Page 91 - Shared Guideline Development Experiences in Fertility Care

and accessibility of the wiki [30,44], but may also improve the e ciency of the
wiki and the usefulness of recommendations in being integrated directly into
the CPG. Introducing a motivation page might give patients the opportunity
to add a personal touch to the recommendation. ird, a prioritization system, continuously re ning the similarity between patients’ perspectives and the top5 recommendations (e.g., by rating recommendations a er every contribution),
could improve the tools’ e ciency by avoiding separate prioritization of recommendations and could improve patients’ satisfaction with the highest-rated recommendations. is modality would also allow more exible use by CPG
developers at the time of their choosing. In addition to the suggested modalities,
some known re nements in overall usability (e.g., ndability, prominent log-in
location), content (comprehensiveness of text), and layout of the website might
improve use of the wiki and would be reduced by repeated cycles of design,
evaluation, and redesign [45,46]. Furthermore, a user-centred design, in which
patients codevelop such new modalities, may improve future implementability 4 and provide chances for local adaptation of a redesigned wiki website [47,48].
Both the feasibility of a wiki as a participatory tool for patients in the development of CPGs and the recommendations for future wiki-based initiatives illustrate the value of eHealth. With this in mind, numerous participatory applications based on wikis are conceivable and may be valuable in various elds of research. In the eld of guideline development, guideline-derived initiatives actively involving patients in the development of patient information lea ets or treatment action plans, in addition to fully online-based CPGs, may also bene t from our results. Finally, our results add to the knowledge base about wikis in health care [49].
Limitations
is wiki has been tested in the eld of infertility care, representing a relatively young target group [50]. More than 98% of this group use the Internet [21]. is participant characteristic is associated with more frequent health-related Internet use [51-53]. erefore, the participants in our study were an ideal subgroup for testing and evaluating a wiki-based method, which argues against the generalizability of our ndings to other patient groups. Nevertheless, health- related Internet use in Europe is increasing over time [54]. Hence, it seems to be a question of time until older people or their caregivers, or both, will be using such tools [55]. Furthermore, this feasibility study provided an important exploratory evaluation component, which resulted in valuable information for future studies
Wiki for patient participation
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