Design and usability testing of a home digital management and mobile smart wellness platform for patients with benign prostatic hyperplasia

Design and usability testing of a home digital management and mobile smart wellness platform for patients with benign prostatic hyperplasia | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Design and usability testing of a home digital management and mobile smart wellness platform for patients with benign prostatic hyperplasia Miaoqing Cai, Jiamei Wang, Wen Zhou, Sudan Zeng, Qiangqiang Cheng, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6387693/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective: This study aimed to develop a Digital Urologic Home Care platform and assess its usability for self-management among patients with benign prostatic hyperplasia (BPH). Methods: Participants, including patients and medical staff, were selected through purposive sampling from a tertiary hospital in Guizhou Province. The investigator provided instructions for using the platform, which required participants to continuously log urination patterns, fluid intake, symptom self-assessments, access a disease information database, and engage in remote communication. Following a three-day usage period, the platform's feasibility was evaluated based on effectiveness, efficiency, and subjective satisfaction. Additionally, semi-structured interviews were conducted to gather participants' experiences and feedback, facilitating further adjustments to the platform's content. Results: The study included three healthcare professionals and two patients, aged 24 to 55 years. The System Usability Scale (SUS) yielded an average satisfaction score of 82.8 (SD = 9.7), while the human-computer interface usability questionnaire produced an average score of 70.0 (SD = 8.5), indicating a high level of participant satisfaction with the platform. Conclusion: This platform realizes automatic tracking and analysis of drinking water and urination, enabling continuous analysis and personalization of patients' urination data, patients' mastery of preliminary self-judgment of the degree of the disease and related knowledge, and the realization of remote communication between doctors and patients, which can realize self-monitoring and home digital management of BPH patients after later debugging and updating. Benign rostatic hyperplasia Voiding diary Usability testing Digital management Digital urology Figures Figure 1 Figure 2 Introduction Benign Prostatic Hyperplasia The prostate is the largest substantial organ in the male genital parasympathetic glands, which grows and develops during three periods: fetal period, puberty, and middle age to old age. Benign prostatic hyperplasia (BPH), also known as prostatic hypertrophy, is a disease in which prostate enlargement is caused by hyperplasia of the stromal cells in the migratory zone of the prostate gland, which in turn compresses the bladder and urethra, resulting in a restriction of the flow of urine[1].The prevalence of BPH increases with age, with one study showing a prevalence of 50% in men between the ages of 50 and 60, rising to 80% between the ages of 50 and 70[2, 3].The pathophysiology of BPH is closely related to hormonal changes, especially the effects of androgens such as testosterone and dihydrotestosterone (DHT) on prostate tissue[4].At present, BPH has become the most common benign disease of urinary disorders in middle-aged and old-aged men, which seriously affects the life of patients, and its main manifestation is the anatomical and histological enlargement of the prostate gland (PV) with bladder outlet obstruction and lower urinary tract symptoms (LUTS), including urinary frequency, urgency, dysuria, and hesitancy, etc. The symptoms cause great life distress and psychological pressure to patients and their families. LUTS include frequent urination, urgency, dysuria and hesitancy, etc., which bring great disturbances and psychological pressure to patients and their families[5, 6].The comprehensive evaluation of LUTS in BPH is usually a history assessment, a Bladder Diaries (BD), and an assessment of urinary flow rate, with the voiding diary being the most critical[7]. BD is a non-invasive, prospective assessment tool in which patients record their voiding patterns and symptoms over a specific time period[8].BD can accurately reflect the severity of the disease and assist physicians in formulating a treatment plan as well as evaluating the efficacy of treatment[9].The current BD mainly relies on paper handwriting, but there are obvious shortcomings: for patients, the cumbersome recording process reduces patient compliance, if the failure to record in a timely manner leads to omission or later recall bias when making up the record, unable to ensure the continuity of the data, and the paper version is easy to be damaged or lost; for healthcare workers: manually counting and analyzing a large amount of paper data is time-consuming and prone to error, the burden of data processing is heavy, and the reliability of paper records is not high when the data are disputed. The reliability of paper records is not high in case of disputes [10, 11].Therefore, in order to ensure that voiding diaries can accurately record patients' urination, it is crucial to require timely, accurate, and convenient voiding diary devices for patients [12]. With the advent of the digital era and the influence of COVID-19 in recent years, the era of telemedicine has been initiated on a large scale[13, 14].Telemedicine is the provision of remote treatment, counseling and evaluation of patients through various types of mobile communication devices, not only that, telemedicine also includes remote care, health education and data collection and management [15].The European Association of Urology (EAU) in its guidelines for men with LUTS suggests that telemedicine and care can be used to monitor LUTS symptoms, including symptom scores and bladder diaries to record, detect and self-assess symptoms [16]. Therefore, this study designs and tests the feasibility of a smart mobile device-based patient intelligence management system (Digital Urologic Home Care platform) that integrates recording and storing data, symptom self-assessment, and knowledge learning to help patients achieve data continuity, increase disease awareness, and reduce healthcare worker time and errors to improve clinical outcomes. Digital Urologic Home Care platform The Digital Urologic Home Care Platform was developed by an external organization with experience in medical technology in conjunction with two caregivers. Operating Side The program consists of three operating terminals: the background control terminal, the medical and nursing operating terminal, and the patient input terminal (Figure 1) (1) Background control terminal: background operators are divided into senior administrators and junior administrators, senior administrators can carry out patient authentication, configuration and modification of various types of fields, knowledge push, remote information exchange, patient data export and modification of the background operation section, etc. Junior administrators can only view the data information and do not have the authority to modify the operation. (2) Medical and nursing operation terminal: Medical and nursing personnel can confirm and categorize patient information in the management platform, visualize and manage patient indicators, and communicate with patients remotely to clarify changes in patient conditions and give professional guidance. (3) Patient input terminal: patients can record their daily urination and water intake, and the relevant data will be stored in the background and can be viewed at any time; set up a questionnaire for relevant disease symptoms, so that patients can self-test at any time and get a preliminary understanding of their own disease; set up a database of information about the disease for knowledge learning; and finally, an online communication platform for communicating with doctors. Introduction to the Section There are five major sections: urination record, drinking water record, symptom management, disease information database, and remote communication (Fig. 2 ). (1) Urination section: set up urination conditions such as number of times, time, volume, incontinence and accompanying status, etc., which will be stored in the background after being recorded by the patient. (2) Drinking water section: set the amount of explicit drinking water (water, drinks, soups, etc.) and non-explicit drinking water (fruits, vegetables, etc.), which are stored in the background after being recorded by patients. (3) Symptom management: incorporating the International Prostate Symptom Score (IPSS) and the International Erectile Function Questionnaire-5 (IIEF-5), patients can self-monitor their prostate symptoms and sexual function at any time, and make initial self-judgment of their condition. (4) Disease Information Library: