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We report on a user needs approach to develop a prototype of a mHealth CDSS for Parkinson\u2019s disease (PD), which is theoretically grounded in the psychological literature about expert decision making and judgement under uncertainty.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A suite of user needs studies was conducted in 4 European countries (Greece, Italy, Slovenia, the UK) prior to the development of PD_Manager, a mHealth-based CDSS designed for Parkinson\u2019s disease, using wireless technology. Study 1 undertook Hierarchical Task Analysis (HTA) including elicitation of user needs, cognitive demands and perceived risks\/benefits (ethical considerations) associated with the proposed CDSS, through structured interviews of prescribing clinicians (<jats:italic>N<\/jats:italic>\u2009=\u200947). Study 2 carried out computational modelling of prescribing clinicians\u2019 (<jats:italic>N<\/jats:italic>\u2009=\u200912) decision strategies based on social judgment theory. Study 3 was a vignette study of prescribing clinicians\u2019 (<jats:italic>N<\/jats:italic>\u2009=\u200918) willingness to change treatment based on either self-reported symptoms data, devices-generated symptoms data or combinations of both.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Study 1 indicated that system development should move away from the traditional silos of \u2018motor\u2019 and \u2018non-motor\u2019 symptom evaluations and suggest that presenting data on symptoms according to goal-based domains would be the most beneficial approach, the most important being patients\u2019 overall Quality of Life (QoL). The computational modelling in Study 2 extrapolated different factor combinations when making judgements about different questions. Study 3 indicated that the clinicians were equally likely to change the care plan based on information about the change in the patient\u2019s condition from the patient\u2019s self-report and the wearable devices.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Based on our approach, we could formulate the following principles of mHealth design: 1) enabling shared decision making between the clinician, patient and the carer; 2) flexibility that accounts for diagnostic and treatment variation among clinicians; 3) monitoring of information integration from multiple sources. Our approach highlighted the central importance of the patient-clinician relationship in clinical decision making and the relevance of theoretical as opposed to algorithm (technology)-based modelling of human judgment.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12911-020-1027-1","type":"journal-article","created":{"date-parts":[[2020,2,19]],"date-time":"2020-02-19T13:03:25Z","timestamp":1582117405000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Designing a mHealth clinical decision support system for Parkinson\u2019s disease: a theoretically grounded user needs approach"],"prefix":"10.1186","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3154-0048","authenticated-orcid":false,"given":"L.","family":"Timotijevic","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. 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However, within the UK, Research & Development approval from the hospital trusts - the two hospitals that allowed access to the clinicians - was obtained. For each study, written Informed Consent was obtained from the participants.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not Applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"34"}}