Perioperative medicine & outcomes
A WeChat mini-program-based perioperative cognitive management tool (WeChat Applet of Cognitive Dysfunction Assessment and Management (WACDAM)): development and clinical evaluation in elderly patients undergoing oromaxillofacial malignancy surgery—a mixed-methods study
Authors' conclusion
This study developed WACDAM, a pioneering WeChat-based mini-program for POCD management. Through a participatory design, the platform established an age-friendly interface and a dual-channel management system for both patients and clinicians, effectively reducing technological barriers for elderly users and facilitating early identification of high-risk POCD cases.
Study context
- Population
- Elderly patients undergoing oral malignancy resection with neck dissection under GA, December 2020 to December 2021
- Participants
- 112 patients
- Outcome
- Incidence of POCD (Z-score method)
- Follow-up
- Postoperative day 7
Methodological detailsparticipatory design
- Participatory design
Main finding
As reported in the abstract
POCD incidence
- Incidence of postoperative cognitive dysfunction (POCD)
- 33.1% (37/112)
- Older age
- OR 1.269 (1.056-1.525) (95% CI)
- Lower education level
- OR 0.792 (0.644-0.974) (95% CI)
- Hypertension
- OR 4.153 (1.355-12.732) (95% CI)
- Sleep disorders
- OR 1.272 (1.001-1.617) (95% CI)
- Prolonged anaesthesia time
- OR 1.009 (1.001-1.018) (95% CI)
- Intraoperative hypotension
- OR 5.512 (1.240-24.506) (95% CI)
Further findings
WACDAM usability (System Usability Scale (SUS), uMARS)
- SUS score
- 70.17
- uMARS objective quality, mean
- 3.65 ± 1.03
- uMARS functionality (highest)
- 3.87 ± 0.98
- uMARS engagement (lowest)
- 3.48 ± 1.07
- uMARS subjective quality
- 3.66 ± 1.06
Semi-structured interviews (20 patients, 10 clinicians)
- Doctor-patient communication, mean satisfaction increase (points)
- 1.63 ± 1.32, P < 0.01
- Improved efficiency of POCD management; perceived as acceptable and valuable clinical tool
Original publication
A WeChat mini-program-based perioperative cognitive management tool (WACDAM): development and clinical evaluation in elderly patients undergoing oromaxillofacial malignancy surgery—a mixed-methods study. Perioper Med (Lond). Published 12 May 2026. doi:10.
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