Development of an Expert System for Diagnosing Toddler Nutritional Status Using a Participatory Design Approach

Authors

  • Wiwin Susanty Bandar Lampung University
  • Dika Hastanto Bandar Lampung University
  • Dian Resha Agustina Bandar Lampung University
  • Nia Kumaladewi Syarif Hidayatullah State Islamic University
  • Taqwan Thamrin Bandar Lampung University
  • Tia Tanjung Bandar Lampung University
  • Asep Trisna Setiawan Universitas Bandar Lampung

DOI:

https://doi.org/10.15408/aism.v9i2.52355

Keywords:

Toddler nutritional status, expert system, certainty factor, participatory design, system usability scale

Abstract

Assessing the nutritional status of a toddler remains an essential challenge for child health, since the process often requires professional expertise and may not always be readily available to the community. This work presents a web-based expert system to assist in assessing toddler nutritional status by combining the Certainty Factor method with the Participatory Design methodology. Nutritionists, Posyandu (Integrated Health Post) cadres, and parents of toddlers were actively involved in the development process, from identifying user requirements to designing the system to evaluating its functionality. The knowledge base consisted of 24 symptoms and six categories of nutritional status, representing expert knowledge, and the Certainty Factor approach was used to address the uncertainty in the diagnostic procedure. The resulting system offers integrated capabilities for Z-Score calculation, symptom-based consultation, nutritional status diagnosis, and follow-up suggestions. The diagnostic validation was performed on 30 selected toddler records and showed promising performance with 88.30% accuracy, 89.98% precision, 88.30% recall, and 87.08% F1-score. Moreover, the usability test conducted with 50 respondents yielded an average System Usability Scale (SUS) score of 79.15, which falls within the Acceptable category, namely Grade B or Good adjective rating. The results of this study show that the proposed system can efficiently enable early diagnosis of children's nutritional status while offering a user-friendly experience and high user approval.

Downloads

Download data is not yet available.

References

[1] H. Y. Addae, C. Apprey, and A. Kwarteng, “Gut microbiome-targeted nutrition interventions and growth among children in low- and middle-income countries: a systematic review and meta-analysis,” Current Developments in Nutrition, vol. 8, no. 3, Art. no. 102085, Feb. 2024, doi: 10.1016/j.cdnut.2024.102085.

[2] T. K. Wudu, A. A. Endalew, and A. A. Dires, “Explainable hybrid machine learning model for predicting stunting and identifying key risk factors among Ethiopian children under five,” Scientific Reports, vol. 16, no. 1, Apr. 2026, doi: 10.1038/s41598-026-46417-w.

[3] N. Ariani, T. Mia Intani, D. Sarli, and S. Poddar, “Psychosocial stimulation towards the development of toddler 1-3 years old,” Malaysian Journal of Medicine and Health Sciences, vol. 17(SUPP4), pp. 88–91, Jun. 2021. [Online]. Available: https://medic.upm.edu.my/upload/dokumen/2021061711405219_MJMHS_0167.pdf

[4] Y. Yuliana et al., “Formulation, nutritional profile, and sensory acceptability of cookies incorporating locally sourced ingredients as complementary foods for toddlers: A strategy for stunting prevention,” Food Chemistry Advances, vol. 7, Art. no. 101017, Jun. 2025, doi: 10.1016/j.focha.2025.101017.

[5] E. Inzaghi, V. Pampanini, A. Deodati, and S. Cianfarani, “The effects of nutrition on linear growth,” Nutrients, vol. 14, no. 9, Art. no. 1752, Apr. 2022, doi: 10.3390/nu14091752.

[6] R. E. Caraka et al., “Bayesian Network analysis of spatial disparities in child nutrition status and health determinants across Indonesia,” International Journal of Applied Earth Observation and Geoinformation, vol. 144, Art. no. 104936, Nov. 2025, doi: 10.1016/j.jag.2025.104936.

[7] E. Oktaviani, J. Feri, S. Susmini, and B. Soewito, “Early detection of growth and development and education for mothers on their children’s nutritional status during the golden age,” (in Indonesian), Journal of Community Engagement in Health, vol. 4, no. 2, pp. 319–324, Sep. 2021, doi: 10.30994/jceh.v4i2.146.

[8] A. Zsakai et al., “A new monitoring system for nutritional status assessment in children at home,” Sci. Rep., vol. 13, no. 1, Art. no. 4155, Mar. 2023, doi: 10.1038/s41598-023-30998-x.

[9] D. Kang, S. Youn, J. W. Min, and E. J. Ko, “Nutritional status evaluation and intervention in chronic kidney disease patients: Practical approach,” Nutrients, vol. 17, no. 20, Art. no. 3264, Oct. 2025, doi: 10.3390/nu17203264.

[10] Y. Yuningsih, A. N. Zannah, A. I. Sari, and R. Handayani, “The relationship between nutritional status and the development of children aged 4-60 months,” Jurnal Kesehatan dr. Soebandi, vol. 12, no. 2, pp. 89–96, Oct. 2024, doi: 10.36858/jkds.v12i2.689.

[11] W. Barker et al., “The evolution of health information technology for enhanced patient-centric care in the United States: Data-driven descriptive study,” J. Med. Internet Res., vol. 26, p. e59791, Oct. 2024, doi: 10.2196/59791.

[12] D. Janjanam, B. Ganesh, and L. Manjunatha, “Design of an expert system architecture: An overview,” J. Phys. Conf. Ser., vol. 1767, no. 1, Art. no. 012036, Feb. 2021, doi: 10.1088/1742-6596/1767/1/012036.

[13] G. V. Torres, L. L. Aponte, and L. Andrade-Arenas, “Implementation of an expert system for automated symptom consultation in Peru,” International Journal of Advanced Computer Science and Applications, vol. 12, no. 12, Jan. 2021, doi: 10.14569/IJACSA.2021.0121298.

