The 'Flapbot'- a global perspective on the validity and usability of a flap monitoring chatbot.

BACKGROUND: The Flapbot chatbot assists in free flap monitoring, emphasising accessibility, user-friendliness, and global reliability. This study assesses Flapbot's worldwide validity and usability and uses qualitative analysis to identify areas for future enhancement.

METHODS: Flapbot, built on Google's Dialogflow, was evaluated by international plastic surgeons. Invitations were sent to the International Lower Limb Reconstruction Collaborative (INTELLECT), International Confederation of Plastic Surgery Societies (ICOPLAST), and the International Microsurgery Club. Out of the 42 surgeons who agreed to participate 21 tested the Flapbot and completed an online survey on its validity and usability. The survey had 13 validity items and 10 usability items. Data analysis involved computing the Individual Content Validity Index (I-CVI) and Scale-wide Content Validity Index (S-CVI) for validity, and the System Usability Score (SUS) for usability. Thematic analysis distilled free text responses to identify key themes.

RESULTS: Nine of thirteen items had an I-CVI over 0.78, denoting significant relevance. The S-CVI score stood at 0.82, indicating high relevance. The SUS score was 68, representing average usability. Themes highlighted issues with the current model, development suggestions, and surgeons' concerns regarding growing reliance on digital tools in healthcare.

CONCLUSION: Flapbot is a promising digital aid for free flap monitoring. While it showcases notable validity and usability, improvements in functionality, usability, and accessibility are needed for broader global use.