Developing a fuzzy expert system for determining the levels of students' eHealth literacy (Preprint)
BACKGROUND The concept of eHealth literacy refers to the ability of a person to access electronic health information, evaluate the information and apply the resulting knowledge in order to address or solve a health problem. In a society with higher levels of e-health literacy, health and aid in health care can be promoted by using electronic health tools. The first step of promoting eHealth literacy is to assess the current situation of society and determine its health literacy level. Although there are different methods for determination of the level of eHealth literacy in the existing studies, there is no way to measure the level of e-health literacy more precisely and realistically due to its subjective concept. OBJECTIVE This research aims to develop and implement a fuzzy expert system to determine the level of eHealth literacy. The system must be able to identify the weakness of students' e-health literacy in order to tailor services and information to the needs of the target group. In addition, the system could be a help for responsible organizations such as the Ministry of Health or the university to suggest intervention programs for improving the students' eHealth literacy based on the results. METHODS In this paper, different ways of measuring the individual’s literacy level were extracted. Due to the experts’ opinion, the Digital Health Literacy Instrument was selected and used to develop a rule-based fuzzy expert system to determine the levels of eHealth literacy. The reliability and validity of the expert system were evaluated based on the experts’ judgment and by asking for the participation of 50 students of Mashhad University of Medical Sciences. In order to decrease the calculation time and make the system easier to use, the fuzzy expert system was modified based on rough set theory, which caused a reduction in the number of rules from 300 to 159. RESULTS The comparison between the two fuzzy expert systems indicated that no significant difference was detected and both systems were succeeded in around 90% of the cases. CONCLUSIONS Determination of the levels of students’ electronic health literacy is a complex problem that includes uncertainty and inaccuracy. Due to the accuracy and agility of expert systems, it is recommended to use the fuzzy-rough expert system in order to overcome this problem.