The DOI matches its Crossref record; 12 of the 12 references it cites were found in a registry or an index.
Collaborative design of a decision aid for stroke survivors with multimorbidity: a qualitative study in the UK engaging key stakeholders
Abstract
Objectives: Effective secondary stroke prevention strategies are suboptimally used. Novel development of interventions to enable healthcare professionals and stroke survivors to manage risk factors for stroke recurrence are required. We sought to engage key stakeholders in the design and evaluation of an intervention informed by a learning health system approach, to improve risk factor management and secondary prevention for stroke survivors with multimorbidity. Design: Qualitative, including focus groups, semistructured interviews and usability evaluations. Data was audio recorded, transcribed and coded thematically. Participants: Stroke survivors, carers, health and social care professionals, commissioners, policymakers and researchers. Setting: Stroke survivors were recruited from the South London Stroke Register; health and social care professionals through South London general practices and King’s College London (KCL) networks; carers, commissioners, policymakers and researchers through KCL networks. Results: 53 stakeholders in total participated in focus groups, interviews and usability evaluations. Thirty-seven participated in focus groups and interviews, including stroke survivors and carers (n=11), health and social care professionals (n=16), commissioners and policymakers (n=6) and researchers (n=4). Sixteen participated in usability evaluations, including stroke survivors (n=8) and general practitioners (GPs; n=8). Eight themes informed the collaborative design of DOTT (Deciding On Treatments Together), a decision aid integrated with the electronic health record system, to be used in primary care during clinical consultations between the healthcare professional and stroke survivor. DOTT aims to facilitate shared decision-making on personalised treatments leading to improved treatment adherence and risk control. DOTT was found acceptable and usable among stroke survivors and GPs during a series of evaluations. Conclusions: Adopting a user-centred data-driven design approach informed an intervention that is acceptable to users and has the potential to improve patient outcomes. A future feasibility study and subsequent clinical trial will provide evidence of the effectiveness of DOTT in reducing risk of stroke recurrence.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“First, decision making tasks that involved more than one decision outcome (Porat et al., 2019;M. A. Rahman et al., 2021) and corresponding support from the AI agent.”
From Human-AI collaboration is not very collaborative yet: a taxonomy of interaction patterns in AI-assisted decision making from a systematic review (2025) · cites this paper as Porat et al., 2019
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Using thematic analysis in psychology
Braun, V., & Clarke, V. (2006) · Qualitative Research in Psychology · doi:10.1191/1478088706qp063oa · Cited by 194,414
Shared decision making: A model for clinical practice
Elwyn, G., Frosch, D., Thomson, R., Joseph-Williams, N., Lloyd, A., Kinnersley, P., Cording, E., Tomson, D., Dodd, C., Rollnick, S., et al. (2012) · Journal of General Internal Medicine · doi:10.1007/s11606-012-2077-6 · Cited by 4,405 · cited 1×
“32 Furthermore, DOTT evolves from a systematic development process, uses non-technical language and presents information in a balanced manner that allows for comparisons across alternatives.”
Shared decision making — The pinnacle of patient-centered care
Barry, M. J., & Edgman-Levitan, S. (2012) · New England Journal of Medicine · doi:10.1056/nejmp1109283 · Cited by 3,433
Katan, M., & Luft, A. (2018) · Seminars in Neurology · doi:10.1055/s-0038-1649503 · Cited by 2,137 · cited 1×
“IntrODuCtIOn Stroke is the second leading cause of death and a major cause of disability worldwide.(1) In 2015, there were 3.”
The Factor Structure of the System Usability Scale
Lewis, J. R., & Sauro, J. (2009) · Lecture Notes in Computer Science · doi:10.1007/978-3-642-02806-9_12 · Cited by 1,278
Fruit and vegetable consumption and stroke: meta-analysis of cohort studies
He, F. J., Nowson, C. A., & MacGregor, G. A. (2006) · The Lancet · doi:10.1016/s0140-6736(06)68069-0 · Cited by 1,108 · cited 1×
“38–41 5.”
