BACKGROUND A key falls prevention intervention delivered within occupational therapy is the home environment falls-risk assessment process. This involves the clinician visiting the patient's home and using a 2D paper-based measurement guidance booklet to ensure that all measurements are taken and recorded accurately. However, 30% of all assistive devices installed within the home are abandoned by patients, in part as a result of the inaccurate measurements being recorded as part of the home environment falls-risk assessment process. In the absence of more appropriate and effective guidance, high levels of device abandonment are likely to persist. AIM This study presents guidetomeasure-OT, a mobile 3D measurement guidance application designed to support occupational therapists in carrying out home environment falls-risk assessments. Furthermore, this study aims to empirically evaluate the performance of guidetomeasure-OT compared with an equivalent paper-based measurement guidance booklet. METHODS Thirty-five occupational therapists took part in this within-subjects repeated measures study, delivered within a living lab setting. Participants carried out the home environment falls-risk assessment process under two counterbalanced treatment conditions; using 3D guidetomeasure-OT; and using a 2D paper-based guide. Systems Usability Scale questionnaires and semi-structured interviews were completed at the end of both task. A comparative statistical analysis explored performance relating to measurement accuracy, measurement accuracy consistency, task completion time, and overall system usability, learnability, and effectiveness of guidance. Interview transcripts were analysed using inductive and deductive thematic analysis, the latter was informed by the Unified Theory of Acceptance and Use of Technology model. RESULTS The guidetomeasure-OT application significantly outperformed the 2D paper-based guidance in terms task efficiency (p <  0.001), learnability (p <  0.001), system usability (p <  0.001), effectiveness of guidance (p =  0.001). Regarding accuracy, in absolute terms, guidetomeasure-OT produced lower mean error differences for 11 out of 12 items and performed significantly better for six out of 12 items (p = < 0.05). In terms of SUS, guidetomeasure-OT scored 83.7 compared with 70.4 achieved by the booklet. Five high-level themes emerged from interviews: Performance Expectancy, Effort Expectancy, Social Influence, Clinical Benefits, and Augmentation of Clinical Practice. Participants reported that guidetomeasure-OT delivered clearer measurement guidance that was more realistic, intuitive, precise and usable than the paper-based equivalent. Audio instructions and animated prompts were seen as being helpful in reducing the learning overhead required to comprehend measurement guidance and maintain awareness of task progression. CONCLUSIONS This study reveals that guidetomeasure-OT enables occupational therapists to carry out significantly more accurate and efficient home environment falls-risk assessments, whilst also providing a measurement guide tool that is considered more usable compared with the paper-based measurement guide that is currently used by clinicians in practice. These results are significant as they indicate that mobile 3D visualisation technologies can be effectively deployed to improve clinical practice, particularly within the home environment falls-risk assessment context. Furthermore, the empirical findings constitute overcoming the challenges associated with the digitisation of health care and delivery of new innovative and enabling technological solutions that health providers and policy makers so urgently need to ease the ever-increasing burden on existing public resources. Future work will focus on the development and empirical evaluation of a mobile 3D application for patient self-assessment and automated assistive equipment prescription. Furthermore, broader User Experience aspects of the application design and the interaction mechanisms that are made available to the user could be considered so as to minimize the effect of cognitive overloading and optimise user performance.

中文翻译：

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Guidetomeasure-OT：一种移动3D应用程序，用于提高临床医生主导的家庭跌倒风险评估的准确性，一致性和效率。

背景技术在职业治疗中提供的关键预防跌倒干预是家庭环境跌倒风险评估过程。这涉及到临床医生拜访患者的家，并使用基于2D纸的测量指导手册来确保所有测量均被准确地记录和记录。但是，家庭中安装的所有辅助设备中有30％被患者丢弃，部分原因是在家庭环境跌落风险评估过程中记录了不正确的测量结果。在缺乏更适当和有效的指导的情况下，高水平的设备遗弃很可能会持续下去。目的本研究提出了guidetomeasure-OT，这是一种移动3D测量指导应用程序，旨在支持职业治疗师进行家庭环境跌落风险评估。此外，本研究旨在以经验为基础，与等效的纸质测量指导手册相比，对guidetomeasure-OT的性能进行评估。方法35名职业治疗师参加了这项在受试者内部重复测量的研究，该研究在居住的实验室环境中进行。参与者在两种平衡的治疗条件下进行了家庭环境跌落风险评估过程；使用3D guidetomeasure-OT; 并使用2D纸质指南。在两项任务结束时，都完成了系统可用性量表调查问卷和半结构化访谈。比较统计分析探讨了与测量精度，测量精度一致性，任务完成时间以及整个系统的可用性，可学习性和指导有效性相关的性能。访谈笔录采用归纳和演绎主题分析进行分析，后者由“接受和使用技术的统一理论”模型提供信息。结果Guidetomeasure-OT应用程序在任务效率（p <0.001），可学习性（p <0.001），系统可用性（p <0.001），指南的有效性（p = 0.001）方面明显优于2D纸质指南。关于准确性，从绝对意义上讲，guidetomeasure-OT在12个项目中有11个产生了较低的平均误差差异，而在12个项目中有6个产生了明显更好的平均误差（p = <0.05）。在SUS方面，guidetomeasure-OT得分为83.7，而手册中的得分为70.4。访谈中出现了五个高层次的主题：预期绩效，预期工作量，社会影响力，临床收益，和临床实践的增强。与会者报告说，guidetomeasure-OT提供了比基于纸质等效技术更清晰，更直观，更精确和更实用的测量指导。音频说明和动画提示被认为有助于减少理解测量指导和保持任务进度意识所需的学习开销。结论这项研究表明，guide-measure-OT使职业治疗师能够进行更加准确和有效的家庭环境跌倒风险评估，同时还提供了一种与当前使用的纸质测量指南相比更有用的测量指南工具。由临床医生在实践中。这些结果非常重要，因为它们表明可以有效地部署移动3D可视化技术以改善临床实践，尤其是在家庭环境跌落风险评估环境中。此外，经验性发现构成了克服与医疗保健数字化以及提供新的创新和可行技术解决方案相关的挑战，医疗提供者和政策制定者迫切需要减轻现有公共资源不断增加的负担。未来的工作将集中于针对患者自我评估和自动辅助设备处方的移动3D应用程序的开发和经验评估。此外，