Effectiveness of enhanced pulse oximetry sonifications for conveying oxygen saturation ranges: a laboratory comparison of five auditory displays

Paterson, Estrella; Sanderson, Penelope; Paterson, Neil; Loeb, Robert G.

doi:10.1093/bja/aex343

Cited by 18 publications

(25 citation statements)

References 19 publications

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“…An important future study would probe for latency differences in detecting enhanced versus conventional sonifications. Findings of Deschamps et al (2016) and Paterson, Sanderson, Paterson, and Loeb (2017) suggest that participants are quicker when using tremolo.…”

Section: Practical Implicationsmentioning

confidence: 97%

A Novel Auditory Display for Neonatal Resuscitation: Laboratory Studies Simulating Pulse Oximetry in the First 10 Minutes After Birth

et al. 2018

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We tested whether enhanced sonifications would improve participants' ability to judge the oxygen saturation levels (SpO 2) of simulated neonates in the first 10 min after birth. Background: During the resuscitation of a newborn infant, clinicians must keep the neonate's SpO 2 levels within the target range, however the boundaries for the target range change each minute during the first 10 min after birth. Resuscitation places significant demand on the clinician's visual attention, and the pulse oximeter's sonification could provide eyes-free monitoring. However, clinicians have difficulty judging SpO 2 levels using the current sonification. Method: In two experiments, nonclinicians' ability to detect SpO 2 range and direction-while performing continuous arithmetic problems-was tested with enhanced versus conventional sonifications. In Experiment 1, tremolo signaled when SpO 2 had deviated below or above the target range. In Experiment 2, tremolo plus brightness signaled when SpO 2 was above target range, and tremolo alone when SpO 2 was below target range. Results: The tremolo sonification improved range identification accuracy over the conventional display (81% vs. 63%, p < .001). The tremolo plus brightness sonification further improved range identification accuracy over the conventional display (92% vs. 62%, p <.001). In both experiments, there was no difference across conditions in arithmetic task accuracy (p >.05). Conclusion: Using the enhanced sonifications, participants identified SpO 2 range more accurately despite a continuous distractor task. Application: An enhanced pulse oximetry sonification could help clinicians multitask more effectively during neonatal resuscitations.

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Section: Practical Implicationsmentioning

confidence: 97%

A Novel Auditory Display for Neonatal Resuscitation: Laboratory Studies Simulating Pulse Oximetry in the First 10 Minutes After Birth

et al. 2018

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“…In the above studies, participants were also more accurate at identifying the absolute SpO 2 value (±1%) at the end of each scenario when they used the stepped sonification (Paterson et al, in press;Paterson et al, 2017). However, despite the substantial superiority of the stepped-effects sonification over the conventional sonification for identifying SpO 2 ranges, accuracy for identifying absolute SpO 2 values still only reached 65% with the stepped sonification in Paterson et al (2017) and 67% in Paterson et al (in press). This may have been because the only acoustic property that varied within each SpO 2 range was pitch.…”

Section: Improving Conventional Po Sonificationmentioning

confidence: 98%

Smooth or Stepped? Laboratory Comparison of Enhanced Sonifications for Monitoring Patient Oxygen Saturation

Collett¹,

Salisbury

Loeb

et al. 2019

Hum Factors

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Background: The pulse oximeter (PO) provides anesthesiologists with continuous visual and auditory information about a patient’s oxygen saturation (SpO2). However, anesthesiologists’ attention is often diverted from visual displays, and clinicians may inaccurately judge SpO2 values when relying on conventional PO auditory tones. We tested whether participants could identify SpO2 value (e.g., “97%”) better with acoustic enhancements that identified three discrete clinical ranges by either changing abruptly at two threshold values (stepped-effects) or changing incrementally with each percentage value of SpO2 (smooth-effects). Method: In all, 79 nonclinicians participated in a between-subjects experiment that compared performance of participants using the stepped-effects display with those who used the smooth-effects display. In both conditions, participants heard sequences of 72 tones whose pitch directly correlated to SpO2 value, and whose value could change incrementally. Primary outcome was percentage of responses that correctly identified the absolute SpO2 percentage, ±1, of the last pulse tone in each sequence. Results: Participants using the stepped-effects auditory tones identified absolute SpO2 percentage more accurately ( M = 53.7%) than participants using the smooth-effects tones ( M = 47.9%, p = .038). Identification of range and detection of transitions between ranges showed even stronger advantages for the stepped-effects display ( p < .005). Conclusion: The stepped-effects display has more pronounced auditory cues at SpO2 range transitions, from which participants can better infer absolute SpO2 values. Further development of a smooth-effects display for this purpose is not necessary.