Shared decision making: really putting patients at the centre of healthcare
Stiggelbout, A. M., Weijden, T. V. D., Wit, M. P. T. D., Frosch, D., Legare, F., Montori, V. M., Trevena, L., & Elwyn, G. (2012) · BMJ · doi:10.1136/bmj.e256 · Cited by 1,014
Physical Activity and Reduced Risk of Cardiovascular Events: Potential Mediating Mechanisms
Mora, S., Cook, N., Buring, J. E., Ridker, P. M., & Lee, I.-M. (2007) · Circulation · doi:10.1161/circulationaha.107.729939 · Cited by 1,000
Resisting medicines: a synthesis of qualitative studies of medicine taking
Pound, P., Britten, N., Morgan, M., Yardley, L., Pope, C., Daker-White, G., & Campbell, R. (2005) · Social Science & Medicine · doi:10.1016/j.socscimed.2004.11.063 · Cited by 868
Patient care information systems and health care work: a sociotechnical approach
Berg, M. (1999) · International Journal of Medical Informatics · doi:10.1016/s1386-5056(99)00011-8 · Cited by 786
Adapting clinical guidelines to take account of multimorbidity
Guthrie, B., Payne, K., Alderson, P., McMurdo, M. E. T., & Mercer, S. W. (2012) · BMJ · doi:10.1136/bmj.e6341 · Cited by 530
Redfern, J., Rudd, A. D., Wolfe, C. D. A., & McKevitt, C. (2008) · Patient Education and Counseling · doi:10.1016/j.pec.2008.03.006 · Cited by 34
Self-citation
Research works printed but not linked: 53
- 10.1161/STROKEAHA.110.602615 · DOI · Paper page
- 10.1161/STR.0000000000000024 · DOI · Paper page
- 10.1136/jnnp-2013-306413 · DOI
- 10.1161/STROKEAHA.111.000655 · DOI
- Bridgwood, 2018, Interventions for improving modifiable risk factor control in the secondary prevention of stroke, Cochrane Database Syst Rev, 5, CD009103
- 10.1161/STROKEAHA.114.005713 · DOI
- 10.1136/bmj.38398.500764.8F · DOI · Paper page
- 10.1016/j.dss.2012.09.018 · DOI
- 10.1186/s12916-014-0151-0 · DOI
- Sadler, 2017, Shaping innovations in long-term care for stroke survivors with multimorbidity through stakeholder engagement, PLoS One, 12, 10.1371/journal.pone.0177102 · DOI
- Nwaru, 2017, Can learning health systems help organisations deliver personalised care?, BMC Med, 15, 177, 10.1186/s12916-017-0935-0 · DOI
- 10.1161/CIR.0000000000000480 · DOI
- 10.3399/bjgp16X688417 · DOI
- Califf, 2016, Transforming evidence generation to support health and health care decisions, N Engl J Med, 375, 2395, 10.1056/NEJMsb1610128 · DOI
- 10.1002/ibd.21394 · DOI
- Starks, 2015, Engaging stakeholders to develop a depression management decision support tool in a tribal health system, Qual Life Res, 24, 1097, 10.1007/s11136-014-0810-9 · DOI
- 10.1016/j.pec.2011.02.004 · DOI · Paper page
- 10.1136/bmj.38926.629329.AE · DOI · Paper page
- 10.1046/j.1525-1497.2002.10905.x · DOI · Paper page
- 10.1164/rccm.200906-0907OC · DOI · Paper page
- 10.1136/bmj.318.7189.967 · DOI · Paper page
- 10.3399/bjgp12X656847 · doi:10.3399/bjgp12x656847
- Brooke, 1996, SUS-A quick and dirty usability scale, Usability evaluation in industry, 189, 4
- 10.1136/jnnp.2008.170456 · DOI
- 10.1016/S1474-4422(13)70255-2 · DOI · Paper page
- 10.1001/archneur.56.6.748 · DOI
- 10.1136/bmj.303.6805.744 · DOI