Publicize the knowledge of BPH through pictures and words in diversified forms, including etiology, clinical manifestations, lifestyle and postoperative rehabilitation guidance. (5) Remote communication:The platform can realize barrier-free communication between patients and medical staff, provide patients with treatment plans and health guidance in a timely manner, improve the efficiency of discharge follow-up, reduce patients' time and economic burden, provide patients with more convenient self-health management methods, use text to communicate with patients, enhance patients' satisfaction with medical work, and enhance patients' ability to manage symptoms at home. The Need and Purpose of Usability Testing Usability testing not only improves user satisfaction and loyalty, but also optimizes product design, improves operational efficiency, increases user engagement, and reduces human and financial costs[ 17 ].So the aim of this study is to explore the usability of Digital Urologic Home Care platform platform. MATERIALS AND METHODS Study Design Evaluation criteria using ISO 9241.11 International Organization for Standardization definition of usability[45]: The effectiveness, high efficiency and subjective satisfaction of a product in a specific use environment for a specific use by a specific research subject: effectiveness: task completion; high efficiency: completion time; subjective satisfaction: user satisfaction. This study is qualitative in nature, participants used the platform for 3 days, and the end of the cycle used a usability questionnaire to conduct usability analysis, followed by semi-structured interviews to express user experience and feedback. Participants Sample size: According to a Nielsen study, five evaluators can detect 75% of usability problems[ 18 ].The sample size of this study was determined by information saturation, and ultimately 3 patients and 2 healthcare professionals participated in this phase of the study (Table 1 )[ 19 , 20 ]. Table 1 Demographics Demographics n=5 n (%) Age (years) 20–40 3(60) 40–60 1(20) >60 1(20) Gender Male 3(60) Female 2(40) Marital status Married/common-law 2(40) Single 3(60) Highest education level High school 1(20) College 1(20) Undergraduate degree 3(60) Current employment status Full-time 3(60) Disability/leave of absence 0(0) Unemployed 0(0) Retired 2(40) Computer and Internet usage Do you use Internet at home? Yes 5(100) No 0(0) How many hours do you spend online every day༟ ≤ 3 0(0) >3 5(100) Do you use an Internet platform or program to record your experience༟ Yes 3(60) No 2(40) How comfortable are you with using the Internet? Very satisfie 3(60) average 2(40) dissatisfied 0(0) Procedure Ethical approval for this study was obtained from the hospital ethics committee. After participants signed the informed consent form, they scanned the QR code to enter the trial version of the platform and followed the prompts to register and sign the platform informed consent form. After registration, patients fill in basic information such as age, gender, contact information, and disease conditions. Once the patient registers and enters the information, a specific binding code is generated, which allows investigators to use the data captured by the Digital Urologic Home Care platform in a specific scientific project, and the program can be used after passing the audit. The main sections of the platform are urination diary, drinking water diary, scale self-measurement, health education, remote communication, which can realize electronic BD recording, analysis, storage and realize real-time communication and exchange of knowledge and messages. The experimental period was 3 days, and usability was analyzed in terms of effectiveness, efficiency, and subjective patient satisfaction, and one researcher acted as an assistant to record any problems participants might encounter during the task and assist in solving them. Finally, the research team set up a semi-structured interview outline:①How do you feel about using the BPH Smart Platform for self-management of LUTS symptoms?②Do you think there are deficiencies in the platform's operational functions? How do you suggest to modify it?③Do you think the existing interface presentation (reasonable) meets your usage habits? Why?④Do you have any problem with the operation of the platform? If yes, where?⑤Would you recommend other participants to use this platform for self-management of LUTS symptoms? What are the reasons? One-on-one semi-structured interviews were conducted with the participants to express user experience and feedback, and the interviews were recorded with a tape recorder, then transcribed verbatim, and then transcribed verbatim for analysis. Data Analysis Quantitative data: descriptive analysis was used, while measures were expressed as X ± S, and counts were presented as number of cases and percentages. Qualitative data: Colaizzi (Thematic analysis) was used to analyze the participants' usability problems and objectivity was maintained during the analysis. RESULTS 1. Effectiveness: 5 participants took the entire test and completed all test components (Table 2). Table 2 Mandate completion rate Entry Urination Diary Drinking Diary Health Education Scale Self-Test Telecommu-nication Participants 5 5 5 5 5 Completion rate(%) 100% 100% 100% 100% 100% 2. High efficiency: Participants recorded the Mean Time(MT) to complete each test component, with the Maximum Duration(Max D), and Minimum Duration(Min D) units in seconds (/s)(Table 3). (3) Subjective patient satisfaction: at the end of the test, patients filled out the System Usability Scale (SUS) and Human-Machine Exchange Interface Usability Questionnaire and underwent a semi-structured interview. The SUS questionnaire contains 10 entries and 3 dimensions with a Cronbach's alpha coefficient of 0.84, and a KMO value of 0.879. The system ranges from 0 to 100: 90 is very satisfied. The total score of this SUS was 82.8 (9.7), and the results indicated that the participants were satisfied with the website. The results of the Human-Machine Exchange Interface Usability Questionnaire usability questionnaire, which includes 5 dimensions of functionality, ease of learning, high efficiency, interactive experience and satisfaction, with 20 entries and a total score of 0-100. <The total score is 0-100. <50 indicates that the feasibility of the system or product is unacceptable; 50–70 indicates that the feasibility of the system or product is average; ≥70 indicates that the feasibility of the system or product is satisfactory. The total score of this questionnaire was 70.0 (8.5), indicating that participants considered the system or product feasibility satisfactory. User Experience and Feedback The researcher conducted one-on-one semi-structured interviews with the participants, and through Colaizzi data analysis, six themes were distilled from the results of the interviews: improved knowledge and confidence, professionalism and convenience together, help with initial self-judgment of illness, high ease of use of the platform, recognition and recommendation, and suggestions for platform improvement. (1)Improved knowledge and confidence: participants generally felt that the platform contained comprehensive content that provided basic knowledge about BPH. M1: “It's rich in accompanying pictures, so you can't help but click on it and learn by clicking on it.”M5: “I've had the disease for 13 years and I've never really known about it, and by using it I can learn about the causes and onset of BPH, which can help improve my confidence in treatment and surgery.” (2)Professionalism and convenience: Participants generally reflected that using the platform for BD recording was more professional and convenient than the traditional paper version. M1: “My previous paper-based BD was easy to miss and especially easy to lose, this platform can record and save for a long time just by clicking in.”M2: “The platform is very friendly to newbies, and it is also more convenient to check the recorded data.”M3: “The platform is characterized by data continuity, which is conducive to reducing the calculation and workload of medical staff.”M5: “The platform enables remote communication between doctors and reduces the number of trips to the hospital.” (3)Helping with initial self-judgment of disease: Participants felt that the platform could help patients to have an initial understanding of their disease progression, which would facilitate the next step of management. M1:“One of my favorite features is that there is a scale symptom self-assessment……, It's very convenient.” M5:“That part of the symptom self-assessment, you can take the test at any time and the score comes out immediately.” (4)High ease of use of the platform:Participants reflected that the platform has a clear interface, reasonable structure, convenient operation and easy to use. M2: “It's very much in line with (one's own usage habits), it has diagrams and text prompts very much