{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T04:17:27Z","timestamp":1772597847087,"version":"3.50.1"},"reference-count":29,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T00:00:00Z","timestamp":1680307200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Appl Clin Inform"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Medical data can be difficult to comprehend for patients, but only a limited number of patient-friendly terms and definitions are available to clarify medical concepts. Therefore, we developed an algorithm that generalizes diagnoses to more general concepts that do have patient-friendly terms and definitions in SNOMED CT. We implemented the generalizations, and diagnosis clarifications with synonyms and definitions that were already available, in the problem list of a hospital patient portal.<\/jats:p><jats:p>\n          Objective\u2003We aimed to assess the extent to which the clarifications cover the diagnoses in the problem list, the extent to which clarifications are used and appreciated by patient portal users, and to explore differences in viewing problems and clarifications between subgroups of users and diagnoses.<\/jats:p><jats:p>\n          Methods\u2003We measured the coverage of diagnoses by clarifications, usage of the problem list and the clarifications, and user, patient and diagnosis characteristics with aggregated, routinely available electronic health record and log file data. Additionally, patient portal users provided quantitative and qualitative feedback about the clarification quality.<\/jats:p><jats:p>\n          Results\u2003Of all patient portal users who viewed diagnoses on their problem list (n\u2009=\u20092,660), 89% had one or more diagnoses with clarifications. In addition, 55% of patient portal users viewed the clarifications. Users who rated the clarifications (n\u2009=\u2009108) considered the clarifications to be of good quality on average, with a median rating per patient of 6 (interquartile range: 4\u20137; from 1 very bad to 7 very good). Users commented that they found clarifications to be clear and recognized the clarifications from their own experience, but sometimes also found the clarifications incomplete or disagreed with the diagnosis itself.<\/jats:p><jats:p>\n          Conclusion\u2003This study shows that the clarifications are used and appreciated by patient portal users. Further research and development will be dedicated to the maintenance and further quality improvement of the clarifications.<\/jats:p>","DOI":"10.1055\/a-2067-5310","type":"journal-article","created":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T22:32:45Z","timestamp":1680388365000},"page":"455-464","source":"Crossref","is-referenced-by-count":5,"title":["Evaluation of Patient-Friendly Diagnosis Clarifications in a Hospital Patient Portal"],"prefix":"10.1055","volume":"14","clinical-trial-number":[{"clinical-trial-number":"isrctn59598141","registry":"10.18810\/isrctn"}],"author":[{"given":"Hugo J. T.","family":"van Mens","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands"},{"name":"Amsterdam Public Health, Digital Health, Methodology, Quality of Care, Amsterdam, The Netherlands"},{"name":"Department of Research and Development, ChipSoft B.V., Amsterdam, The Netherlands"}]},{"given":"Gaby E. G.","family":"Hannen","sequence":"additional","affiliation":[{"name":"Department of Implementation and Support, ChipSoft B.V., Amsterdam, The Netherlands"}]},{"given":"Remko","family":"Nienhuis","sequence":"additional","affiliation":[{"name":"Managing Board, Melius Health Informatics, Gouda, The Netherlands"}]},{"given":"Roel J.","family":"Bolt","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Franciscus Gasthuis & Vlietland, Rotterdam and Schiedam, The Netherlands"}]},{"given":"Nicolette F.","family":"de Keizer","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands"},{"name":"Amsterdam Public Health, Digital Health, Methodology, Quality of Care, Amsterdam, The Netherlands"}]},{"given":"Ronald","family":"Cornet","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands"},{"name":"Amsterdam Public Health, Digital Health, Methodology, Quality of Care, Amsterdam, The