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Ergonomic Evaluation of an Ecological Interface and a Profilogram Display for Hemodynamic Monitoring

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Abstract

Objective.Comprehensive monitoring of the patient state andsubsequent decision making is an essential part of the task of ananaesthetist. The physicians' decision making process is based upon aconcept of partly abstract physiologic parameters such as depth of anaesthesiaor contractility. This concept is derived from the measured parameters givenon todays' trend displays in addition to context information availablefor the anaesthetist. We investigated two alternative approaches of displaydesign for hemodynamic monitoring: 1) integrated displays based on ecologicalinterface design, and 2) profilogram displays based on intelligent alarms.Method.To evaluate differences in decision making, the two displaysand a trend display were compared in an experimental set-up with computersimulated vital parameter curves. From a start state with random parameterdeviations from the ideal state, subjects had to achieve the ideal circulatoryperformance as fast as possible by manipulating vasomotor tone, heart rate,blood volume and contractility. To analyse subjects' decision makingprocess, eye-tracking, event-logging, and the method of think aloud protocolswere used. Twenty anaesthesiologists performed 113 experiments (approximately2 with each display). Results.The anaesthetists failed to achieve thetask in 37% using the trend display, in 19% using the profilogram display, andin 13% using the ecological interface. Hence, a safer task solution waspossible with the ecological interface and the profilogram display but at theexpense of various performance parameters such as higher trial time, moreinteractions with the simulated system, and more frequent eye movements. Incontrast to the trend display and the profilogram display, where anaesthetistswere mainly focussed on controlling the left atrial pressure, such anbehaviour was less observed with the ecological interface. Conclusion.Our results have shown that subjects came to more effective solutions withthe traditional trend display. The main reason for this result may be theiryears of experience with this kind of display type. Regarding safe andgoal-intended decision finding, the results are encouraging for furtherexperiments with redesigned ecological displays. But these displays ought tohave smoother changes with respect to the traditional trend displays.Furthermore, new experiments have to be performed under real or fairly real(e.g. together with an anaesthesia simulator) conditions to underline thepositive results for ecological interfaces.

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Authors and Affiliations

  1. Helmholtz-Institute for Biomedical Engineering at the Aachen University of Technology, Pauwelsstr. 20, D-52074, Aachen, Germany

    Andreas Jungk, Bernhard Thull & Günter Rau

  2. Department of Anaesthesiology and Intensive-Care-Medicine, Rheinische Friedrich-Wilhelms-University Bonn, Sigmund-Freud-Str. 25, D-53105, Bonn, Germany

    Andreas Hoeft

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  1. Andreas Jungk
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  2. Bernhard Thull
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  3. Andreas Hoeft
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  4. Günter Rau
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Jungk, A., Thull, B., Hoeft, A. et al. Ergonomic Evaluation of an Ecological Interface and a Profilogram Display for Hemodynamic Monitoring. J Clin Monit Comput 15, 469–479 (1999). https://doi.org/10.1023/A:1009909229827

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