in line with me ……, you're not sure where to go from (click), you can find it according to the text and the pictures.” M4: “It has a clearer interface……, You can directly know what you want to do, what you want to see, and then it is in which section you can directly find.”M5: “This interface design is just very simple, and then the division of functional areas is also very detailed.” (5)Recognition and recommendation: participants generally recognized the platform patient and healthcare provider needs and would recommend it to others because it provides data continuity records and high quality knowledge. M3:“I will, the clinical work is busy, this platform record data, can ensure that the data is true, to avoid affecting our clinical judgment, save time, convenient for everyone ……”;M4:“Many patients visit the clinic, ask the urination situation, the patient's answer is very vague, or even wrong, this platform will be able to view the patient's urination and other conditions directly from the medical and nursing end, to avoid errors, so …… I would recommend it.” M5: “I previously recorded my own urination is to remember on paper, it is very troublesome and often forget, this he will send me tips every day, I will record ……” (6)Platform Improvement Suggestions: The platform as a whole is better, the account part of the font is smaller and in a single form and the picture is more fuzzy, the scale self-assessment section has no prompts, and the information on the communication end of the doctor and patient is not notified in a timely manner, etc., which needs to be further improved. M1:“The font in the part of urination situation is a bit small, and every one of them has to be entered manually, which is a bit of a waste of time ……, and in the place of popularizing knowledge, the picture of the causes of prostate hyperplasia is blurred.” M5: “The result of the scale self-assessment is only a score, there is no severity or recommendation.” M3: “Sometimes patients send me messages, will not receive tips.” Modification: According to the result of usability analysis, the platform is improved and modified as follows: (1)Fonts: Adjust some of the smaller fonts, unify the size, and set personalized fonts to meet the needs of various types of users. (2)Pictures: Upgrade the clarity of pictures. (3)Options: set up a variety of option types such as: linear scrolling, single choice, multiple choice, fill in the blanks, input, etc., to enrich the form. (4)Scale self-assessment section: automatically display scores, results and related suggestions after users fill out the scale. (5)Remote communication: set up enhanced message alert frequency, for untimely response to the message, it will be pushed repeatedly in the message box. CONCLUSION Principal Findings In this study, we designed and developed a BPH Wisdom Platform, known as the Digital Urinary Home Care Platform, based on the needs of BPH patients and the traditional voiding diary. We conducted a usability analysis focusing on effectiveness, efficiency, and patient satisfaction, which demonstrated that the platform possesses a high degree of usability and utility in practical applications. To further explore and optimize the user experience, we conducted semi-structured interviews with users. These interviews provided direct feedback on various platform functions and allowed us to identify and summarize specific challenges and areas for improvement.In response to the identified user experience barriers, we undertook an iterative process to enhance the platform. Ultimately, following a series of usability evaluations and corrective measures, the platform exhibited considerable potential as an effective tool for the self-management of patients with Benign Prostatic Hyperplasia (BPH). This underscores the platform's feasibility for application in real-world healthcare management scenarios and offers a valuable reference framework and practical insights for the development and optimization of similar smart healthcare platforms in the future. Limitations Several limitations must be acknowledged. Firstly, while this study confirmed the usability and potential of the Benign Prostatic Hyperplasia Smart Platform (Digital Urinary Home Care platform) for BPH patients, it did not quantify the impact of the platform's functional properties on improving clinical symptoms and self-management behaviors. Secondly, factors such as patient age, education level, geographic region, and individual differences may limit the self-management capabilities of users. Therefore, enhancing patient guidance and education is recommended for future iterations. Lastly, this study did not conduct an applicability analysis, which should be addressed in subsequent research. Conclusions Internet-based self-management is becoming more and more common as a way of adjuvant medical treatment to manage complex diseases. In this study, we developed and found evidence to support the availability of a smart platform for benign prostatic hyperplasia (Digital Urinary Home Care platform) . Declarations Ethics approval and consent to participate: The study was approved by the Institutional Ethics Committee of Guiyang No. 2 People's Hospital（JYYY-2025-WZ-07）and was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. All patients provided written informed consent. Consent for publication: Consent for publication was obtained from the participants. Availability of data and materials: The data that support the findings of this study are available from the corresponding author upon reasonable request. Competing Interests: The author(s) declared no potential conflicts o f interest with respect to the research, author- ship, and/or publication of this article. Funding: This study received the Science and Technology Fund project of Guizhou Provincial Health Commission (gzwjkj2021-141); Guizhou High-level innovative Talent selection and Training Program Project (Guizhou Committee leader issued [2022] No. 3; Support of Chuke Contract -GCC[2022] No. 16). Authors' contributions: Miaoqing Cai (First Author): Conceptualization, Data Curation, Fommal Analysis，Investigation,Methodology,Sofware，Writing-Original Draft，Writing-Review & Editing: Jiamei Wang（co-author).Wen Zhou . Sudan Zeng. Qiangqiang Cheng.Huan Wang.Beibei Yan：ethodology,Supervision，Data Curation. Aobing Mei(Corresponding Author):Conceptualization, Funding cquisition.Resources, Supervision, Validation, Writing-Original Draft, Writing-Review &Editing. Mei Chen:Supervision.Validation,Funding Acquisition Wei Wang: Data Curation.Investigation,Funding Acquisition Acknowledgements: Not applicable. Clinical Trial Number: Not applicable. Data availability' on the system ： The data are available from the corresponding author upon reasonable request."，contact［ [email protected] ］ for access." "The data are not publicly available due to privacy/ethical restrictions. References Holst, B.S. and S. Nilsson, Age, weight and circulating concentrations of total testosterone are associated with the relative prostatic size in adult intact male dogs. Theriogenology, 2023. 198: p. 356-360. Berry, S.J., et al., The development of human benign prostatic hyperplasia with age. J Urol, 1984. 132(3): p. 474-9. Taoka, R. and Y. Kakehi, The influence of asymptomatic inflammatory prostatitis on the onset and progression of lower urinary tract symptoms in men with histologic benign prostatic hyperplasia. Asian J Urol, 2017. 4(3): p. 158-163. Elbaz, E.M., et al., Immunomodulatory effect of diallyl sulfide on experimentally-induced benign prostate hyperplasia via the suppression of CD4+T/IL-17 and TGF-beta1/ERK pathways. Inflammopharmacology, 2020. 28(5): p. 1407-1420. Djavan, B., Lower urinary tract symptoms/benign prostatic hyperplasia: fast control of the patient's quality of life. Urology, 2003. 62(3 Suppl 1): p. 6-14. Chiang, B.J., H.C. Kuo and C.H. Liao, Can Botulinum Toxin A Still Have a Role in Treatment of Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia Through Inhibition of Chronic Prostatic Inflammation? Toxins (Basel), 2019. 11(9). Rosier, P., et al., International Continence Society Good Urodynamic Practices and Terms 2016: Urodynamics, uroflowmetry, cystometry, and pressure-flow study. Neurourol Urodyn, 2017. 36(5): p. 1243-1260. Liapis, I., et al., Can we increase the value of data from bladder diaries? International Consultation on Incontinence-Research Society 2023. Neurourol Urodyn, 2024. 43(6): p. 1311-1320. Cameron, A.P., et al., Are three-day voiding diaries feasible and reliable? Results from the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) cohort. Neurourol Urodyn, 2019. 38(8): p. 2185-2193. Kim, J.K., et al., A Novel Acoustic Uroflowmetry-Based Mobile App Voiding Diary: Comparison with Conventional Paper-Based Voiding Diary. Biomed Res Int, 2022. 2022: p. 3390338. Aydin, S., M. Yasli and A. Kunt, Development of urinary diary mobile application and evaluation in patients with urinary incontinence. Urologia, 2024. 