Commercialization of Graphical Display for Critical Care Environments

描述(申请人提供)：该项目的目标是开发和测试信息可视化显示技术，以帮助临床医生诊断和治疗重症监护环境中的意外事件。ICU中经常发生意外事件，许多事件与遗漏、不准确或误解的信息有关。在一项对ICU中1024名患者的一年研究中，241个人为错误将ICU的停留时间延长了425个病人日，并消耗了ICU资源的15%。当数据以图形显示时，重症监护临床医生可以更早地发现危重事件，并更准确地诊断事件。初步研究发现，当使用动脉血气信息的图形显示时，视觉ABG显示在向用户传达pH、PaCO2和HCO3-值的状态方面更有效，从而显著提高了用户的情景意识。此外，显示器显著提高了诊断的准确性，同时减少了认知工作量。我们的研究计划是在第一阶段成功结果的基础上，扩大显示范围，包括更多变量，让临床医生对患者的气体交换状态有一个全面的了解。数据驱动的视觉隐喻将通过迭代设计过程得到提炼。可用性测试将指导设计增强。结果显示将用C++编程语言实现。图形显示的效用将使用真实的患者模拟器和临床ICU研究来衡量。30名重症监护临床医生将被召集到一个模拟的ICU，在4种不同的情况下评估患者的状况。参与者在模拟中的表现将根据检测到给定事件、制定正确诊断和提供有效支持护理的时间进行评估。在临床评估中，我们将把新的显示器放置在ICU房间，并观察和记录临床医生的干预和行动。专家评价员将对有无展示的临床医生的表现进行排名。此外，我们将使用一系列主观工具来确定关于可取性、感知有效性和实用性的信息。这一建议的显示系统能够通过减少与误解该信息相关的错误数量来显著提高患者的安全性。此外，预计新的可视化系统将产生教育影响，因为它将向新手和专家提供明确的变量演示和交互。

DESCRIPTION (provided by applicant): The objective of this project is to develop and test information visualization display technology that will aid clinicians in diagnosing and treating unexpected events in critical care environments. Unexpected events occur frequently in the ICU and many are related to missing, inaccurate or misinterpreted information. In a one year study of 1024 patients in an ICU, 241 human errors extended the stay in the ICU by 425 patient days and consumed 15% of the ICU's resources. Critical care clinicians discover critical events earlier and diagnose the events more accurately when data is presented in a graphic display. Preliminary studies found that when a graphic display of arterial blood gas information was used, the visual ABG display was more effective in communicating the status of the pH, PaCo2 and HCO3-values to the user, thus significantly increasing the situational awareness of the user. In addition, the display significantly increased the accuracy of the diagnosis while reducing cognitive workload. Our research plan is to build upon the successful results in phase 1 and extend the display to include more variables to give the clinicians a holistic understanding of the patients gas exchange state. Data-driven visual metaphors will be refined through an iterative design process. Usability testing will guide design enhancements. The resulting display will be implemented in C++ programming language. The utility of the graphic display will be measured using both a realistic patient simulator and a clinical ICU study. Thirty critical care clinicians will be called into a simulated ICU to assess the status of a patient in 4 different scenarios. Performance of the participants in the simulation will be evaluated based on the time to detect a given event, formulate a correct diagnosis, and provide effective supportive care. During the clinical evaluation we will place the new display in the ICU room and observe and record clinician's interventions and actions. Expert evaluators will rank order the performance of the clinicians both with the display and without. In addition, we will use a series of subjective instruments to ascertain information about desirability, perceived effectiveness and utility. This proposed display system has the ability to significantly increase patient safety by reducing the number of errors associated with misinterpretation of this information. In addition, it is anticipated that the new visualization system will have educational impact, as it will provide a clear demonstration and interaction of variables to both novices and experts alike.