A qualitative study exploring physician perspectives on a cardiac-based seizure prediction digital service for epilepsy management

Objective: The unpredictability of epileptic seizures represents a significant challenge to people with epilepsy. To address this, research on seizure prediction has been evolving rapidly. However, insights from end-users that guide the development of this technology have been limited. This study aimed to explore physicians’ perspectives on the management of epilepsy and their perception of a proposed cardiac-based seizure prediction digital service. Method: One-hour semi-structured interviews were conducted individually with physicians who treat epilepsy in Malaysia. The interviews explored challenges in managing epilepsy, information priorities, and feedback on the proposed digital service. Thematic analysis was used to identify relevant themes and subthemes. Results: The study identified significant challenges related to clinical and treatment, patient management, and the workplace. Knowledge about patients’ well-being outside of the clinic was considered as most important among physicians, while having data on patients’ daily lives was cited as least important. Overall, physicians expressed interest in the digital service, describing its usefulness in clinical decision-making, enhancing patient outcomes, and providing objective seizure documentation. However, barriers related to increased workload, lack of trust in technology, and poor usability among patients also emerged. Requirements identified for the web-based portal that is linked to the digital service were categorized into seizure data and monitoring, patient management, and usability. Significance: This study revealed significant challenges, clinical information needs, and requirements for the accompanying web-based portal. Design guidelines were generated in following aspects: [1] support clinical decision-making and comprehensive care, [2] interoperability and integration with clinical workflows, [3] building trust in technology, and [4] increase usability and accessibility. Overall, insights gained from this study will serve as a guide for the design and development of a seizure prediction digital service. Future research can consider exploring the perspectives of physicians in private settings and evaluating the effectiveness of the technology in a real-world setting.