91(2): p. 419-425. Mangera, A., et al., Development of two electronic bladder diaries: a patient and healthcare professionals pilot study. Neurourol Urodyn, 2014. 33(7): p. 1101-9. Meng, G., et al., Factors That Influence Patient Satisfaction With the Service Quality of Home-Based Teleconsultation During the COVID-19 Pandemic: Cross-Sectional Survey Study. JMIR Cardio, 2024. 8: p. e51439. Simonato, A., et al., Clinical pathways for urology patients during the COVID-19 pandemic. Minerva Urol Nefrol, 2020. 72(3): p. 376-383. Ting, C.Y., et al., The use of a multi-disciplinary geriatric telemedicine service (TELEG) and its acceptance at a tertiary care centre in Malaysia. BMC Geriatr, 2024. 24(1): p. 133. Ribal, M.J., et al., European Association of Urology Guidelines Office Rapid Reaction Group: An Organisation-wide Collaborative Effort to Adapt the European Association of Urology Guidelines Recommendations to the Coronavirus Disease 2019 Era. Eur Urol, 2020. 78(1): p. 21-28. Pauly, T., et al., Using Wearables to Study Biopsychosocial Dynamics in Couples Who Cope With a Chronic Health Condition: Ambulatory Assessment Study. JMIR Mhealth Uhealth, 2024. 12: p. e49576. Nielsen, J., Estimating the number of subjects needed for a thinking aloud test. International Journal of Human-Computer Studies, 1994. 41(3): p. 385-397. Malterud, K., V.D. Siersma and A.D. Guassora, Sample Size in Qualitative Interview Studies: Guided by Information Power. Qual Health Res, 2016. 26(13): p. 1753-1760. Morse, J., The significance of saturation," Qualitative Health Research, (5), . 1995. Additional Declarations No competing interests reported. Supplementary Files file.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6387693","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":456498787,"identity":"8d6ab08c-e148-4d58-a482-630c71780d3e","order_by":0,"name":"Miaoqing Cai","email":"","orcid":"","institution":"Guizhou University of Traditional Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"Miaoqing","middleName":"","lastName":"Cai","suffix":""},{"id":456498788,"identity":"00c59bde-25a4-493d-8e82-b511649b2d0f","order_by":1,"name":"Jiamei Wang","email":"","orcid":"","institution":"Guizhou University of Traditional Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"Jiamei","middleName":"","lastName":"Wang","suffix":""},{"id":456498789,"identity":"2d207358-dc69-41cf-bf9e-ad16279042d2","order_by":2,"name":"Wen Zhou","email":"","orcid":"","institution":"Guizhou Medical University","correspondingAuthor":false,"prefix":"","firstName":"Wen","middleName":"","lastName":"Zhou","suffix":""},{"id":456498790,"identity":"2850a517-d94a-4c50-82ae-b9b4de56b1cf","order_by":3,"name":"Sudan Zeng","email":"","orcid":"","institution":"Guizhou Medical University","correspondingAuthor":false,"prefix":"","firstName":"Sudan","middleName":"","lastName":"Zeng","suffix":""},{"id":456498791,"identity":"2f84a1d9-49c8-4e1b-a3e5-b6b27169747a","order_by":4,"name":"Qiangqiang Cheng","email":"","orcid":"","institution":"Guizhou University of Traditional Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"Qiangqiang","middleName":"","lastName":"Cheng","suffix":""},{"id":456498792,"identity":"5ad8e631-fcf7-4882-b7cd-1ded99651572","order_by":5,"name":"Huan Wang","email":"","orcid":"","institution":"Guizhou University of Traditional Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"Huan","middleName":"","lastName":"Wang","suffix":""},{"id":456498793,"identity":"ae45cdf6-f563-49ee-a65c-42957fb11185","order_by":6,"name":"Beibei Yan","email":"","orcid":"","institution":"Shenzhen Yorktal Digital Medical Imaging Technology Co","correspondingAuthor":false,"prefix":"","firstName":"Beibei","middleName":"","lastName":"Yan","suffix":""},{"id":456498794,"identity":"05a9820c-3de0-495c-8f05-ecafd8992b29","order_by":7,"name":"Wei Wang","email":"","orcid":"","institution":"Guizhou Medical University, The Second People's Hospital of Guiyang","correspondingAuthor":false,"prefix":"","firstName":"Wei","middleName":"","lastName":"Wang","suffix":""},{"id":456498795,"identity":"dd6e0c98-fdec-493e-8386-8d484d7384d8","order_by":8,"name":"Mei Chen","email":"","orcid":"","institution":"Guizhou Medical University, The Second People's Hospital of Guiyang","correspondingAuthor":false,"prefix":"","firstName":"Mei","middleName":"","lastName":"Chen","suffix":""},{"id":456498796,"identity":"f668d0e2-639f-456a-9c64-a601582c2f13","order_by":9,"name":"Aobing Mei","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAxUlEQVRIiWNgGAWjYFACxgYgkmBgYG9sfPiBNC08h5uNJUixiIFBIr1NgIcY1brtzY0fPu6wyJOPfNjGIMFgJ6fbQECL2ZmDzZIzz0gUG95ObHtQwJBsbHaAkJYbiQ3SvG0SiRtnJ7YbSDAcSNxGUMv9h82/wVpmHmyT4CFKyw3GNrAt8yUYidVyJrHNEuiXxA08icBANiDGL8ePP77xcUdd4vz24w8ffqiwkyOoBQ4MwCoNiFUOAvINpKgeBaNgFIyCEQUAWBxH44rNNowAAAAASUVORK5CYII=","orcid":"","institution":"Guizhou Medical University, The Second People's Hospital of Guiyang","correspondingAuthor":true,"prefix":"","firstName":"Aobing","middleName":"","lastName":"Mei","suffix":""}],"badges":[],"createdAt":"2025-04-06 15:53:10","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6387693/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6387693/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":83023622,"identity":"0dad79ee-a8d2-40ae-99c6-a26e6cd6a20d","added_by":"auto","created_at":"2025-05-19 07:56:57","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":114342,"visible":true,"origin":"","legend":"\u003cp\u003eThe relationship between the three operating segments of the digital urology home care platform\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-6387693/v1/60527ef4650394b55e0c0ab7.png"},{"id":83023624,"identity":"4d5e8dda-d54f-447c-b8be-31f7553616a0","added_by":"auto","created_at":"2025-05-19 07:56:58","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":291063,"visible":true,"origin":"","legend":"\u003cp\u003eDemonstration of digital urologic home care platforml section\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-6387693/v1/725a8266f4e101c655dd2daa.png"},{"id":105752121,"identity":"b87fc377-3360-473d-a7f3-7998cb0e37db","added_by":"auto","created_at":"2026-03-30 15:55:03","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1127513,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6387693/v1/788a2c4f-f5f1-462c-97dc-d712596d7459.pdf"},{"id":83023621,"identity":"2c716204-39d3-42ec-acd8-b38a62ae78c1","added_by":"auto","created_at":"2025-05-19 07:56:57","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":17279,"visible":true,"origin":"","legend":"","description":"","filename":"file.docx","url":"https://assets-eu.researchsquare.com/files/rs-6387693/v1/b25fff18397263bdab2c28db.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Design and usability testing of a home digital management and mobile smart wellness platform for patients with benign prostatic hyperplasia","fulltext":[{"header":"Introduction","content":"\u003cp\u003e\u003cstrong\u003eBenign Prostatic Hyperplasia\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe prostate is the largest substantial organ in the male genital parasympathetic glands, which grows and develops during three periods: fetal period, puberty, and middle age to old age. Benign prostatic hyperplasia (BPH), also known as prostatic hypertrophy, is a disease in which prostate enlargement is caused by hyperplasia of the stromal cells in the migratory zone of the prostate gland, which in turn compresses the bladder and urethra, resulting in a restriction of the flow of urine[1].The prevalence of BPH increases with age, with one study showing a prevalence of 50% in men between the ages of 50 and 60, rising to 80% between the ages of 50 and 70[2, 3].The pathophysiology of BPH is closely related to hormonal changes, especially the effects of androgens such as testosterone and dihydrotestosterone (DHT) on prostate tissue[4].At present, BPH has become the most common benign disease of urinary disorders in middle-aged and old-aged men, which seriously affects the life of patients, and its main manifestation is the anatomical and histological enlargement of the prostate gland (PV) with bladder outlet obstruction and lower urinary tract symptoms (LUTS), including urinary frequency, urgency, dysuria, and hesitancy, etc. The symptoms cause great life distress and psychological pressure to patients and their families. LUTS include frequent urination, urgency, dysuria and hesitancy, etc., which bring great disturbances and psychological pressure to patients and their families[5, 6].The comprehensive evaluation of LUTS in BPH is usually a history assessment, a Bladder Diaries (BD), and an assessment of urinary flow rate, with the voiding diary being the most critical[7].