Introduction...3. The web application...3. User roles...4. Rater...4. Key informant...4. Field Trial Site Coordinator...4

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1 ICD-FiT USER MANUAL Index Introduction...3 The web application...3 User roles...4 Rater...4 Key informant...4 Field Trial Site Coordinator...4 Field Trial Centre Coordinator...4 WHO Coordinator...4 User registration...4 Main user pages...6 Rater...6 Key informant...8 FTS Coordinator...8 Inviting raters...8 Dashboard...9 FTC Coordinator...10 Defining sites...10 Assigning cases...12

2 Key informants...13 Dashboard...14 Cases translation...14 Field trial studies...16 Study 1: basic questions...16 Study 2:...17 Study 3:...18 Overall evaluation form...21 Language choice...23 Demo site of Udine, Italy Dept of Maths & Computer Science, University

3 Introduction This is the user manual for the web-based application aimed at supporting the implementation of ICD-11 Field Trial core study protocols, called ICD-FiT (ICD Field trials). The web application The web-based application is currently hosted by the dept. of Mathematics and Computer Science at the University of Udine, Italy. The provisional address for the system is: A demo version, useful for testing and learning the system, is available at: Thanks to the technical choices done, the web interface is responsive, i.e., it gracefully adapts to screen sizes, so that even on smartphones it is easier to browse it. The next two screenshots are examples of how the interface appears on a smartphone. 3 Dept of Maths & Computer Science, University of Udine, Italy

4 User roles Rater The rater carries out the basic work of participating into studies as classification user. He/she should register into the system upon invitation and filling the participant form. After that, he/she should access his/her own web page, check for assigned cases in field trial studies, fill in the related forms, and fill also the final evaluation form after completing all cases of a study. Key informant The key informant participates into basic questions studies as classifications stakeholder, which do not involve cases. He/she should register into the system upon invitation and filling the participant form. After that, he/she should access his/her own web page, and fill in the forms related to basic questions. The key informant might have a category associated among: with coding experience, clinician, statistician, policy maker. Field Trial Site Coordinator An FTS coordinator is able to invite and manage raters. A dashboard is available to check advancement status (cases/rater, percentage of ended work, etc). Field Trial Centre Coordinator An FTC coordinator has the ability to assign new field trial sites in their country, invite and assign key informants for basic questions studies, and assign cases to raters for each study in which the centre is involved. A dashboard is available to check advancement status (raters/case, cases/site, etc). WHO Coordinator The central coordination is able to insert new fields trial centers in the system, assign them to field trials studies as well as inserting cases. A dashboard is available to check advancement status (raters/case, cases/center, etc). In some specific cases, a user could be associated to more than a role. For example, a rater can act also as a key informant, and a FTS coordinator might also act as a rater. User registration ICD-FiT is open only to invited users, at various levels. No public pages are available, thus any activity is filtered through a login page. When accessing the first page of the web application, the user is requested to provide username and password. There is no link to a registration page, because registration to the system can be made only upon invitation by a centre or site coordinator. When clicking on the link found in the invitation , the user is guided through three forms. 4 Dept of Maths & Computer Science, University of Udine, Italy

5 The first one collects user data: The second step is the declaration of conflict of interests: 5 Dept of Maths & Computer Science, University of Udine, Italy

6 The last step is the license agreement for ICD11: Main user pages After login, each user is directed to a specific summary page that lists the actions available for him/her, depending on the role. In the following, some screenshots from those pages are shown. Rater The rater is the crucial user for ICD-FiT, since he/she carries out the basic work of participating into studies. His/her summary page contains links to forms related to all studies to which the rater has been assigned (at present, only Study 2 and 3 are implemented, but eventually other studies will be visible too). If the rater has been also chosen as a key informant, he/she will automatically see also studies related to key informants at present, Study 1 only. The next screenshot shows the main page: 6 Dept of Maths & Computer Science, University of Udine, Italy

7 Study 2 and 3 consist in rating a number of cases, that are shown as a list when clicking on their icons, as shown in the next screenshot for Study 2: Completed cases are identified by an orange icon. Multi-step cases (e.g., Study 3 with individual assessment and then joint assessment) will show more than an icon. 7 Dept of Maths & Computer Science, University of Udine, Italy

8 Key informant Key informants that do not act as raters will see Study 1 only in their summary page, as shown in the next screenshot: FTS Coordinator An FTS coordinator is able to invite and manage raters. Inviting raters To invite a rater, the FTS coordinator has to send an invitation to him/her using the invite raters icon. The rater will provide his/her own details when registering, so is sufficient. Below the invitation form, there is a summary table of all the invitations sent by the coordinators. Every item have buttons for resend and for delete the invitation. 8 Dept of Maths & Computer Science, University of Udine, Italy

