%0 Journal Article %@ 2563-6316 %I JMIR Publications %V 3 %N 1 %P e31679 %T Continuous User Experience Monitoring of a Patient-Completed Preoperative Assessment System in the United Kingdom: Cross-sectional Study %A Maramba,Inocencio Daniel %A Chatterjee,Arunangsu %+ Centre for Health Technology, University of Plymouth, Drake Circus, Plymouth, PL4 8AA, United Kingdom, 44 1752 587484, inocencio.maramba@plymouth.ac.uk %K preoperative assessment %K self-completed patient questionnaires %K digital health %K usability %K user experience %K web-based %D 2022 %7 6.1.2022 %9 Original Paper %J JMIRx Med %G English %X Background: Anesthetic preoperative assessment (POA) is now a common part of the surgical care pathway, and guidelines support its routine use. MyPreOp (Ultramed Ltd) is a web-based POA system that enables remote assessments. Usability is a key factor in the success of digital health solutions. Objective: This study aims to assess the usability of the MyPreOp system through patient feedback, investigate the amount of time it took for patients to complete the POA questionnaire and the factors that influenced completion time, and explore the effect on completion times of implementing a validated eHealth usability scale, as compared to using a simple but unvalidated usability evaluation scale, and to test the feasibility of administering a more detailed usability evaluation scale in a staggered manner so as not to unduly increase completion times. Methods: In this cross-sectional study, anonymized data sets were extracted from the MyPreOp system. The participants were adults (aged ≥18 years), scheduled for nonurgent surgical procedures performed in hospitals in the United Kingdom, who gave consent for their anonymized data to be analyzed. Data collected included age, gender, American Society of Anesthesiology (ASA) physical classification status, and completion time. Two user experience evaluations were used: in Phase 1, 2 questions asking about overall experience and ease of use, and in Phase 2, a previously validated usability questionnaire, with its 20 questions equally distributed among 5 succeeding patient cohorts. There were 2593 respondents in total (Phase 1: n=1193; Phase 2: n=1400). The median age of the participants was 46 years, and 1520 (58.62%) of the 2593 respondents were female. End points measured were the median completion times in Phase I and Phase II. The data were collected by extracting a subset of records from the database and exported to a spreadsheet for analysis (Excel, Microsoft Corporation). The data were analyzed for differences in completion times between Phase I and Phase II, as well as for differences between age groups, genders, and ASA classifications. Results: MyPreOp scored well in usability in both phases. In Phase 1, 81.64% (974/1193) of respondents had a good or better experience, and 93.8% (1119/1193) found it easy to use. The usability rating in Phase 2 was 4.13 out of a maximum of 5, indicating high usability. The median completion time was 40.4 minutes. The implementation of the longer usability evaluation scale in Phase 2 did not negatively impact the completion times. Age and ASA physical status were found to be moderately associated with increased completion times. Conclusions: MyPreOp rates high in both user experience and usability. The method of dividing the questionnaire into 5 blocks is valid and does not negatively affect completion times. Further research into the factors affecting completion time is recommended. %M 37725545 %R 10.2196/31679 %U https://med.jmirx.org/2022/1/e31679 %U https://doi.org/10.2196/31679 %U http://www.ncbi.nlm.nih.gov/pubmed/37725545 %0 Journal Article %@ 2563-6316 %I JMIR Publications %V 2 %N 2 %P e25204 %T Use of Spinal Anesthesia in Pediatric Laparoscopic Appendectomies: Case Series %A Hannan,Md Jafrul %A Parveen,Mosammat Kohinnor %A Nandy,Alak %A Hasan,Md Samiul %+ Department of Pediatric Surgery, South Point Hospital, Apt B3, House 72/A, Road 1, Panchlaish, Chittagong, 4100, Bangladesh, 880 1819345305, jafrulhannan@gmail.com %K pediatrics %K appendectomy %K spinal anesthesia %K general anesthesia %K laparoscopy %K vomiting %K keyhole %K surgery %K anesthesia %K appendix %D 2021 %7 28.4.2021 %9 Original Paper %J JMIRx Med %G English %X Background: Owing to the widespread use of general anesthesia, administration of spinal anesthesia in pediatric patients is not widely practiced. Yet there is ample positive evidence demonstrating its safety, effectiveness, and success. Objective: The objective of this study is to compare postoperative patient comfort, length of hospital stay, and cost-effectiveness of pediatric laparoscopic appendectomies performed under spinal and general anesthesia with the usual standard-of-care procedures employed in the hospital. Methods: This is a case series of 77 consecutive pediatric laparoscopic appendectomies (involving 5-8–year-old children) that took place in a hospital in Chittagong, Bangladesh, in 2019. A total of 40 patients underwent spinal anesthesia and 37 patients underwent general anesthesia. Variables such as surgery and operation theater times, pain score, incidence of postsurgery vomiting, analgesic usage, discharge times, and hospital costs were recorded. Statistical analysis was used to analyze the data as a function of anesthesia type. Results: The probability of vomiting when using spinal compared to general anesthesia was lower within the first 5 hours (P<.001) and 6 hours (P=.008) postoperation. A significant difference (P<.001) was observed between the total costs of the two procedures, with spinal anesthesia being less expensive. Patients were more likely to be discharged the same day of the procedure when spinal anesthesia was used (P=.008). Conclusions: Spinal anesthesia has many advantages compared to general anesthesia for pediatric laparoscopic appendectomies. Patient comfort is improved due to a significant decrease in vomiting. This allows for more rapid hospital discharges and substantial cost savings, without compromising the outcome of the procedure. %M 37725540 %R 10.2196/25204 %U https://xmed.jmir.org/2021/2/e25204 %U https://doi.org/10.2196/25204 %U http://www.ncbi.nlm.nih.gov/pubmed/37725540