\u003c/p\u003e\n\u003cp\u003eBD is a non-invasive, prospective assessment tool in which patients record their voiding patterns and symptoms over a specific time period[8].BD can accurately reflect the severity of the disease and assist physicians in formulating a treatment plan as well as evaluating the efficacy of treatment[9].The current BD mainly relies on paper handwriting, but there are obvious shortcomings: for patients, the cumbersome recording process reduces patient compliance, if the failure to record in a timely manner leads to omission or later recall bias when making up the record, unable to ensure the continuity of the data, and the paper version is easy to be damaged or lost; for healthcare workers: manually counting and analyzing a large amount of paper data is time-consuming and prone to error, the burden of data processing is heavy, and the reliability of paper records is not high when the data are disputed. The reliability of paper records is not high in case of disputes\u0026nbsp;[10, 11].Therefore, in order to ensure that voiding diaries can accurately record patients\u0026apos; urination, it is crucial to require timely, accurate, and convenient voiding diary devices for patients\u0026nbsp;[12].\u003c/p\u003e\n\u003cp\u003eWith the advent of the digital era and the influence of COVID-19 in recent years, the era of telemedicine has been initiated on a large scale[13, 14].Telemedicine is the provision of remote treatment, counseling and evaluation of patients through various types of mobile communication devices, not only that, telemedicine also includes remote care, health education and data collection and management\u0026nbsp;[15].The European Association of Urology (EAU) in its guidelines for men with LUTS suggests that telemedicine and care can be used to monitor LUTS symptoms, including symptom scores and bladder diaries to record, detect and self-assess symptoms\u0026nbsp;[16].\u003c/p\u003e\n\u003cp\u003eTherefore, this study designs and tests the feasibility of a smart mobile device-based\u0026nbsp;patient intelligence management system\u0026nbsp;(Digital Urologic Home Care platform) that integrates recording and storing data, symptom self-assessment, and knowledge learning to help patients achieve data continuity, increase disease awareness, and reduce healthcare worker time and errors to improve clinical outcomes.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDigital Urologic Home Care platform\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Digital Urologic Home Care Platform was developed by an external organization with experience in medical technology in conjunction with two caregivers.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOperating Side\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe program consists of three operating terminals: the background control terminal, the medical and nursing operating terminal, and the patient input terminal (Figure 1)\u003c/p\u003e\n\u003cp\u003e(1) Background control terminal: background operators are divided into senior administrators and junior administrators, senior administrators can carry out patient authentication, configuration and modification of various types of fields, knowledge push, remote information exchange, patient data export and modification of the background operation section, etc. Junior administrators can only view the data information and do not have the authority to modify the operation.\u003c/p\u003e\n\u003cp\u003e(2) Medical and nursing operation terminal: Medical and nursing personnel can confirm and categorize patient information in the management platform, visualize and manage patient indicators, and communicate with patients remotely to clarify changes in patient conditions and give professional guidance.\u003c/p\u003e\n\u003cp\u003e(3) Patient input terminal: patients can record their daily urination and water intake, and the relevant data will be stored in the background and can be viewed at any time; set up a questionnaire for relevant disease symptoms, so that patients can self-test at any time and get a preliminary understanding of their own disease; set up a database of information about the disease for knowledge learning; and finally, an online communication platform for communicating with doctors.\u003c/p\u003e\n\u003ch3\u003eIntroduction to the Section\u003c/h3\u003e\n\u003cp\u003eThere are five major sections: urination record, drinking water record, symptom management, disease information database, and remote communication (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e(1) Urination section: set up urination conditions such as number of times, time, volume, incontinence and accompanying status, etc., which will be stored in the background after being recorded by the patient.\u003c/p\u003e \u003cp\u003e(2) Drinking water section: set the amount of explicit drinking water (water, drinks, soups, etc.) and non-explicit drinking water (fruits, vegetables, etc.), which are stored in the background after being recorded by patients.\u003c/p\u003e \u003cp\u003e(3) Symptom management: incorporating the International Prostate Symptom Score (IPSS) and the International Erectile Function Questionnaire-5 (IIEF-5), patients can self-monitor their prostate symptoms and sexual function at any time, and make initial self-judgment of their condition.\u003c/p\u003e \u003cp\u003e(4) Disease Information Library: Publicize the knowledge of BPH through pictures and words in diversified forms, including etiology, clinical manifestations, lifestyle and postoperative rehabilitation guidance.\u003c/p\u003e \u003cp\u003e(5) Remote communication:The platform can realize barrier-free communication between patients and medical staff, provide patients with treatment plans and health guidance in a timely manner, improve the efficiency of discharge follow-up, reduce patients' time and economic burden, provide patients with more convenient self-health management methods, use text to communicate with patients, enhance patients' satisfaction with medical work, and enhance patients' ability to manage symptoms at home.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e\n\u003ch3\u003eThe Need and Purpose of Usability Testing\u003c/h3\u003e\n\u003cp\u003eUsability testing not only improves user satisfaction and loyalty, but also optimizes product design, improves operational efficiency, increases user engagement, and reduces human and financial costs[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].So the aim of this study is to explore the usability of Digital Urologic Home Care platform platform.\u003c/p\u003e"},{"header":"MATERIALS AND METHODS","content":"\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\n \u003ch2\u003eStudy Design\u003c/h2\u003eEvaluation criteria using ISO 9241.11 International Organization for Standardization definition of usability[45]: The effectiveness, high efficiency and subjective satisfaction of a product in a specific use environment for a specific use by a specific research subject: effectiveness: task completion; high efficiency: completion time; subjective satisfaction: user satisfaction.\u003cbr\u003e\n \u003cp\u003eThis study is qualitative in nature, participants used the platform for 3 days, and the end of the cycle used a usability questionnaire to conduct usability analysis, followed by semi-structured interviews to express user experience and feedback.\u003c/p\u003e\n\u003c/div\u003e\n\u003ch3\u003eParticipants\u003c/h3\u003e\n\u003cp\u003eSample size: According to a Nielsen study, five evaluators can detect 75% of usability problems[\u003cspan class=\"CitationRef\"\u003e18\u003c/span\u003e].The sample size of this study was determined by information saturation, and ultimately 3 patients and 2 healthcare professionals participated in this phase of the study (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e)[\u003cspan class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eDemographics\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003eDemographics\u003cbr\u003e\u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/th\u003e\n \u003cth align=\"left\"\u003en=5\u003cbr\u003e\u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003en (%)\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003eAge (years)\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003e20\u0026ndash;40\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003e3(60)\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003e40\u0026ndash;60\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003e1(20)\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026gt;60\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003e1(20)\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003eGender\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003eMale\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003e3(60)\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003eFemale\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003e2(40)\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003eMarital status\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003eMarried/common-law\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003e2(40)\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003eSingle\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003e3(60)\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003eHighest education level\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003eHigh school\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003e1(20)\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003eCollege\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003e1(20)\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003eUndergraduate degree\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003e3(60)\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003eCurrent employment status\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003eFull-time\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003e3(60)\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003eDisability/leave of absence\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003e0(0)\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003eUnemployed\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003e0(0)\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003eRetired\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003e2(40)\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003eComputer and Internet usage\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003eDo you use Internet at home?