Effects of an Animated Blood Clot Technology (Visual Clot) on the Decision-Making of Users Inexperienced in Viscoelastic Testing: Multicenter Trial

Autor:	Johannes Herrmann, Donat R. Spahn, M. López-Baamonde, Julia Braun, Eva Rivas, Christoph B. Nöthiger, Micheal Thomas Ganter, Florian Piekarski, Kai Zacharowski, Patrick Meybohm, Florian J Raimann, Sadiq Said, Tadzio Raoul Roche, David W. Tscholl
Přispěvatelé:	University of Zurich, Roche, Tadzio Raoul
Jazyk:	angličtina
Rok vydání:	2021
Předmět:	Technology medicine.medical_specialty 10216 Institute of Anesthesiology Computer applications to medicine. Medical informatics R858-859.7 610 Medicine & health Health Informatics rotational thromboelastometry 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology Multicenter trial Health care Humans Medicine 030212 general & internal medicine user-centered design 2718 Health Informatics avatar technology Original Paper Hemostasis intuitive design business.industry Confounding Thrombosis Workload Odds ratio Blood Coagulation Disorders testing coagulation management Thrombelastography Test (assessment) Thromboelastometry Physical therapy Public aspects of medicine RA1-1270 business Visual Clot
Zdroj:	Journal of Medical Internet Research, Vol 23, Iss 5, p e27124 (2021) Journal of Medical Internet Research
ISSN:	1438-8871
Popis:	Background Viscoelastic test–guided coagulation management has become increasingly important in assessing hemostasis. We developed Visual Clot, an animated, 3D blood clot that illustrates raw rotational thromboelastometry (ROTEM) parameters in a user-centered and situation awareness–oriented method. Objective This study aimed to evaluate the applicability of Visual Clot by examining its effects on users that are novices in viscoelastic-guided resuscitation. Methods We conducted an investigator-initiated, international, multicenter study between September 16, 2020, and October 6, 2020, in 5 tertiary care hospitals in central Europe. We randomly recruited medical students and inexperienced resident physicians without significant prior exposure to viscoelastic testing. The 7 participants per center managed 9 different ROTEM outputs twice, once as standard ROTEM tracings and once as the corresponding Visual Clot. We randomly presented the 18 viscoelastic cases and asked the participants for their therapeutic decisions. We assessed the performance, diagnostic confidence, and perceived workload in managing the tasks using mixed statistical models and adjusted for possible confounding factors. Results Analyzing a total of 630 results, we found that the participants solved more cases correctly (odds ratio [OR] 33.66, 95% CI 21.13-53.64; P Conclusions This study emphasizes the practical benefit of presenting viscoelastic test results in a user-centered way. Visual Clot may allow inexperienced users to be involved in the decision-making process to treat bleeding-associated coagulopathy. The increased diagnostic confidence, diagnostic certainty, reduced workload, and positive user feedback associated with this visualization may promote the further adoption of viscoelastic methods in diverse health care settings.
Databáze:	OpenAIRE
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