Netherlands"}]}],"member":"194","published-online":{"date-parts":[[2023,6,21]]},"reference":[{"issue":"06","key":"ref1","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1016\/j.jbi.2012.07.012","article-title":"A classification of errors in lay comprehension of medical documents","volume":"45","author":"A Keselman","year":"2012","journal-title":"J Biomed Inform"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"e148","DOI":"10.2196\/jmir.4255","article-title":"Patient portals and patient engagement: a state of the science review","volume":"17","author":"T Irizarry","year":"2015","journal-title":"J Med Internet Res"},{"issue":"08","key":"ref3","doi-asserted-by":"crossref","first-page":"e27764","DOI":"10.2196\/27764","article-title":"Anticipated benefits and concerns of sharing hospital outpatient visit notes with patients (Open Notes) in Dutch hospitals: mixed methods study","volume":"23","author":"S L Janssen","year":"2021","journal-title":"J Med Internet Res"},{"issue":"11","key":"ref4","doi-asserted-by":"crossref","first-page":"e23851","DOI":"10.2196\/23851","article-title":"The state of evidence in patient portals: umbrella review","volume":"22","author":"M G Antonio","year":"2020","journal-title":"J Med Internet Res"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.pec.2017.07.010","article-title":"The health literacy demands of electronic personal health records (e-PHRs): an integrative review to inform future inclusive research","volume":"101","author":"B Hemsley","year":"2018","journal-title":"Patient Educ Couns"},{"issue":"02","key":"ref6","doi-asserted-by":"crossref","first-page":"446","DOI":"10.4338\/ACI-2015-10-RA-0130","article-title":"Patient experiences using an inpatient personal health record","volume":"7","author":"J Woollen","year":"2016","journal-title":"Appl Clin Inform"},{"issue":"05","key":"ref7","doi-asserted-by":"crossref","first-page":"e26354","DOI":"10.2196\/26354","article-title":"Evaluating the effectiveness of NoteAid in a community hospital setting: randomized trial of electronic health record note comprehension interventions with patients","volume":"23","author":"J P Lalor","year":"2021","journal-title":"J Med Internet Res"},{"key":"ref8","first-page":"846","article-title":"Making texts in electronic health records comprehensible to consumers: a prototype translator","author":"Q Zeng-Treitler","year":"2007","journal-title":"AMIA Annu Symp Proc"},{"key":"ref9","first-page":"366","article-title":"A semantic and syntactic text simplification tool for health content","volume":"2010","author":"S Kandula","year":"2010","journal-title":"AMIA Annu Symp Proc"},{"key":"ref10","first-page":"617","volume-title":"Radiological Text Simplification Using a General Knowledge Base","author":"L Ramadier","year":"2018"},{"issue":"S 10","key":"ref11","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1186\/s12911-020-01286-9","article-title":"Evaluation of lexical clarification by patients reading their clinical notes: a quasi-experimental interview study","volume":"20","author":"H JT van Mens","year":"2020","journal-title":"BMC Med Inform Decis Mak"},{"key":"ref12","first-page":"900","article-title":"Clarifying diagnoses to laymen by employing the SNOMED CT hierarchy","volume":"247","author":"H JT van Mens","year":"2018","journal-title":"Stud Health Technol Inform"},{"key":"ref13","volume-title":"SNOMED CT Patient-Friendly Extension Release","author":"SNOMED CT Netherlands National Release Center","year":"2022"},{"key":"ref14","first-page":"245","article-title":"Inventory of tools for Dutch clinical language processing","volume":"180","author":"R Cornet","year":"2012","journal-title":"Stud Health Technol Inform"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"104071","DOI":"10.1016\/j.jbi.2022.104071","article-title":"Diagnosis clarification by generalization to patient-friendly terms and definitions: validation study","volume":"129","author":"H JT van Mens","year":"2022","journal-title":"J Biomed Inform"},{"key":"ref16","volume-title":"Jaarverslag 2021 (Annual Report)","author":"Franciscus Gasthuis & Vlietland","year":"2021"},{"issue":"03","key":"ref17","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1055\/s-0038-1634079","article-title":"A framework for characterizing terminological systems","volume":"45","author":"R