\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003eYes\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003e5(100)\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003eNo\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003e0(0)\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003eHow many hours do you spend online every day༟\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026le; 3\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003e0(0)\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026gt;3\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003e5(100)\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003eDo you use an Internet platform or program to record your experience༟\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003eYes\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003e3(60)\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003eNo\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003e2(40)\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003eHow comfortable are you with using the\u003cbr\u003eInternet?\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003eVery satisfie\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003e3(60)\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003eaverage\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003e2(40)\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003edissatisfied\u003cbr\u003e\u003c/td\u003e\n \u003ctd align=\"left\"\u003e0(0)\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003ch3\u003eProcedure\u003c/h3\u003e\n\u003cp\u003eEthical approval for this study was obtained from the hospital ethics committee.\u003c/p\u003e\n\u003cp\u003eAfter participants signed the informed consent form, they scanned the QR code to enter the trial version of the platform and followed the prompts to register and sign the platform informed consent form. After registration, patients fill in basic information such as age, gender, contact information, and disease conditions. Once the patient registers and enters the information, a specific binding code is generated, which allows investigators to use the data captured by the Digital Urologic Home Care platform in a specific scientific project, and the program can be used after passing the audit. The main sections of the platform are urination diary, drinking water diary, scale self-measurement, health education, remote communication, which can realize electronic BD recording, analysis, storage and realize real-time communication and exchange of knowledge and messages.\u003c/p\u003e\n\u003cp\u003eThe experimental period was 3 days, and usability was analyzed in terms of effectiveness, efficiency, and subjective patient satisfaction, and one researcher acted as an assistant to record any problems participants might encounter during the task and assist in solving them. Finally, the research team set up a semi-structured interview outline:①How do you feel about using the BPH Smart Platform for self-management of LUTS symptoms?②Do you think there are deficiencies in the platform\u0026apos;s operational functions? How do you suggest to modify it?③Do you think the existing interface presentation (reasonable) meets your usage habits? Why?④Do you have any problem with the operation of the platform? If yes, where?⑤Would you recommend other participants to use this platform for self-management of LUTS symptoms? What are the reasons? One-on-one semi-structured interviews were conducted with the participants to express user experience and feedback, and the interviews were recorded with a tape recorder, then transcribed verbatim, and then transcribed verbatim for analysis.\u003c/p\u003e\n\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\n \u003ch2\u003eData Analysis\u003c/h2\u003e\n \u003cp\u003eQuantitative data: descriptive analysis was used, while measures were expressed as X\u0026thinsp;\u0026plusmn;\u0026thinsp;S, and counts were presented as number of cases and percentages.\u003c/p\u003e\n \u003cp\u003eQualitative data: Colaizzi (Thematic analysis) was used to analyze the participants\u0026apos; usability problems and objectivity was maintained during the analysis.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"RESULTS","content":"\u003cp\u003e1. Effectiveness: 5 participants took the entire test and completed all test components (Table\u0026nbsp;2).\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable id=\"Tab2\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 2\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003eMandate completion rate\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eEntry\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eUrination Diary\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eDrinking Diary\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eHealth Education\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eScale Self-Test\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eTelecommu-nication\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eParticipants\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eCompletion rate(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e100%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e100%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e100%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e100%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e100%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e2. High efficiency: Participants recorded the Mean Time(MT) to complete each test component, with the Maximum Duration(Max D), and Minimum Duration(Min D) units in seconds (/s)(Table 3).\u003c/p\u003e\n\u003cdiv\u003e\u003cimg src=\"data:image/png;base64,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\"\u003e\u003c/div\u003e\n\u003cp\u003e(3) Subjective patient satisfaction: at the end of the test, patients filled out the System Usability Scale (SUS) and Human-Machine Exchange Interface Usability Questionnaire and underwent a semi-structured interview.\u003c/p\u003e\n\u003cp\u003eThe SUS questionnaire contains 10 entries and 3 dimensions with a Cronbach\u0026apos;s alpha coefficient of 0.84, and a KMO value of 0.879. The system ranges from 0 to 100: \u0026lt;60 is dissatisfied, 60\u0026thinsp;~\u0026thinsp;69 is low satisfied, 70\u0026thinsp;~\u0026thinsp;79 is moderately satisfied, 80\u0026thinsp;~\u0026thinsp;89 is satisfied, and \u0026gt;\u0026thinsp;90 is very satisfied. The total score of this SUS was 82.8 (9.7), and the results indicated that the participants were satisfied with the website.\u003c/p\u003e\n\u003cp\u003eThe results of the Human-Machine Exchange Interface Usability Questionnaire usability questionnaire, which includes 5 dimensions of functionality, ease of learning, high efficiency, interactive experience and satisfaction, with 20 entries and a total score of 0-100. \u0026lt;The total score is 0-100. \u0026lt;50 indicates that the feasibility of the system or product is unacceptable; 50\u0026ndash;70 indicates that the feasibility of the system or product is average; \u0026ge;70 indicates that the feasibility of the system or product is satisfactory. The total score of this questionnaire was 70.0 (8.5), indicating that participants considered the system or product feasibility satisfactory.\u003c/p\u003e\n\u003ch3\u003eUser Experience and Feedback\u003c/h3\u003e\n\u003cp\u003eThe researcher conducted one-on-one semi-structured interviews with the participants, and through Colaizzi data analysis, six themes were distilled from the results of the interviews: improved knowledge and confidence, professionalism and convenience together, help with initial self-judgment of illness, high ease of use of the platform, recognition and recommendation, and suggestions for platform improvement.