To measure the PSR from clinicians, we developed a new tool utilizing the R package shiny3 (Chang, Cheng, Allaire, Xie, & McPherson, 2020). This tool assessed the relation between all possible 190 symptom pairs of the 20 symptoms that were also included in the empirical network. Clinicians were asked to indicate how two specific symptoms relate to each other. They could choose on a 9-point scale ranging from ‘relate very strongly negative’ to ‘do not relate’ to ‘relate very strongly positive’. When the clinicians indicated a relationship between symptoms, the resulting network was displayed in an adjacent window. An image of the tool is displayed in Figure 1. Clinicians were asked to base their perception on an ‘average patient’ they would treat in the OCR, emphasizing that we are interested in how symptoms relate in general.

Image of the tool assessing the clinicians’ PSR

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