal, Canada. Population: PWH on ART, speaking French or English, owning a smartphone, willing to use the patient portal, reporting adherence issues. Intervention/Instrument: Patients visited their HIV physician at Time 1 (T1), 3 months (T2), and 6 months (T3). Before visits, they completed the I-Score. After visits, they completed a survey on sociodemographic characteristics (T1), and feasibility and acceptability of the I-Score. Outcome Measures: Feasibility was assessed with consent and retention rates; frequency of technological problems; and the 4-item Feasibility of Intervention Measure (FIM). Acceptability was evaluated with the adapted 6-item Acceptability E-scale for web-based PROMs (AES); and the 4-item Acceptability of Intervention Measure (AIM). We provide descriptive statistics. Results: Out of 34 PWH with identified adherence issues, 32/34 (94%) consented. Average age was 48 years (standard deviation (SD)=15), 12/32 (38%) were women, 19/32 (59%), migrants, and 10/32 (31%) lived below the poverty line. Overall, 26/32 (81%) completed the study, for a total of 78 visits; 4 were lost-to-follow-up and 2 withdrew due to difficulties with technology. During T1, T2, and T3, there were 12/26 (46%), 17/26 (65%), and 16/26 (62%) participants, respectively, reporting no technological problem. Problems met included needing to: remind patients to complete the I-Score before medical visit (15 visits); re-initialize passwords (8); resolve connectivity issues (2); and re-install the patient portal (2). Physicians could not access I-Score results at 4 visits; 10 visits were postponed due to difficulties. Average scores on FIM increased from 17/20 (T1;SD=5), to 18/20 (T2;2), to 19/20 (T3;2). Average AES increased from 24/30 (SD=5), to 26/30 (3), to 27/30 (3). Average AIM scores passed from 16/20 (5), to 18/20 (2), to 17/20 (3). Conclusions: The feasibility and acceptability of using a patient portal to administer the I-Score ePROM was high for vulnerable PWH, but use was challenged by patient literacy and technology.
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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 | 0.034 | 0.055 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 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".