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Avatar-based versus conventional vital sign display in a central monitor for monitoring multiple patients: A multicenter computer-based laboratory study.
David Werner Tscholl
University Hospital Zurich
Corresponding Author
ORCiD: https://orcid.org/0000-0003-4284-6859
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Medical Informatics and Decision Making.
Background Maintaining adequate situation awareness is crucial for patient safety. Previous studies found that the use of avatar-based monitoring (Visual Patient Technology) improved the perception of vital signs compared to conventional monitoring showing numerical and waveform data; and was further associated with a reduction of perceived workload. In this study, we aimed to evaluate the effectiveness of Visual Patient Technology on perceptive performance and perceived workload when monitoring multiple patients at the same time, such as in central station monitors in intensive care units or operating rooms. Methods A prospective, within-subject, computer-based laboratory study was performed in two tertiary care hospitals in Switzerland in 2018. Thirty-eight physician and nurse anesthetists volunteered for the study. The participants were shown four different central monitor scenarios in sequence, where each scenario displayed two critical and four healthy patients simultaneously for 10 or 30 seconds. After each scenario, participants had to recall the vital signs of the critical patients. Perceived workload was assessed with the National Aeronautics and Space Administration Task-Load-Index (NASA TLX) questionnaire. Results In the 10-second scenarios, the median number of remembered vital signs significantly improved from 7 to 11 using avatar-based versus conventional monitoring with a mean of differences of 4 vital signs, 95% confidence interval (CI) 2 to 6, p < 0.001. At the same time, the median NASA TLX scores were significantly lower for avatar-based monitoring (67 vs. 77) with a mean of differences of 6 points, 95% CI 0.5 to 11, p = 0.034. In the 30-second scenarios, vital sign perception and workload did not differ significantly. Conclusions In central monitor multiple patient monitoring, we found a significant improvement of vital sign perception and reduction of perceived workload using Visual Patient Technology, compared to conventional monitoring. The technology enabled improved assessment of patient status and may, thereby, help to increase situation awareness and enhance patient safety.
Keywords
Patient monitoring, Patient safety, Signal Processing, Situation awareness
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CURRENT STATUS: Published
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On 10 Feb, 2020
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On 22 Jan, 2020
Reviewer #1 agreed
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Reviewer #2 agreed
On 03 Jan, 2020
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Received 03 Jan, 2020
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Reviewers invited
Invitations sent on 31 Dec, 2019
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On 17 Dec, 2019
Editor invited
On 17 Dec, 2019
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Received 17 Nov, 2019
Editorial decision: Major revision
On 17 Nov, 2019
Reviewer #2 agreed
On 08 Nov, 2019
Review #2 received
Received 08 Nov, 2019
Reviewer #1 agreed
On 06 Nov, 2019
Reviewers invited
Invitations sent on 06 Nov, 2019
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Submission checks complete
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Editor invited
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No comments provided
Editorial decision: Major revision
On 03 Oct, 2019
Review #1 received
Received 22 Sep, 2019
Review #2 received
Received 22 Sep, 2019
Editor assigned
On 12 Sep, 2019
Reviewers invited
Invitations sent on 12 Sep, 2019
Reviewer #1 agreed
On 12 Sep, 2019
Reviewer #2 agreed
On 12 Sep, 2019
Submission checks complete
On 11 Sep, 2019
Editor invited
On 11 Sep, 2019
First submitted
On 30 Aug, 2019
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Subject Areas
Medical Informatics
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This preprint is under consideration at BMC Medical Informatics and Decision Making. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Avatar-based versus conventional vital sign display in a central monitor for monitoring multiple patients: A multicenter computer-based laboratory study.
David Werner Tscholl
University Hospital Zurich
Corresponding Author
ORCiD: https://orcid.org/0000-0003-4284-6859
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 3
Posted 20 Dec, 2019
Published
On 10 Feb, 2020
No community comments so far
Editorial decision: Accept
On 22 Jan, 2020
Reviewer #1 agreed
On 03 Jan, 2020
Reviewer #2 agreed
On 03 Jan, 2020
Review #1 received
Received 03 Jan, 2020
Review #2 received
Received 03 Jan, 2020
Reviewers invited
Invitations sent on 31 Dec, 2019
Editor assigned
On 18 Dec, 2019
Submission checks complete
On 17 Dec, 2019
Editor invited
On 17 Dec, 2019
No comments provided
Review #1 received
Received 17 Nov, 2019
Editorial decision: Major revision
On 17 Nov, 2019
Reviewer #2 agreed
On 08 Nov, 2019
Review #2 received
Received 08 Nov, 2019
Reviewer #1 agreed
On 06 Nov, 2019
Reviewers invited
Invitations sent on 06 Nov, 2019
Editor assigned
On 05 Nov, 2019
Submission checks complete
On 04 Nov, 2019
Editor invited
On 04 Nov, 2019
No comments provided
Editorial decision: Major revision
On 03 Oct, 2019
Review #1 received
Received 22 Sep, 2019
Review #2 received
Received 22 Sep, 2019
Editor assigned
On 12 Sep, 2019
Reviewers invited
Invitations sent on 12 Sep, 2019
Reviewer #1 agreed
On 12 Sep, 2019
Reviewer #2 agreed
On 12 Sep, 2019
Submission checks complete
On 11 Sep, 2019
Editor invited
On 11 Sep, 2019
First submitted
On 30 Aug, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Medical Informatics
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Medical Informatics and Decision Making.
Background Maintaining adequate situation awareness is crucial for patient safety. Previous studies found that the use of avatar-based monitoring (Visual Patient Technology) improved the perception of vital signs compared to conventional monitoring showing numerical and waveform data; and was further associated with a reduction of perceived workload. In this study, we aimed to evaluate the effectiveness of Visual Patient Technology on perceptive performance and perceived workload when monitoring multiple patients at the same time, such as in central station monitors in intensive care units or operating rooms. Methods A prospective, within-subject, computer-based laboratory study was performed in two tertiary care hospitals in Switzerland in 2018. Thirty-eight physician and nurse anesthetists volunteered for the study. The participants were shown four different central monitor scenarios in sequence, where each scenario displayed two critical and four healthy patients simultaneously for 10 or 30 seconds. After each scenario, participants had to recall the vital signs of the critical patients. Perceived workload was assessed with the National Aeronautics and Space Administration Task-Load-Index (NASA TLX) questionnaire. Results In the 10-second scenarios, the median number of remembered vital signs significantly improved from 7 to 11 using avatar-based versus conventional monitoring with a mean of differences of 4 vital signs, 95% confidence interval (CI) 2 to 6, p < 0.001. At the same time, the median NASA TLX scores were significantly lower for avatar-based monitoring (67 vs. 77) with a mean of differences of 6 points, 95% CI 0.5 to 11, p = 0.034. In the 30-second scenarios, vital sign perception and workload did not differ significantly. Conclusions In central monitor multiple patient monitoring, we found a significant improvement of vital sign perception and reduction of perceived workload using Visual Patient Technology, compared to conventional monitoring. The technology enabled improved assessment of patient status and may, thereby, help to increase situation awareness and enhance patient safety.
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