Predicting Device Implementation Potential: Development and Validation of a Tool Based on the DART Framework

Introduction

The Design for AcceleRated Translation (DART) framework identifies factors that impact translation speed. This study outlines the development and validation of the DART for Rehabilitation Technologies (DART-RT). We hypothesized a survey-based tool could predict the readiness for implementation of a device based on end-user evaluations on seven determinants: cost, safety, effectiveness, clinical demand, patient values, relative advantage, and clinical utility.

Methods

DART-RT was developed through three phases: 1) item development, 2) scale development, and 3) scale evaluation. In Phase 1, content experts generated and reviewed items and descriptions of neurorehabilitation technologies. Phase 2 included cognitive interviews with end users (i.e., rehabilitation clinicians, providers, patients, and engineers). The survey was then pilot-tested with end users. Phase 3 included exploratory factor analysis, model fit, reliability, and validity.

Results

Phase 1 resulted in 12 descriptions of neurorehabilitation tools and seven constructs as defined by the DART framework. Phase 2 iteratively interviewed six end users to assess the questions' appropriateness and the responses' strength. The pilot data included 104 responses. Preliminary factor analysis and model fit indicate results load into two factors (< 0.4) determined to be F1: Viability (cost, safety, effectiveness) and F2: Implementation potential (clinical demand, patient values, relative advantage, and clinical utility). Preliminary model fit was adequate (CFI: 0.969, SRMR: 0.064, RMSEA: 0.054).

Conclusions

DART-RT addresses the complexity of describing implementation potential. Understanding implementation potential profiles can inform whether a technology is ready for clinical implementation, requires further refinement, or lacks viability.