Article Text

Download PDFPDF

PO.8.186 SLE-T2T – a digital treat-to-target clinical decision support system for the management of systemic lupus erythematosus patients: development and usability evaluation
  1. A Parra Sanchez1,
  2. MG Grimberg2,
  3. MMA Hanssen2,
  4. MO Aben2,
  5. EE Jairth2,
  6. PS Dhoeme2,
  7. M Tsang-A-Sjoe3,
  8. A Voskuyl3,
  9. JH Leopold4 and
  10. R Van Vollenhoven1
  1. 1Amsterdam UMC, locatie AMC, Amsterdam Rheumatology Center ARC, Department of Rheumatology and Clinical Immunology, Amsterdam, the Netherlands
  2. 2University of Amsterdam, Medical Informatics Bachelor program, Amsterdam, the Netherlands
  3. 3Amsterdam UMC, Locatie VUmc, Amsterdam Rheumatology Center ARC, Department of Rheumatology and Clinical Immunology, Amsterdam, the Netherlands
  4. 4Amsterdam UMC, Locatie AMC, Dept. of Medical Informatics, Amsterdam, the Netherlands


Purpose We aimed to design and develop a first prototype of SLE-T2T, an online clinical decision support system (CDSS) tool, and test its usability for the implementation of a treat-to-target strategy in the management of patients with SLE.

Methods SLE-T2T was conceived as a web-based application with a specific task – to generate appropriate treatment advice based on entered patients data. A general sketch of the program was made, and general consensus was achieved with regards to the desired functionalities. In the development phase, a beta version of SLE-T2T was conceived using a free integrated development environment, and based on Javascript, HTML and CSS. After, the system was hosted temporarily on the website of the Amsterdam Rheumatology & Immunology Center, to be accessible for the participants in evaluation phase. Finally, a System Usability Score Survey (SUS) was chosen as the usability test tool, given its simplicity and advantages; coupled with unstructured feedback collected using the think aloud method to determine whether the CDSS was user-friendly, comprehensible, easy-to-deliver, and workflow-oriented.

Results The SLE-T2T web-based system developed, consisted of: (1) an input scheme with the set of indexes and scores existing for the measurement of SLE disease activity (cSLEDAI-2K, SLEDAI-2K, PGA score) as well as the patients’ medication; (2) a rule-based interface that collects and processes patients data, and (3) an output dashboard with the generated set of recommendations tailored for the patients clinical state and aiming to reach a pre-stablished target of treatment (figure 1). In the interim usability and acceptability evaluation, 7 participants completed the SUS survey. The mean usage time for SLE-T2T was 8 minutes. On a scale of 0 (worst) to 100 (best), the median SUS score of SLE-T2T was 79, categorizing the application as ‘good’ and indicating the need for minor improvements to the design necessary to reach a final version for later implementation in a treat-to-target pilot study.

Conclusions SLE-T2T is the first eHealth tool to be designed for the management of SLE patients in a treat-to-target context. The SUS score and unstructured feedback showed high acceptance of this digital instrument.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.