- Marshall, 2018, ’People like you?': how people with hypertension make sense of future cardiovascular risk-a qualitative study, BMJ Open, 8, 10.1136/bmjopen-2018-023726 · doi:10.1136/bmjopen-2018-023726
- 10.1136/bmj.e3953 · DOI · Paper page
- Porat, 2018, Engaging stakeholders in the design and usability evaluation of a decision aid to improve secondary stroke prevention, Stud Health Technol Inform, 247, 765
- 10.3399/bjgp15X683953 · DOI
- Kaiser, 2015, Development of a shared decision-making tool to assist patients and clinicians with decisions on oral anticoagulant treatment for atrial fibrillation, Curr Med Res Opin, 31, 2261, 10.1185/03007995.2015.1096767 · DOI
- 10.1136/bmj.e3996 · DOI
- 10.1007/s11606-011-1810-x · DOI · Paper page
- Kenning, 2013, Primary care practitioner and patient understanding of the concepts of multimorbidity and self-management: A qualitative study, SAGE Open Med, 1, 205031211351000, 10.1177/2050312113510001 · DOI
- 10.1080/108107399126904 · DOI
- 10.1097/HJR.0b013e328337ccd3 · DOI
- Powers, 2008, Perceived and actual stroke risk among men with hypertension, J Clin Hypertens, 10, 287, 10.1111/j.1751-7176.2008.07797.x · DOI
- 10.1037//0278-6133.3.5.431 · doi:10.1037//0278-6133.3.5.431 · Paper page
- Petr, 2014, Perceived lifetime risk for cardiovascular disease (from the Dallas Heart Study), Am J Cardiol, 114, 53, 10.1016/j.amjcard.2014.04.006 · DOI
- Kowall, 2017, Perceived risk of diabetes seriously underestimates actual diabetes risk: The KORA FF4 study, PLoS One, 12, 10.1371/journal.pone.0171152 · DOI
- 10.1007/BF00845372 · DOI · Paper page
- 10.1037/0278-6133.14.1.56 · DOI · Paper page
- 10.1258/hsmr.2008.008001 · DOI
- 10.1186/1471-2296-14-133 · DOI
- 10.1097/00006842-200007000-00001 · DOI · Paper page
- 10.1161/STROKEAHA.110.598839 · DOI · Paper page
- 10.1002/jae.596 · DOI
- 10.1097/MLR.0b013e31819a5acc · DOI · Paper page
- 10.1016/j.pec.2008.07.024 · DOI
- 10.1136/bmj.j1744 · DOI · Paper page
- Balatsoukas P , Porat T , Sassoon I , et al . User involvement in the design of a data-driven self-management decision support tool for stroke survivors. 18th IEEE International Conference on Smart Technologies:EUROCON, 2019. · DOI
- 10.1186/s12911-017-0477-6 · DOI
Cited by
Gomez, C., Cho, S. M., Ke, S., Huang, C.-M., & Unberath, M. (2025) · Frontiers in Computer Science · doi:10.3389/fcomp.2024.1521066 · Cited by 209
Metadata
- Authors
- Porat, T., Marshall, I. J., Sadler, E., Vadillo, M. A., McKevitt, C., Wolfe, C. D. A., & Curcin, V.
- Affiliations
- Dyson School of Design Engineering, Imperial College London, London, UK
- School of Population Health and Environmental Sciences, King’s College London, London, UK
- School of Health Sciences, University of Southampton, UK
- Departamento de Psicología Básica, Universidad Autónoma de Madrid, Madrid, Spain
- Venue
- BMJ Open
- Publisher
- BMJ
- Published
- 2019-08
- Volume
- 9
- Issue
- 8
- Pages
- e030385
- ISSN
- 2044-6055
- Cited by
- 27
- References
- 12
- Language
- en
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
Data sources
Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