9 Dashboard The FTS dashboard lists the raters belonging to the site, cases assigned and already rated, etc. 9 Dept of Maths & Computer Science, University of Udine, Italy

10 The FTS coordinator is also acting as a rater and he/she can switch the role by using the top-right menu: FTC Coordinator An FTC coordinator has the ability to assign new field trial sites in their country, and manages also key informants for additional studies. This corresponds to four icons in the main page: Defining sites At present, a site can be defined by a name and by inviting one or more site coordinators, like in the following steps: 10 Dept of Maths & Computer Science, University of Udine, Italy

11 11 Dept of Maths & Computer Science, University of Udine, Italy

12 Furthermore, the coordinator can easily rename the FTS Assigning cases The FTC coordinator has an overall view on every rater available, so he/she will assign cases to them. The case assignment page shows a menu for choosing the Study (2 or 3), another one to choose the raters (you can assign cases individually or by site or to all), and then a list of available cases for the selected study plus the raters selected in the previous step. By clicking on the checkboxes you will assign cases to raters (and you will also see previously assigned cases). 12 Dept of Maths & Computer Science, University of Udine, Italy

13 Key informants The FTC coordinator also manages key informants. They could be either chosen among existing raters in the center sites, or external experts invited by . The Key informants management page allows to do both: The invitation mechanism is the same as for raters and coordinators. To each key informant, a category shall be selected that might be used to personalize the Study 1 form. 13 Dept of Maths & Computer Science, University of Udine, Italy

14 Dashboard A dashboard is available to check advancement status (raters/case, cases/site, etc). Cases translation A mechanism to translate the cases in other languages is available for the FTC coordinator. The next screenshot show the translation page (for Spanish language): 14 Dept of Maths & Computer Science, University of Udine, Italy

15 15 Dept of Maths & Computer Science, University of Udine, Italy

16 Field trial studies In this section, further details are provided about the system core, i.e., the forms related to studies as they are seen and filled by the Raters and Key informant user category. A progress bar under the study icons in the main page show the advancement status (useful in particular for Study 2 and 3). Study 1: basic questions Study 1 is not connected to cases, so there is just one multi-page form to be filled. Just fill it and save at the end. 16 Dept of Maths & Computer Science, University of Udine, Italy

17 Study 2: The next forms are related to the second study. Participant data are not recorded here since they are already available. The first form is aimed at the ICD-11 side of bridge coding: On the right of the ICD-11 code field there is a link to the ICD-11 Coding Tool to helping the user during the filling. 17 Dept of Maths & Computer Science, University of Udine, Italy

18 Study 3: The next screenshots document the forms provided for Study 3, adapted to web usage, i.e., without the need for filling participant data, since they are already in the system (like the study 2). The first form is the Individual assessment form, and according to the Field Trials Manual, after the individual assessment there will be a Joint Assessment too. The Joint assessment should be organized by the FTS coordinator. At present there is no online support for joint assessment agendas, but in case of need, it will be provided. 18 Dept of Maths & Computer Science, University of Udine, Italy

19 19 Dept of Maths & Computer Science, University of Udine, Italy

20 20 Dept of Maths & Computer Science, University of Udine, Italy

21 Overall evaluation form After having rated every assigned case, an Overall Evaluation Form should be filled by each participant to describe their experience in participating to the field trial Study 2 and to the field trial Study 3: 21 Dept of Maths & Computer Science, University of Udine, Italy

22 22 Dept of Maths & Computer Science, University of Udine, Italy

23 Language choice All the ICD-FiT users can set the system language for their own usage. On the top bar there is the settings link available in every page. Setting the ICD-FiT language is very easy, since there is a simple drop down menu with all the available languages (with the menu growing whenever a new language is added). Demo site The demo site can be accessed by using the following demo users: WHO coordinator: who@mail.com FTC coordinator: ita.ftc@mail.com FTS coordinator: ita.fts.1@mail.com and ita.fts.2@mail.com raters: ita.rater.1@mail.com and ita.rater.2@mail.com N.B: password is test. These will bring to a demo center with two sites. Feel free to create other sites, invite raters, etc. Countries participating in the technical testing will also access to their own demo centers, from where they can build up the site and raters infrastructure. 23 Dept of Maths & Computer Science, University of Udine, Italy

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