Improved Task Performance, Low Workload, and User-Centered Design in Medical Diagnostic Equipment Enhance Decision Confidence of Anesthesia Providers: A Meta-Analysis and a Multicenter Online Survey

Abstract

Decision confidence—the subjective belief to have made the right decision—is central in planning actions in a complex environment such as the medical field. It is unclear by which factors it is influenced. We analyzed a pooled data set of eight studies and performed a multicenter online survey assessing anesthesiologists’ opinions on decision confidence. By applying mixed models and using multiple imputation to determine the effect of missing values from the dataset on the results, we investigated how task performance, perceived workload, the utilization of user-centered medical diagnostic devices, job, work experience, and gender affected decision confidence. The odds of being confident increased with better task performance (OR:1.27, 95%CI: 0.94 to 1.7; p = 0.12; after multiple imputation OR:3.19,95%CI: 2.29 to 4.45; p < 0.001) and when user-centered medical devices were used (OR:5.01, 95%CI: 3.67 to 6.85; p < 0.001; after multiple imputation OR:3.58, 95%CI: 2.65 to 4.85; p < 0.001). The odds of being confident decreased with higher perceived workload (OR: 0.94, 95%CI: 0.93 to 0.95; p < 0.001; after multiple imputation, OR:0.94, 95%CI: 0.93 to 0.95; p < 0.001). Other factors, such as gender, job, or professional experience, did not affect decision confidence. Most anesthesiologists who participated in the online survey agreed that task performance (25 of 30; 83%), perceived workload (24 of 30; 80%), work experience (28 of 30; 93%), and job (21 of 30; 70%) influence decision confidence. Improved task performance, lower perceived workload, and user-centered design in medical equipment enhanced the decision confidence of anesthesia providers.

Coagulation Management of Critically Bleeding Patients With Viscoelastic Testing Presented as a 3D-Animated Blood Clot (The Visual Clot): Randomized Controlled High-Fidelity Simulation Study

“…Finally, we examined participants' perceived decision confidence (binary as confident or unconfident) and perceived workload during the simulations [17,18]. We measured the workload using the raw National Aeronautics and Space Administration Task Load Index (NASA TLX).…”

User Perceptions of ROTEM-Guided Haemostatic Resuscitation: A Mixed Qualitative–Quantitative Study

“…Free mental capacity is necessary to build optimal situation awareness [ 24 ]. In particular, in stressful situations, this should not be compromised by complicated data interpretation [ 39 ]. One way to increase situation awareness is through user-centred design.…”

“…It leads to a reduction in errors and an improvement in productivity, acceptance and user satisfaction [ 24 ]. There are some examples of such technologies based on the principles of situation awareness and user-centred design [ 39 , 40 , 41 ]. To help healthcare providers interpret the results of viscoelastic coagulation tests, Visual Clot, a new technology for alternative presentation of thromboelastometry data has been developed.…”

Visual Blood, a 3D Animated Computer Model to Optimize the Interpretation of Blood Gas Analysis

“…Streamlining this mental model creation process was likely also responsible for the improved confidence and reduced perceived workload observed with VB. Pooled analyses found that task performance was proportional to perceived diagnostic confidence and inversely proportional to workload [ 28 , 37 ]. Justified diagnostic confidence is vital because clinicians who feel justifiably confident can make better and faster decisions.…”