The added value of the artificial intelligence patient-reported experience measure (AI-PREM tool) in clinical practise: Deployment in a vestibular schwannoma care pathway.

Objectives: Patient-reported experience measures (PREMs) can be used for the improvement of quality of care. In this study, the outcome of an open-ended question PREM combined with computer-assisted analysis is compared to the outcome of a closed-ended PREM questionnaire. Methods: This survey study assessed the outcome of the open-ended questionnaire PREM and a close-ended question PREM of patients with unilateral vestibular schwannoma in a tertiary vestibular schwannoma expert centre. Results: The open-ended questions PREM, consisting of five questions, was completed by 507 participants and resulted in 1508 positive and 171 negative comments, categorised into 27 clusters. The close-ended questions PREM results were mainly positive (overall experience graded as 8/10), but did not identify specific action points. Patients who gave high overall scores (>8) on the close-ended question provided points for improvement in the open-ended question PREM, which would have been missed using the close-ended questions only. Conclusions: Compared to the close-ended question PREM, the open-ended question PREM provides more detailed and specific information about the patient experience in the vestibular schwannoma care pathway. Innovation: Automated analysis of feedback with the open-ended question PREM revealed relevant insights and identified topics for targeted quality improvement, whereas the close-ended PREM did not.

[Clinical history in times of big data; a plea for a standard for the structured recording of the clinical history]. / Anamnese in tijden van big data.

Clinical decision support systems to aid the clinician in making a correct diagnosis will only succeed if data from the clinical history are taken into account. However, currently, very little is known on diagnostic test characteristics of specific symptoms, let alone of a pattern of several symptoms with all their cardinal features. We plead for the nation-wide introduction of a standard for the structured recording of the clinical history. To allow for such structured recording, user interfaces of electronic healthcare records must become far more user-friendly. Furthermore, scribes may be used, or, ideally, a digital scribe, a computer application that records the conversation between healthcare professional and patient and creates an automated summary. So far, to our knowledge, no digital scribe encompassing the entire patient history has been implemented into medical practice. We are currently trying to develop such a digital scribe.