Tappan Jacqueline M, Daniels Jeremy, Slavin Brad, Lim Joanne, Brant Rollin, Ansermino J Mark
Engineering Systems Division, Massachusetts Institute of Technology, Cambridge, MA, USA.
J Clin Monit Comput. 2009 Aug;23(4):223-32. doi: 10.1007/s10877-009-9186-8. Epub 2009 Jun 21.
Physiological monitoring is a requisite for optimal care to ensure that the condition of a patient is maintained within safe levels. Monitoring can be jeopardized by the inability of a clinician to recognize important changes in the visual display of data throughout the duration of the monitoring task. We hypothesized that the addition of a visual cue imparting contextual information to a physiological display would improve the detection ability and response time of a clinician to a change in a patient variable.
Contextual information based on trend information was added to a physiological display in the form of a visual cue. Following IRB approval, the resulting enhanced display was evaluated by 22 anesthesiologists in a simulated operating room, through the observation of six simulated scenarios using a standard anesthesia display and the enhanced display. Demographic information, response time, accuracy of detection, and usability data were collected.
The enhanced display reduced the detection time to a change in the simulated scenarios by 14.4 s (95% CI: -26.4 to -2.38), and reduced the expected number of missed events per scenario by 0.23 (95% CI: -0.439 to -0.0203), based on the repeated measures analysis (Poisson model).
The data collected and analyzed in this study supports the addition of a visual cue to future physiological monitors. The graphic representation and the context relevant information that it transmits appears to aid clinicians. While the results indicate that enhanced visualization of context relevant information can lead to a significant improvement in event recognition and identification, further evaluation in clinical settings is required.
生理监测是提供最佳护理的必要条件,以确保患者状况维持在安全水平。在整个监测任务过程中,临床医生若无法识别数据视觉显示中的重要变化,监测工作可能会受到影响。我们假设,在生理数据显示中添加传达背景信息的视觉提示,将提高临床医生对患者变量变化的检测能力和反应时间。
基于趋势信息的背景信息以视觉提示的形式添加到生理数据显示中。经机构审查委员会(IRB)批准后,22名麻醉医生在模拟手术室中,通过观察使用标准麻醉显示和增强显示的六个模拟场景,对生成的增强显示进行评估。收集人口统计学信息、反应时间、检测准确性和可用性数据。
根据重复测量分析(泊松模型),增强显示将模拟场景中变化的检测时间缩短了14.4秒(95%可信区间:-26.4至-2.38),并将每个场景中预期的漏报事件数量减少了0.23(95%可信区间:-0.439至-0.0203)。
本研究收集和分析的数据支持在未来的生理监测仪中添加视觉提示。其图形表示及其传达的相关背景信息似乎有助于临床医生。虽然结果表明增强相关背景信息的可视化可显著改善事件识别和判定,但仍需要在临床环境中进行进一步评估。