Commercialization of Graphical Display for Critical Care Environments

描述（由申请人提供）：本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，许多事件与信息缺失、不准确或误解有关。在对ICU中的1024名患者进行的为期一年的研究中，241个人为错误使ICU中的停留时间延长了425个患者日，消耗了ICU资源的15%。当数据以图形显示的形式呈现时，重症监护临床医生可以更早地发现关键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、PaCO 2和HCO 3值的状态方面更有效，从而显著提高了用户的情境意识。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。我们的研究计划是建立在第1阶段的成功结果基础上，并扩展显示，以包括更多的变量，使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进行优化。可用性测试将指导设计增强。结果显示将在C++编程语言中实现。将使用真实患者模拟器和临床ICU研究测量图形显示的效用。30名重症监护临床医生将被召集到模拟ICU中，以评估4种不同情况下患者的状态。将根据检测给定事件、制定正确诊断和提供有效支持性护理的时间来评估参与者在模拟中的表现。在临床评价期间，我们将把新显示器放置在ICU病房，观察并记录临床医生的干预和行动。专家评估员将对有显示器和无显示器的临床医生的表现进行排序。此外，我们将使用一系列主观工具来确定有关可取性，感知有效性和实用性的信息。所提出的显示系统具有通过减少与该信息的误解相关联的错误的数量来显著增加患者安全的能力。此外，预计新的可视化系统将产生教育影响，因为它将为新手和专家提供清晰的变量演示和互动。

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.