Christopher L Brett | Searcharxiv

arXiv2026

User-Centered Design for Digital Patient-Navigation Tools in Oncology: Scoping Review

Navigation programs for patients with cancer improve access and continuity of care, yet their digital transformation is often limited by poor usability and inadequate uptake. Applying user-centered and human-centered design (UCD/HCD) principles may close this gap, but the extent to which such design methods are used and evaluated in oncology navigation tools remains unclear. This scoping review identifies how UCD/HCD principles have been, and should be, applied in developing and implementing digital health tools for navigation for patients with cancer. A scoping review was conducted following PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) and Joanna Briggs Institute guidance. A total of 7 databases (PubMed/MEDLINE, Scopus, IEEE Xplore, Web of Science, Embase, ACM Digital Library, and CINAHL) were searched for English-language articles published between January 2015 and July 2025. Eligible studies reported original, peer-reviewed research on digital or mobile health interventions linked to cancer navigation and documented at least 1 UCD/HCD activity. Two reviewers independently screened records and charted data on context, target users, functions, tool modality, design phase, methods, and outcomes. Findings were synthesized descriptively and thematically. A total of 36 studies met the inclusion criteria. Findings were organized into 4 domains: study characteristics, navigation functions and digital modalities, design processes and methods, and UCD/HCD application. Iterative prototyping and usability testing were the most common, while participatory design and implementation evaluation were underused. UCD/HCD approaches enhance usability and patient relevance of digital cancer navigation tools. However, their application remains limited across cancer types, regions, and functions.

cs.HC↗

arXiv2025

Cancer Diagnosis Categorization in Electronic Health Records Using Large Language Models and BioBERT: Model Performance Evaluation Study

Electronic health records contain inconsistently structured or free-text data, requiring efficient preprocessing to enable predictive health care models. Although artificial intelligence-driven natural language processing tools show promise for automating diagnosis classification, their comparative performance and clinical reliability require systematic evaluation. The aim of this study is to evaluate the performance of 4 large language models (GPT-3.5, GPT-4o, Llama 3.2, and Gemini 1.5) and BioBERT in classifying cancer diagnoses from structured and unstructured electronic health records data. We analyzed 762 unique diagnoses (326 International Classification of Diseases (ICD) code descriptions, 436free-text entries) from 3456 records of patients with cancer. Models were tested on their ability to categorize diagnoses into 14predefined categories. Two oncology experts validated classifications. BioBERT achieved the highest weighted macro F1-score for ICD codes (84.2) and matched GPT-4o in ICD code accuracy (90.8). For free-text diagnoses, GPT-4o outperformed BioBERT in weighted macro F1-score (71.8 vs 61.5) and achieved slightly higher accuracy (81.9 vs 81.6). GPT-3.5, Gemini, and Llama showed lower overall performance on both formats. Common misclassification patterns included confusion between metastasis and central nervous system tumors, as well as errors involving ambiguous or overlapping clinical terminology. Although current performance levels appear sufficient for administrative and research use, reliable clinical applications will require standardized documentation practices alongside robust human oversight for high-stakes decision-making.

cs.CL↗