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“…Further studies have increased the amount of information being conveyed by using advanced auditory (sonification) displays that map onto, and change according to, a single patient's current condition. These studies found that using more descriptive pitch, harmonics, and tremolo improve participants' ability to recognize abnormal trends when compared to less descriptive displays (Hinckfuss, Sanderson, Loeb, Liley, & Liu, 2016;Loeb & Fitch, 2002;Paterson, Sanderson, Paterson, & Loeb, 2017;Watson & Sanderson, 2004).…”

Section: Directed Attention With Advanced Displaysmentioning

confidence: 99%

“…Specifically, the results of the current studies suggest that HWDs might be potential mediators to the alarm problem (Woods, 1995) by decentralizing patient information, which can contribute to better decision-making and improved situation awareness without negatively affecting performance on other tasks. However, to avoid perceptual limitations imposed by HWDs and task loading , the visual stimuli should be paired with advanced auditory stimuli (Edworthy et al, 2017;Paterson et al, 2017) that guide attention to the visual display meaningfully. Still, before HWDs can be put into practice for multiple patient monitoring, future research will need to address several questions relating to sustained use (vigilance), the benefits in more representativeness testing contexts, display checking behaviours, and the ease of access to information using different integrative displays.…”

Section: Limitations and Future Researchmentioning

confidence: 99%

“…HWDs with configurable displays may make information acquisition faster, possibly reducing the amount of attention necessary to get an update . With respects to auditory displays, the studies investigating spearcons and earcons (Edworthy et al, 2017;Paterson et al, 2017) might uncover auditory displays that could be used to guide attention to the display with greater reliability. Some of these displays are even rich enough to convey specific patient information without requiring an HWD, but information becomes more difficult to retain as the number of patients being presented increases .…”

Section: Limitations and Future Researchmentioning

confidence: 99%

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Evaluating head-worn displays for alarm prioritisation and situation awareness in multiple-patient contexts

Pascale¹

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Objective: To compare people's ability to detect peripherally presented stimuli on a monocular head-worn display (HWD) versus a conventional screen. Background: Visual attention capture has been systematically investigated, but not with respect to HWDs. How stimulus properties affect attention capture is likely to be different on an HWD when compared to a computer display. Method: Participants performed an ongoing perceptual task and attempted to detect stimuli that were displayed peripherally on either a computer monitor or a monocular HWD. Results: Participants were less able to detect peripheral stimuli when the stimuli were presented on an HWD than when presented on a computer monitor. Moreover, the disadvantage of the HWD was more pronounced when peripheral stimuli were less distinct and when the stimuli were presented further into the periphery Conclusion: Presenting stimuli on a monocular head-worn display reduces participants' ability to notice peripheral visual stimuli compared to presentation on a normal computer monitor. This effect increases as stimuli are presented further in the periphery, but can be ameliorated to a degree by using high-contrast stimuli. Application: The findings are useful for designers creating visual stimuli intended to capture attention when viewed on a peripherally positioned monocular head-worn display.

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Effectiveness of enhanced pulse oximetry sonifications for conveying oxygen saturation ranges: a laboratory comparison of five auditory displays

Abstract: Enhanced sonifications are more informative than conventional sonification. The implication is that they might allow anaesthetists to judge better when desaturation decreases below, or returns to, a target range.

Cited by 18 publications

References 19 publications

A Novel Auditory Display for Neonatal Resuscitation: Laboratory Studies Simulating Pulse Oximetry in the First 10 Minutes After Birth

A Novel Auditory Display for Neonatal Resuscitation: Laboratory Studies Simulating Pulse Oximetry in the First 10 Minutes After Birth

Smooth or Stepped? Laboratory Comparison of Enhanced Sonifications for Monitoring Patient Oxygen Saturation

Evaluating head-worn displays for alarm prioritisation and situation awareness in multiple-patient contexts

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