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Biomedical subjects

G T Blike

Publications and source records attributed to G T Blike.

5 recordsLinked to original sources
PubMed2000

Specific elements of a new hemodynamics display improves the performance of anesthesiologists.

OBJECTIVE: We tested the hypothesis that a monitoring display proposed by Blike et al. improves the performance of anesthesiologists. We measured the performance of anesthesiologists using the new display and compared it to their performance with a traditional display. We studied three different displays on how they affected recognition and differentiation of five etiologies of shock-anaphylaxis, bradycardia, hypovolemia, ischemia and pulmonary embolus. METHODS: The participants monitored heart rate, systemic arterial and pulmonary blood pressure, central venous pressure, and cardiac output during five shock states and five non-shock states. The resulting 10 data sets made up ten decision screens, which we presented randomly on a computer monitor to the subjects in one of three different formats (a Single Sensor Single Indicator (SSSI) Numeric display; an Object display; and an Object Minus Shapes display). Subjects used soft-buttons on a computer touch-screen monitor to: a) advance to the next display; b) differentiate a non-shock state from a shock state; and, c) select the etiology of shock state represented by the display (Figure 4). The internal clock and memory of the computer made the collection of data automatic. RESULTS: The subjects recognized a problem more rapidly with the help of a graphical "pointer on a reference scale" in both Object displays, but their accuracy had not improved in comparison to the SSSI Numeric display. The shape of the Object display improved performance of etiology determination compared to the Object Minus Shapes display and SSSI Numeric display. Testing (10 trials) was completed in less than 45 minutes. CONCLUSIONS: The new display with "emergent features" can improve the diagnostic performance of clinicians.

Anesthesiology↗
PubMed1999

A graphical object display improves anesthesiologists' performance on a simulated diagnostic task.

OBJECTIVE: This study tests the hypothesis that a graphical object display (a data display consisting of meaningful shapes) will affect the ability of anesthesiologists to perform a diagnostic task rapidly and correctly. The diagnostic tasks studied were recognition and differentiation of five etiologies of shock--anaphylaxis, bradycardia, myocardial ischemia, hypovolemia, pulmonary embolus. METHODS: Data sets consisting of HR, Systemic Arterial BP, Pulmonary Arterial BP, CVP, and Cardiac Output were generated for five shock states and five non-shock states. The resulting 10 data sets were presented on a computer monitor to study subjects twice (first in an alpha-numeric format and then in the object format) for a total of twenty decision screens. Subjects used soft-buttons on a computer touch-screen monitor to: a) advance to the next display; b) differentiate a non-shock state from a shock state; and, c) select the etiology of shock state represented by the display (Figure 2). Data collection was automatic, using the internal clock and memory of the computer. RESULTS: Eleven anesthesiologists participated in this study. They completed a total of 3060 diagnostic decisions, half with each display format. Performance measures were time to decision and diagnostic accuracy. The object display improved no-shock recognition by 1.0 second and shock etiology determination by 1.4 seconds (p < 0.05). The object display also significantly improved accuracy for shock recognition by 1.4% and etiology determination by 4.1% (p < 0.05). Testing was completed in a time interval of <45 min per 10 trials. CONCLUSIONS: The primary finding of this study was that anesthesiologists using the object display format committed significantly fewer diagnostic errors when interpreting physiologic data. In addition, both the recognition of no-shock and the diagnosis of shock etiology were completed more rapidly when the object display was used. The major limitation of this initial trial is the simplicity of the test. Future investigation of the impact of the display on clinical decision making will require more realistic clinical scenarios with partial or full simulation to better understand the potential clinical impact.

Anesthesiology↗