Cornet","year":"2006","journal-title":"Methods Inf Med"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"13","DOI":"10.20982\/tqmp.04.1.p013","article-title":"The Mann-Whitney U: a test for assessing whether two independent samples come from the same distribution","volume":"4","author":"N Nachar","year":"2008","journal-title":"Tutor Quant Methods Psychol"},{"key":"ref19","first-page":"91","article-title":"Algorithm AS 159: an efficient method of generating random R \u00d7 C tables with given row and column totals","volume":"30","author":"W M Patefield","year":"1981","journal-title":"J R Stat Soc Ser C Appl Stat"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1214\/aos\/1013699998","article-title":"The control of the false discovery rate in multiple testing under dependency","volume":"29","author":"Y Benjamini","year":"2001","journal-title":"Ann Stat"},{"issue":"01","key":"ref21","doi-asserted-by":"crossref","first-page":"e10793","DOI":"10.2196\/10793","article-title":"Improving electronic health record note comprehension with NoteAid: randomized trial of electronic health record note comprehension interventions with crowdsourced workers","volume":"21","author":"J P Lalor","year":"2019","journal-title":"J Med Internet Res"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"104109","DOI":"10.1016\/j.ijmedinf.2020.104109","article-title":"Design, development and validation of a system for automatic help to medical text understanding","volume":"138","author":"M Alfano","year":"2020","journal-title":"Int J Med Inform"},{"issue":"06","key":"ref23","doi-asserted-by":"crossref","first-page":"e16670","DOI":"10.2196\/16670","article-title":"Patient perception of plain-language medical notes generated using artificial intelligence software: pilot mixed-methods study","volume":"4","author":"S Bala","year":"2020","journal-title":"JMIR Form Res"},{"issue":"01","key":"ref24","doi-asserted-by":"crossref","first-page":"e26","DOI":"10.2196\/jmir.8669","article-title":"A natural language processing system that links medical terms in electronic health record notes to lay definitions: system development using physician reviews","volume":"20","author":"J Chen","year":"2018","journal-title":"J Med Internet Res"},{"issue":"09","key":"ref25","doi-asserted-by":"crossref","first-page":"2571","DOI":"10.1007\/s11606-020-06432-7","article-title":"Words matter: what do patients find judgmental or offensive in outpatient notes?","volume":"36","author":"L Fern\u00e1ndez","year":"2021","journal-title":"J Gen Intern Med"},{"issue":"03","key":"ref26","first-page":"130","article-title":"Empowering informal caregivers with health information: OpenNotes as a safety strategy","volume":"44","author":"H Chimowitz","year":"2018","journal-title":"Jt Comm J Qual Patient Saf"},{"issue":"04","key":"ref27","doi-asserted-by":"crossref","first-page":"930","DOI":"10.4338\/ACI-2014-07-RA-0057","article-title":"Increasing patient engagement: patients' responses to viewing problem lists online","volume":"5","author":"A Wright","year":"2014","journal-title":"Appl Clin Inform"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"e066720","DOI":"10.1136\/bmj-2021-066720","article-title":"Presenting complaint: use of language that disempowers patients","volume":"377","author":"C Cox","year":"2022","journal-title":"BMJ"},{"key":"ref29","volume-title":"Better explanations for diagnoses in your medical record: use and ratings of an information button to clarify diagnoses in a hospital patient portal","author":"H JT van Mens","year":"2022"}],"container-title":["Applied Clinical Informatics"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2067-5310.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,22]],"date-time":"2023-06-22T05:58:28Z","timestamp":1687413508000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2067-5310"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,1]]},"references-count":29,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2023,5,24]]},"published-print":{"date-parts":[[2023,5]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2067-5310","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1869-0327"],"issn-type":[{"value":"1869-0327","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,4,1]]},"published":{"date-parts":[[2023,4,1]]}}}