OBJECTIVES: This paper focuses on the user perspective in usability testing (UT) for eCOAs and provides recommendations and guidelines to ensure that the patient perspective and experience becomes the focal point of the testing. We argue that UT needs to be performed consistently on new eCOA instruments. We emphasize that the interaction between a COA, an eCOA platform’s user interface, and its intended users is complex and requires consistent testing tailored to relevant target populations to improve the usability of the platform and COAs it administers, and provide a positive user experience.

METHODS: We present qualitative results from a UT study conducted with 14 cancer patients, split into two groups of 7, each group using a different device (smartphone and tablet). The patients had different conditions due to their cancer diagnosis such as difficulty gripping, reading and concentrating, and tactile challenges. The UT session required participants to complete different tasks using a pre-designed interview script administered by a trained interviewer.

RESULTS: Participants completed various activities allowing the interviewer to observe any challenges faced, and answered general and population-specific questions about usability of the platforms. The participants were also encouraged to talk through challenges encountered, and provide their impressions of the eCOA and device. The qualitative analysis of the results informed the development of guidelines and recommendations based on the patients’ experience.

CONCLUSIONS: In UT, we determine a participant’s ease of responding a questionnaire electronically and their interaction with the eCOA platform’s user interface. When an eCOA has been designed specifically for electronic administration, UT serves to: assess operational efficiency of the eCOA system; identify design issues causing patient dissatisfaction and hindering data collection; explore software and working improvements; and understand and evaluate user interaction. Full realization of these UT objectives requires a testing process focused on and adapted for specific patient populations.