User-centered design and formative evaluation of a gait dashboard for multidimensional walking assessment in multiple sclerosis
TL;DR
The results indicate that a workflow-anchored, human-centered design approach can yield patient-centered visualizations that are understandable, well accepted, and clinically meaningful, with potential to improve communication of multidimensional gait outcomes in routine care.
Abstract
Digital gait analysis using wearable sensors and instrumented walkways is increasingly implemented in routine care for people with multiple sclerosis. However, multidimensional walking assessments generate longitudinal and heterogeneous outputs that are often presented in fragmented, hard-to-interpret reports, limiting their usefulness for clinical communication and shared decision-making. This study aimed to develop a patient-centered dashboard that integrates multidimensional gait data into a coherent and intuitive overview, to apply a human-centered design process aligned with routine clinical workflows, and to conduct a formative concept evaluation of the dashboard regarding comprehensibility, perceived usability, and perceived usefulness from the perspectives of medical professionals and patients. User requirements were identified through contextual interviews, workflow analysis, persona development, a stakeholder workshop, and a patient survey. Two mid-fidelity dashboard prototypes were iteratively developed and evaluated. The first prototype was assessed by medical professionals (N = 4) using a workshop-based walkthrough, while the revised version was evaluated by patients (N = 24) during clinic visits using a questionnaire following a narrated video walkthrough. Medical professionals rated the information structure, domain-based organization, and longitudinal visualizations positively and provided suggestions for improvement. In the patient evaluation, the revised prototype received high ratings across all assessed dimensions, and most participants (87.5%) preferred it over the previously used visualization, reporting improved understanding of their gait results and health status. However, differences in presentation format (narrated video vs. recall) may have influenced the comparison. Overall, the results indicate that a workflow-anchored, human-centered design approach can yield patient-centered visualizations that are understandable, well accepted, and clinically meaningful, with potential to improve communication of multidimensional gait outcomes in routine care.