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Master’s student helps design award-winning app for patients considering elective mastectomy

Marisa Grayson came to The Ohio State University to study cognitive systems engineering (CSE) and conduct research in a world-leading laboratory focused on making people and computers team players. Now set to graduate with a master’s degree, Grayson has made her own mark on a project that aims to help breast cancer patients make the difficult decision of whether or not to have an elective mastectomy.

Marisa Grayson

Grayson couldn’t pass up the opportunity to become part of the Cognitive Systems Engineering Lab’s 35-year history of designing computers to support people making risky decisions in areas like aviation, space and health care.  

“It’s an extremely unique and specialized area, which can only be really studied in a few places in the world,” Grayson said. “Having the opportunity to come work for one of the founders, Dr. David Woods, and rising stars like Dr. Mike Rayo, being able to work in the lab while taking classes—I really couldn’t pass it up. Ohio State offers a lot of great things, but CSE is special and unique to it.”

During her studies, Grayson worked on several research projects and won first place in the international Mobile Health Applications for Consumers Student Design Competition for her work with Rayo, an assistant professor of integrated systems engineering, as one of the lead designers of the RecorDr app.

The app is part of a collaboration between Rayo and Clara Lee, MD, associate professor of plastic surgery in the College of Medicine. The first of its kind, it allows patients to record and securely send their conversations with physicians about whether or not to have a contralateral prophylactic mastectomy—removal of the healthy breast in a patient who is undergoing a mastectomy due to breast cancer.

The number of these surgeries is on the rise, even for patients without a genetic predisposition or other risk factors, Grayson explained. The research team wants to understand how aspects of these conversations influence the decision-making process.

By enabling patients with smartphones to become data collectors for the research, the scale and reach of the research grows exponentially.  Patients agree to be part of the study in advance and privacy concerns were addressed during the app’s development.

RecorDr was designed to support the needs of both patients and researchers. In addition to recording and sending conversations with physicians, the app reminds patients to start recording at the beginning of appointments, allows users to bookmark and annotate the recording, and notifies them of upcoming appointments. Transcriptions are generated by a third-party and provided to patients.

As a lead designer of the app, Grayson did all of the prototyping and usability testing to ensure it was easy to understand and use. "The most rewarding aspect of this project was seeing people interact with the app during rounds of usability testing and explaining how they would really use it in their own health care visits.”

Feedback from the usability testing was very positive, she explained. Users mentioned the app’s utility for all doctor appointments, especially for elderly patients. “We did some usability testing with older patients as well to get a sense of how they react to it and had really great feedback.”

RecorDr is currently available in the Google Play store and the App Store. A pilot study is underway with a target of 70 patients, however future development plans remain open ended.

“The target population that we have are, I’m sure, going to find it very helpful,” Grayson said. “And it’ll be greatly informative to us for our research, to understand more of decision making and to understand in general how the interaction between patients and physicians really plays out.”

Grayson’s future plans are also open ended. Set to graduate in December, Grayson has wrapped up her involvement with RecorDr, but still hopes to pursue a PhD in cognitive systems engineering in the future. First she wants to gain more real-world experience as her Ohio State mentors did.

“Suffice to say the people in my field do have a lot of extensive experience in safety-critical realms,” Grayson said. “I think it’s hugely valuable to have that experience before coming back.”

by Candi Clevenger, College of Engineering Communications,