CITEC, Bielefeld University, Inspiration 1, 33619 Bielefeld, Germany.
CITEC, Bielefeld University, Inspiration 1, 33619 Bielefeld, Germany.
Am J Emerg Med. 2022 Aug;58:286-297. doi: 10.1016/j.ajem.2022.05.016. Epub 2022 May 31.
ST segment elevation myocardial infarction is a common reason for out-of-hospital cardiac arrest in adult patients. The surveillance of the ST segment in the electrocardiogram is limited to visual presentation. However, the ST segment can change during the course of treatment. If ST elevation is present immediate coronary revascularization is needed, therefore detecting ST elevation changes the treatment fundamentally. Sonification of the ST segment is a new method which enables the emergency team to detect intermediate changes of the ST segment.
We have chosen two sonification designs which were introduced to two groups, medical students and computer science students. Twenty-one participants took part in the study. The sonification was designed for evaluation of the ST segment. The user was supposed to become empowered to distinguish between no, medium-low, medium-high or extreme ST elevation by listening to the sonification. The two groups were asked to evaluate the sounds for possible ST elevation as well as for aesthetics and usability. In a second study twenty-five medical students were taking part in a medical scenario in which sonification was played during a simulated case. The patient was suffering from a myocardial infarction, ST elevation was transient and sonification sounds were changing appropriately. The students were supposed to detect these changes and act accordingly by modifying the treatment.
Both groups were able to classify ST segment elevation by listening to the sonification samples. The higher the ST segment, the better was the detection rate overall. In all of the three categories (pleasantness, informativeness and long-term listening) the Water Ambience sonification was rated higher compared to the Polarity sonification. Moreover, in the two groups that took part in the study, we found a significant difference when comparing classification performance using both sonification designs. For the group of medical students as t(20) = 4.31, p = 3.44 × 10, p < 0.01 and for the computer science students as t(19) = 3.40, p = 9.39 × 10, p < 0.01. In the simulated medical scenario participants indicated that 96% detected the ST elevation. 60% stated that sonification played a role whereas for 32% it did not play a role for the detection of ST elevation.
Sonification has the potential to play an important role as a new supporting tool for the surveillance of the ST segment during the care of patients with suspicion of myocardial infarction. It can be helpful to differentiate between ST segment elevation myocardial infarction and non-ST segment myocardial infarction especially if ST elevation is transient. Furthermore, sonification is viewed as pleasant to listen to and might not contribute to alarm fatigue.
ST 段抬高型心肌梗死是成人院外心脏骤停的常见原因。心电图中 ST 段的监测仅限于视觉呈现。然而，ST 段在治疗过程中会发生变化。如果存在 ST 段抬高，则需要立即进行冠状动脉血运重建，因此检测 ST 段抬高从根本上改变了治疗方法。ST 段的声化是一种新的方法，使急救团队能够检测 ST 段的中间变化。
我们选择了两种声化设计，并将其介绍给两组参与者，一组是医学生，一组是计算机科学专业的学生。共有 21 名参与者参加了这项研究。声化设计用于评估 ST 段。使用者应该能够通过听声化来区分无、中低、中高或极重度 ST 段抬高。两组参与者被要求评估声音是否可能存在 ST 段抬高，以及评估声音的美感和可用性。在第二项研究中，25 名医学生参加了一个模拟病例，在模拟病例中播放了声化声音。患者患有心肌梗死，ST 段抬高是短暂的，声化声音也相应变化。学生们应该能够检测到这些变化，并通过修改治疗方案做出相应的反应。
两组参与者都能够通过听声化样本来分类 ST 段抬高。ST 段抬高越高，整体检测率越高。在所有三个类别（愉悦度、信息量和长期听感）中，水氛围声化的评分都高于极性声化。此外，在参加研究的两组中，我们发现使用两种声化设计进行分类性能比较时存在显著差异。对于医学生组，t(20) = 4.31，p = 3.44 × 10，p < 0.01；对于计算机科学学生组，t(19) = 3.40，p = 9.39 × 10，p < 0.01。在模拟医疗场景中，参与者表示 96%的人检测到了 ST 段抬高。60%的人表示声化在检测 ST 段抬高方面发挥了作用，而 32%的人表示声化在检测 ST 段抬高方面没有发挥作用。
声化有可能成为监测疑似心肌梗死患者 ST 段的一种新的辅助工具，发挥重要作用。它可以帮助区分 ST 段抬高型心肌梗死和非 ST 段抬高型心肌梗死，特别是当 ST 段抬高是短暂的时候。此外，声化听起来令人愉悦，可能不会导致报警疲劳。