[14] Y. Deng, “An expert system for health diagnosis based on natural language processing and reasoning engine,” Advances in Computer, Signals and Systems, vol. 8, no. 5, 2024, doi: 10.23977/acss.2024.080515.

[15] K. Lamba, S. Rani, and M. Shabaz, “Synergizing advanced algorithm of explainable artificial intelligence with hybrid model for enhanced brain tumor detection in healthcare,” Scientific Reports, vol. 15, no. 1, Art, no. 20489, Jul. 2025, doi: 10.1038/s41598-025-07524-2.

[16] S. Tsao and W. Chen, “A hybrid framework integrating fuzzy logic and artificial intelligence for corporate financial management and risk prediction,” Discover Computing, vol. 29, no. 1, Feb. 2026, doi: 10.1007/s10791-026-09969-z.

[17] R. Maulana and A. Desiani, “Development of an expert system for the diagnosis of kidney disease using the certainty factor method,” Majalah Bisnis & IPTEK, vol. 16, no. 1, pp. 16–25, Jun. 2023, doi: 10.55208/bistek.v16i1.345.

[18] D. M. D. Kumara, L. P. Wanti, and R. Purwanto, “The certainty factor method in an expert system for tuberculosis disease diagnosis,” Bulletin of Computer Science Research, vol. 5, no. 4, pp. 806–812, Jun. 2025, doi: 10.47065/bulletincsr.v5i4.549.

[19] S. Sumiati, H. Saragih, T. K. A. Rahman, and A. Triayudi, “Expert system for heart disease based on electrocardiogram data using certainty factor with multiple rule,” IAES International Journal of Artificial Intelligence, vol. 10, no. 1, pp. 43–50, 2021, doi: 10.11591/ijai.v10.i1.pp43-50.

[20] S. D. Putra, M. B. Ulum, and D. Aryani, “Expert system for diagnosis of uterine myomas using the certainty factor method,” International Journal of Engineering, Science and Information Technology, vol. 1, no. 4, pp. 103–108, Oct. 2021, doi: 10.52088/ijesty.v1i4.177.

[21] M. H. Nasri, R. Hammad, and G. Y. Pratama, “Development of a platform for interventions on the nutritional status of pregnant women based on the integration of case-based reasoning and Dempster–Shafer theory,” (in Indonesian), Jurnal Teknologi Informasi dan Multimedia, vol. 8, no. 1, pp. 76–84, Jan. 2026, doi: 10.35746/jtim.v8i1.905.

[22] I. Puspitasari, N. Nuzulita, and C.-S. Hsiao, “Agile user-centered design framework to support the development of e-health for patient education,” in Studies in Computational Intelligence, 2024, pp. 131–144. doi: 10.1007/978-3-031-57037-7_10.

[23] L. Ospina-Pinillos et al., “Co-Designing, developing, and testing a mental health platform for young people using a participatory design methodology in Colombia: Mixed methods study,” JMIR Human Factors, vol. 12, Art. no. e66558, Apr. 2025, doi: 10.2196/66558.

[24] S. Campbell et al., “Purposive sampling: Complex or simple? Research case examples,” Journal of Research in Nursing, vol. 25, no. 8, pp. 652–661, Dec. 2020, doi: 10.1177/1744987120927206.

[25] K. Andre and N. Christian, “Participatory design, user involvement and health IT evaluation,” in Studies in health technology and informatics, vol. 222, 2016, pp. 139–51. doi: 10.3233/978-1-61499-635-4-139.

[26] M. Raj et al., “Development of a novel web-based platform to support culturally and medically tailored comprehensive nutrition assessments: SPICE-Healthcare,” JAMIA Open, vol. 8, no. 6, Art. no. ooaf129, Oct. 2025, doi: 10.1093/jamiaopen/ooaf129.

[27] S. Elsayed-Ali, E. Bonsignore, and J. Chan, “Exploring challenges to inclusion in participatory design from the perspectives of global north practitioners,” Proc. ACM Hum. Comput. Interact., vol. 7, no. CSCW1, pp. 1–25, Apr. 2023, doi: 10.1145/3579606.

[28] E. Kurniawan, N. Nofriadi, and A. Nata, “Application of the system usability scale (SUS) in measuring the usability of the academic program website at STMIK Royal,” (in Indonesian), Journal of Science and Social Research, vol. 5, no. 1, pp. 43–49, Feb. 2022, doi: 10.54314/jssr.v5i1.817.

[29] A. Saputra, “Application of usability to the PENTAS application using the system usability scale (SUS) method,” (in Indonesian), JTIM: Jurnal Teknologi Informasi dan Multimedia, vol. 1, no. 3, pp. 206–212, Nov. 2019, doi: 10.35746/jtim.v1i3.50.

[30] K. Albrink, D. Schröder, C. Joos, F. Müller, and E. M. Noack, “Usability of an app for medical history taking in general practice from the patients’ perspective: Cross-sectional study,” JMIR Human Factors, vol. 11, Art. no. e47755, Jan. 2024, doi: 10.2196/47755.

[31] S. Afrizal, R. Prihatni, and S. P. Hastono, “Evaluation of the quality of health applications using the system usability scale,” Jurnal Manajemen Informasi Kesehatan (Health Information Management), vol. 9, no. 1, pp. 1–9, Jun. 2024, doi: 10.51851/jmis.v9i1.492.

Downloads

Published

2026-10-09

How to Cite

Development of an Expert System for Diagnosing Toddler Nutritional Status Using a Participatory Design Approach. (2026). Applied Information System and Management (AISM), 9(2), 407-417. https://doi.org/10.15408/aism.v9i2.52355