{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T14:48:56Z","timestamp":1785854936805,"version":"3.56.0"},"reference-count":32,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Form Res"],"abstract":"\n Background<\/jats:title>\n Up to half of the children with new-onset type 1 diabetes present to the hospital with diabetic ketoacidosis, a life-threatening condition that can develop because of diagnostic delay. Three-quarters of Australian children visit their general practitioner (GP) the week before presenting to the hospital with diabetic ketoacidosis. Our prototype, DIRECT-T1DM (Decision-Support for Integrated, Real-Time Evaluation and Clinical Treatment of Type 1 Diabetes Mellitus), is an electronic clinical decision support tool that promotes immediate point-of-care testing in general practice to confirm the suspicion of diabetes. This avoids laboratory testing, which has been documented internationally as a cause of diagnostic delay.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n In this investigation, we aimed to pilot and assess the feasibility and acceptability of our prototype to GP end users. We also explored the challenges of diagnosing type 1 diabetes in the Australian general practice context.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n In total, 4 GPs, a pediatric endocrinologist, and a PhD candidate were involved in conceptualizing the DIRECT-T1DM prototype, which was developed at the Department of General Practice and Primary Care at the University of Melbourne. Furthermore, 6 GPs were recruited via convenience sampling to evaluate the tool. The study involved 3 phases: a presimulation interview, simulated clinical scenarios, and a postsimulation interview. The interview guide was developed using the Consolidated Framework for Implementation Research (CFIR) as a guide. All phases of the study were video, audio, and screen recorded. Audio recordings were transcribed by the investigating team. Analysis was carried out using CFIR as the underlying framework.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Major themes were identified among three domains and 7 constructs of the CFIR: (1) outer setting\u2014time pressure, difficulty in diagnosing pediatric type 1 diabetes, and secondary care considerations influenced GPs\u2019 needs regarding DIRECT-T1DM; (2) inner setting\u2014DIRECT-T1DM fits within existing workflows, it has a high relative priority due to its importance in patient safety, and GPs exhibited high tension for change; and (3) innovation\u2014design recommendations included altering coloring to reflect urgency, font style and bolding, specific language, information and guidelines, and inclusion of patient information sheets.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n End-user acceptability of DIRECT-T1DM was high. This was largely due to its implications for patient safety and its \u201creal-time\u201d nature. DIRECT-T1DM may assist in appropriate management of children with new-onset diabetes, which is an uncommon event in general practice, through safety netting.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/60411","type":"journal-article","created":{"date-parts":[[2024,7,6]],"date-time":"2024-07-06T00:46:45Z","timestamp":1720226805000},"page":"e60411","source":"Crossref","is-referenced-by-count":1,"title":["Exploring the User Acceptability and Feasibility of a Clinical Decision Support Tool Designed to Facilitate Timely Diagnosis of New-Onset Type 1 Diabetes in Children: Qualitative Interview Study Among General Practitioners"],"prefix":"10.2196","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-0497-8432","authenticated-orcid":false,"given":"Chiara","family":"Beccia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1268-3166","authenticated-orcid":false,"given":"Barbara","family":"Hunter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2153-3482","authenticated-orcid":false,"given":"Jo-Anne","family":"Manski-Nankervis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8636-239X","authenticated-orcid":false,"given":"Mary","family":"White","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2024,9,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.15081"},{"key":"ref2","first-page":"26","author":"McMorrow, 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Practitioners2024-08-29https:\/\/www.racgp.org.au\/clinical-resources\/clinical-guidelines\/key-racgp-guidelines\/view-all-racgp-guidelines\/emergency-management-of-hyperglycaemia"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-020-0221-y"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1071\/PY22022"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmedinf.2021.104506"},{"key":"ref15","unstructured":"The validitronThe University of Melbourne2024-08-29https:\/\/mdhs.unimelb.edu.au\/digitalhealth\/our-work\/validitron"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmedinf.2017.06.003"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-022-01245-0"},{"key":"ref18","unstructured":"VicREN: Victorian primary care practice-based research and education networkThe University of 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Welfare2024-08-29https:\/\/www.aihw.gov.au\/reports\/primary-health-care\/practice-incentives-program-quality-improvement\/contents\/about"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-015-0088-4"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.1998.tb116013.x"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1186\/s12875-020-01277-9"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1370\/afm.2908"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1002\/edm2.8"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.31128\/AJGP-03-22-6381"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1111\/pedi.13229"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1136\/postgradmedj-2016-134023"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmedinf.2022.104901"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X20926136"}],"container-title":["JMIR Formative 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