\u003c/p\u003e\n\u003cp\u003e(1)Improved knowledge and confidence: participants generally felt that the platform contained comprehensive content that provided basic knowledge about BPH.\u003c/p\u003e\n\u003cp\u003eM1: \u0026ldquo;It\u0026apos;s rich in accompanying pictures, so you can\u0026apos;t help but click on it and learn by clicking on it.\u0026rdquo;M5: \u0026ldquo;I\u0026apos;ve had the disease for 13 years and I\u0026apos;ve never really known about it, and by using it I can learn about the causes and onset of BPH, which can help improve my confidence in treatment and surgery.\u0026rdquo;\u003c/p\u003e\n\u003cp\u003e(2)Professionalism and convenience: Participants generally reflected that using the platform for BD recording was more professional and convenient than the traditional paper version.\u003c/p\u003e\n\u003cp\u003eM1: \u0026ldquo;My previous paper-based BD was easy to miss and especially easy to lose, this platform can record and save for a long time just by clicking in.\u0026rdquo;M2: \u0026ldquo;The platform is very friendly to newbies, and it is also more convenient to check the recorded data.\u0026rdquo;M3: \u0026ldquo;The platform is characterized by data continuity, which is conducive to reducing the calculation and workload of medical staff.\u0026rdquo;M5: \u0026ldquo;The platform enables remote communication between doctors and reduces the number of trips to the hospital.\u0026rdquo;\u003c/p\u003e\n\u003cp\u003e(3)Helping with initial self-judgment of disease: Participants felt that the platform could help patients to have an initial understanding of their disease progression, which would facilitate the next step of management.\u003c/p\u003e\n\u003cp\u003eM1:\u0026ldquo;One of my favorite features is that there is a scale symptom self-assessment\u0026hellip;\u0026hellip;, It\u0026apos;s very convenient.\u0026rdquo; M5:\u0026ldquo;That part of the symptom self-assessment, you can take the test at any time and the score comes out immediately.\u0026rdquo;\u003c/p\u003e\n\u003cp\u003e(4)High ease of use of the platform:Participants reflected that the platform has a clear interface, reasonable structure, convenient operation and easy to use.\u003c/p\u003e\n\u003cp\u003eM2: \u0026ldquo;It\u0026apos;s very much in line with (one\u0026apos;s own usage habits), it has diagrams and text prompts very much in line with me \u0026hellip;\u0026hellip;, you\u0026apos;re not sure where to go from (click), you can find it according to the text and the pictures.\u0026rdquo; M4: \u0026ldquo;It has a clearer interface\u0026hellip;\u0026hellip;, You can directly know what you want to do, what you want to see, and then it is in which section you can directly find.\u0026rdquo;M5: \u0026ldquo;This interface design is just very simple, and then the division of functional areas is also very detailed.\u0026rdquo;\u003c/p\u003e\n\u003cp\u003e(5)Recognition and recommendation: participants generally recognized the platform patient and healthcare provider needs and would recommend it to others because it provides data continuity records and high quality knowledge.\u003c/p\u003e\n\u003cp\u003eM3:\u0026ldquo;I will, the clinical work is busy, this platform record data, can ensure that the data is true, to avoid affecting our clinical judgment, save time, convenient for everyone \u0026hellip;\u0026hellip;\u0026rdquo;;M4:\u0026ldquo;Many patients visit the clinic, ask the urination situation, the patient\u0026apos;s answer is very vague, or even wrong, this platform will be able to view the patient\u0026apos;s urination and other conditions directly from the medical and nursing end, to avoid errors, so \u0026hellip;\u0026hellip; I would recommend it.\u0026rdquo; M5: \u0026ldquo;I previously recorded my own urination is to remember on paper, it is very troublesome and often forget, this he will send me tips every day, I will record \u0026hellip;\u0026hellip;\u0026rdquo;\u003c/p\u003e\n\u003cp\u003e(6)Platform Improvement Suggestions: The platform as a whole is better, the account part of the font is smaller and in a single form and the picture is more fuzzy, the scale self-assessment section has no prompts, and the information on the communication end of the doctor and patient is not notified in a timely manner, etc., which needs to be further improved.\u003c/p\u003e\n\u003cp\u003eM1:\u0026ldquo;The font in the part of urination situation is a bit small, and every one of them has to be entered manually, which is a bit of a waste of time \u0026hellip;\u0026hellip;, and in the place of popularizing knowledge, the picture of the causes of prostate hyperplasia is blurred.\u0026rdquo; M5: \u0026ldquo;The result of the scale self-assessment is only a score, there is no severity or recommendation.\u0026rdquo; M3: \u0026ldquo;Sometimes patients send me messages, will not receive tips.\u0026rdquo;\u003c/p\u003e\n\u003cp\u003eModification: According to the result of usability analysis, the platform is improved and modified as follows:\u003c/p\u003e\n\u003cp\u003e(1)Fonts: Adjust some of the smaller fonts, unify the size, and set personalized fonts to meet the needs of various types of users.\u003c/p\u003e\n\u003cp\u003e(2)Pictures: Upgrade the clarity of pictures.\u003c/p\u003e\n\u003cp\u003e(3)Options: set up a variety of option types such as: linear scrolling, single choice, multiple choice, fill in the blanks, input, etc., to enrich the form.\u003c/p\u003e\n\u003cp\u003e(4)Scale self-assessment section: automatically display scores, results and related suggestions after users fill out the scale.\u003c/p\u003e\n\u003cp\u003e(5)Remote communication: set up enhanced message alert frequency, for untimely response to the message, it will be pushed repeatedly in the message box.\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003ePrincipal Findings\u003c/h2\u003e \u003cp\u003eIn this study, we designed and developed a BPH Wisdom Platform, known as the Digital Urinary Home Care Platform, based on the needs of BPH patients and the traditional voiding diary. We conducted a usability analysis focusing on effectiveness, efficiency, and patient satisfaction, which demonstrated that the platform possesses a high degree of usability and utility in practical applications. To further explore and optimize the user experience, we conducted semi-structured interviews with users. These interviews provided direct feedback on various platform functions and allowed us to identify and summarize specific challenges and areas for improvement.In response to the identified user experience barriers, we undertook an iterative process to enhance the platform. Ultimately, following a series of usability evaluations and corrective measures, the platform exhibited considerable potential as an effective tool for the self-management of patients with Benign Prostatic Hyperplasia (BPH). This underscores the platform's feasibility for application in real-world healthcare management scenarios and offers a valuable reference framework and practical insights for the development and optimization of similar smart healthcare platforms in the future.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eSeveral limitations must be acknowledged. Firstly, while this study confirmed the usability and potential of the Benign Prostatic Hyperplasia Smart Platform (Digital Urinary Home Care platform) for BPH patients, it did not quantify the impact of the platform's functional properties on improving clinical symptoms and self-management behaviors. Secondly, factors such as patient age, education level, geographic region, and individual differences may limit the self-management capabilities of users. Therefore, enhancing patient guidance and education is recommended for future iterations. Lastly, this study did not conduct an applicability analysis, which should be addressed in subsequent research.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eConclusions\u003c/h3\u003e\n\u003cp\u003eInternet-based self-management is becoming more and more common as a way of adjuvant medical treatment to manage complex diseases. In this study, we developed and found evidence to support the availability of a smart platform for benign prostatic hyperplasia (Digital Urinary Home Care platform) .\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate:\u003c/strong\u003eThe study was approved by the Institutional Ethics Committee of Guiyang No. 2 People\u0026apos;s Hospital（JYYY-2025-WZ-07）and was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. All patients provided written informed consent.