Clinical Utility and Usability of the Digital Box and Block Test: Mixed Methods Study

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Eveline Prochaska - , Institute for Medical Informatics and Biometry, Private University for Health Sciences, Medical Informatics and Technology (Author)
  • Elske Ammenwerth - , Private University for Health Sciences, Medical Informatics and Technology (Author)

Abstract

Background: The Box and Block Test (BBT) is a clinical tool used to measure hand dexterity, which is often used for tracking disease progression or the effectiveness of therapy, particularly benefiting older adults and those with neurological conditions. Digitizing the measurement of hand function may enhance the quality of data collection. We have developed and validated a prototype that digitizes this test, known as the digital BBT (dBBT), which automatically measures time and determines and displays the test result. Objective: This study aimed to investigate the clinical utility and usability of the newly developed dBBT and to collect suggestions for future improvements. Methods: A total of 4 occupational therapists participated in our study. To evaluate the clinical utility, we compared the dBBT to the BBT across dimensions such as acceptance, portability, energy and effort, time, and costs. We observed therapists using the dBBT as a dexterity measurement tool and conducted a quantitative usability questionnaire using the System Usability Scale (SUS), along with a focus group. Evaluative, structured, and qualitative content analysis was used for the qualitative data, whereas quantitative analysis was applied to questionnaire data. The qualitative and quantitative data were merged and analyzed using a convergent mixed methods approach. Results: Overall, the results of the evaluative content analysis suggested that the dBBT had a better clinical utility than the original BBT, with ratings of all collected participant statements for the dBBT being 45% (45/99) equal to, 48% (48/99) better than, and 6% (6/99) lesser than the BBT. Particularly in the subcategories “acceptance,” “time required for evaluation,” and “purchase costs,” the dBBT was rated as being better than the original BBT. The dBBT achieved a mean SUS score of 83 (95% CI 76-96). Additionally, several suggested changes to the system were identified. Conclusions: The study demonstrated an overall positive evaluation of the clinical utility and usability of the dBBT. Valuable insights were gathered for future system iterations. These pioneering results highlight the potential of digitizing hand dexterity assessments.

Details

Original languageEnglish
Article numbere54939
Pages (from-to)e54939
Journal JMIR Rehabilitation and Assistive Technologies
Volume11
Issue number11
Publication statusPublished - 23 May 2024
Peer-reviewedYes

External IDs

Scopus 85196042650
ORCID /0000-0002-7609-1565/work/173055867

Keywords

Research priority areas of TU Dresden

Subject groups, research areas, subject areas according to Destatis

Keywords

  • assessment, dexterity, digital box and block test, digital health, assessment, clinical utility, dBBT, dexterity, digital Box and Block Test, hand dexterity, usability