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u003c/strong\u003eConsent for publication was obtained from the participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials:\u003c/strong\u003eThe data that support the findings of this study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests:\u003c/strong\u003eThe author(s) declared no potential conflicts o f interest with respect to the research, author- ship, and/or publication of this article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003eThis study received the Science and Technology Fund project of Guizhou Provincial Health Commission (gzwjkj2021-141); Guizhou High-level innovative Talent selection and Training Program Project (Guizhou Committee leader issued [2022] No. 3; Support of Chuke Contract -GCC[2022] No. 16).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMiaoqing Cai (First Author): Conceptualization, Data Curation, Fommal Analysis，Investigation,Methodology,Sofware，Writing-Original Draft，Writing-Review \u0026amp; Editing:\u003c/p\u003e\n\u003cp\u003eJiamei Wang（co-author).Wen Zhou . Sudan Zeng. Qiangqiang Cheng.Huan Wang.Beibei Yan：ethodology,Supervision，Data Curation.\u003c/p\u003e\n\u003cp\u003eAobing Mei(Corresponding Author):Conceptualization, Funding cquisition.Resources, Supervision, Validation, Writing-Original Draft, Writing-Review \u0026amp;Editing.\u003c/p\u003e\n\u003cp\u003eMei Chen:Supervision.Validation,Funding Acquisition\u003c/p\u003e\n\u003cp\u003eWei Wang: Data Curation.Investigation,Funding Acquisition\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u003c/strong\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical Trial Number:\u003c/strong\u003e Not applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u0026apos; on the system\u003c/strong\u003e\u003cstrong\u003e：\u003c/strong\u003eThe data are available from the corresponding author upon reasonable request.\u0026quot;，contact［[email protected]］\u0026nbsp;for access.\u0026quot;\u003c/p\u003e\n\u003cp\u003e\u0026quot;The data are not publicly available due to privacy/ethical restrictions.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eHolst, B.S. and S. Nilsson, Age, weight and circulating concentrations of total testosterone are associated with the relative prostatic size in adult intact male dogs. Theriogenology, 2023. 198: p. 356-360.\u003c/li\u003e\n\u003cli\u003eBerry, S.J., et al., The development of human benign prostatic hyperplasia with age. J Urol, 1984. 132(3): p. 474-9.\u003c/li\u003e\n\u003cli\u003eTaoka, R. and Y. Kakehi, The influence of asymptomatic inflammatory prostatitis on the onset and progression of lower urinary tract symptoms in men with histologic benign prostatic hyperplasia. Asian J Urol, 2017. 4(3): p. 158-163.\u003c/li\u003e\n\u003cli\u003eElbaz, E.M., et al., Immunomodulatory effect of diallyl sulfide on experimentally-induced benign prostate hyperplasia via the suppression of CD4+T/IL-17 and TGF-beta1/ERK pathways. Inflammopharmacology, 2020. 28(5): p. 1407-1420.\u003c/li\u003e\n\u003cli\u003eDjavan, B., Lower urinary tract symptoms/benign prostatic hyperplasia: fast control of the patient\u0026apos;s quality of life. Urology, 2003. 62(3 Suppl 1): p. 6-14.\u003c/li\u003e\n\u003cli\u003eChiang, B.J., H.C. Kuo and C.H. Liao, Can Botulinum Toxin A Still Have a Role in Treatment of Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia Through Inhibition of Chronic Prostatic Inflammation? Toxins (Basel), 2019. 11(9).\u003c/li\u003e\n\u003cli\u003eRosier, P., et al., International Continence Society Good Urodynamic Practices and Terms 2016: Urodynamics, uroflowmetry, cystometry, and pressure-flow study. Neurourol Urodyn, 2017. 36(5): p. 1243-1260.\u003c/li\u003e\n\u003cli\u003eLiapis, I., et al., Can we increase the value of data from bladder diaries? International Consultation on Incontinence-Research Society 2023. Neurourol Urodyn, 2024. 43(6): p. 1311-1320.\u003c/li\u003e\n\u003cli\u003eCameron, A.P., et al., Are three-day voiding diaries feasible and reliable? Results from the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) cohort. Neurourol Urodyn, 2019. 38(8): p. 2185-2193.\u003c/li\u003e\n\u003cli\u003eKim, J.K., et al., A Novel Acoustic Uroflowmetry-Based Mobile App Voiding Diary: Comparison with Conventional Paper-Based Voiding Diary. Biomed Res Int, 2022. 2022: p. 3390338.\u003c/li\u003e\n\u003cli\u003eAydin, S., M. Yasli and A. Kunt, Development of urinary diary mobile application and evaluation in patients with urinary incontinence. Urologia, 2024. 91(2): p. 419-425.\u003c/li\u003e\n\u003cli\u003eMangera, A., et al., Development of two electronic bladder diaries: a patient and healthcare professionals pilot study. Neurourol Urodyn, 2014. 33(7): p. 1101-9.\u003c/li\u003e\n\u003cli\u003eMeng, G., et al., Factors That Influence Patient Satisfaction With the Service Quality of Home-Based Teleconsultation During the COVID-19 Pandemic: Cross-Sectional Survey Study. JMIR Cardio, 2024. 8: p. e51439.\u003c/li\u003e\n\u003cli\u003eSimonato, A., et al., Clinical pathways for urology patients during the COVID-19 pandemic. Minerva Urol Nefrol, 2020. 72(3): p. 376-383.\u003c/li\u003e\n\u003cli\u003eTing, C.Y., et al., The use of a multi-disciplinary geriatric telemedicine service (TELEG) and its acceptance at a tertiary care centre in Malaysia. BMC Geriatr, 2024. 24(1): p. 133.\u003c/li\u003e\n\u003cli\u003eRibal, M.J., et al., European Association of Urology Guidelines Office Rapid Reaction Group: An Organisation-wide Collaborative Effort to Adapt the European Association of Urology Guidelines Recommendations to the Coronavirus Disease 2019 Era. Eur Urol, 2020. 78(1): p. 21-28.\u003c/li\u003e\n\u003cli\u003ePauly, T., et al., Using Wearables to Study Biopsychosocial Dynamics in Couples Who Cope With a Chronic Health Condition: Ambulatory Assessment Study. JMIR Mhealth Uhealth, 2024. 12: p. e49576.\u003c/li\u003e\n\u003cli\u003eNielsen, J., Estimating the number of subjects needed for a thinking aloud test. International Journal of Human-Computer Studies, 1994. 41(3): p. 385-397.\u003c/li\u003e\n\u003cli\u003eMalterud, K., V.D. Siersma and A.D. Guassora, Sample Size in Qualitative Interview Studies: Guided by Information Power. Qual Health Res, 2016. 26(13): p. 1753-1760.\u003c/li\u003e\n\u003cli\u003eMorse, J., The significance of saturation,\u0026quot; Qualitative Health Research, (5), . 1995.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Benign rostatic hyperplasia, Voiding diary, Usability testing, Digital management, Digital urology","lastPublishedDoi":"10.21203/rs.3.rs-6387693/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6387693/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective: \u003c/strong\u003eThis study aimed to develop a Digital Urologic Home Care platform and assess its usability for self-management among patients with benign prostatic hyperplasia (BPH).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003eParticipants, including patients and medical staff, were selected through purposive sampling from a tertiary hospital in Guizhou Province. The investigator provided instructions for using the platform, which required participants to continuously log urination patterns, fluid intake, symptom self-assessments, access a disease information database, and engage in remote communication. Following a three-day usage period, the platform's feasibility was evaluated based on effectiveness, efficiency, and subjective satisfaction. Additionally, semi-structured interviews were conducted to gather participants' experiences and feedback, facilitating further adjustments to the platform's content.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eThe study included three healthcare professionals and two patients, aged 24 to 55 years. The System Usability Scale (SUS) yielded an average satisfaction score of 82.8 (SD = 9.7), while the human-computer interface usability questionnaire produced an average score of 70.0 (SD = 8.5), indicating a high level of participant satisfaction with the platform.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e This platform realizes automatic tracking and analysis of drinking water and urination, enabling continuous analysis and personalization of patients' urination data, patients' mastery of preliminary self-judgment of the degree of the disease and related knowledge, and the realization of remote communication between doctors and patients, which can realize self-monitoring and home digital management of BPH patients after later debugging and updating.\u003c/p\u003e","manuscriptTitle":"Design and usability testing of a home digital management and mobile smart wellness platform for patients with benign prostatic hyperplasia","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-19 07:56:53","doi":"10.21203/rs.3.rs-6387693/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"4d78bf44-2d55-45b3-855a-53d32b5406aa","owner":[],"postedDate":"May 19th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-03-28T05:39:32+00:00","versionOfRecord":[],"versionCreatedAt":"2025-05-19 07:56:53","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6387693","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6387693","identity":"rs-6387693","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}