Spearcon Sequences for Monitoring Multiple Patients: Laboratory Investigation Comparing Two Auditory Display Designs

Abstract

The aim was to compare the effectiveness of two auditory displays, implemented with spearcons (time-compressed speech), for monitoring multiple patients. Background: Sequences of sounds can convey information about patients' vital signs, such as oxygen saturation (SpO 2) and heart rate (HR). We tested whether participants could monitor five patients using spearcon-based sound sequences. Method: A 2 × 3 within-subjects design was used. The first factor was interface, with two levels: the ALL interface used spearcons to convey vital signs for all five patients, whereas the ABN (abnormal) interface represented patients who had normal vital signs with a low-pitched single-tone sound and patients who had at least one abnormal vital sign with spearcons. The second factor was the number of patients who had at least one abnormal vital sign: there were one, two, or three such patients in each monitoring sequence. Participants were 40 nonclinicians. Results: Participants identified abnormal patients' SpO 2 and HR levels and located abnormal patients in the sound sequence more accurately with the ABN interface than the ALL interface. Accuracy declined as the number of abnormal patients increased. Participants associated ABN with easier identification of vital signs, resulting in higher ratings of confidence and pleasantness compared with ALL. Conclusion: Sequences of spearcons may support effective eyes-free monitoring of multiple patients. Application: Sequences of spearcons may be useful in monitoring multiple patients and the underlying design principles may extend to monitoring in other domains such as industrial process control or control of multiple autonomous vehicles.

Monitoring vital signs with time-compressed speech.

“…Accordingly, in this article we report four experiments that address certain aspects of using spearcons to represent the vital signs of monitored patients (see Figure 3). In all experiments we used the five levels for pulse oximetry values that were introduced in Janata and Edwards (2013) and that were used in Li et al (2017) and Li et al (2018). As in Li et al (2018), when testing multiple-patient monitoring with sound sequences we required participants to identify the location of abnormal patients in the sequence, as shown in Figure 1, as well as the status of abnormal patients’ vital signs.…”

“…To design the study, we built on previous work by Li et al (2018), who tested the effectiveness of Cantonese spearcons for multiple-patient monitoring. Participants listened to sequences of five patients, and identified both the location and status of abnormal patients in the sequence.…”

Spearcons for Patient Monitoring: Program of Laboratory-Based Feasibility Studies

“…SAT low, HR normal) of each patient with any abnormal vital signs. Li et al (2019) found that participants could identify the sequence location of patients with abnormal vital signs with accuracies well over 80%, even for three abnormal patients. When identifying the actual vital sign ranges for patients with abnormal vital signs, accuracy dropped as the number of patients with abnormal vital signs increased, but it was still greatly above chance.…”

“…Accordingly, we considered how the status of several patients could be conveyed acoustically, making it clear from which patient each status sound was coming. Based on earlier work by Hickling, Brecknell, Loeb, and Sanderson (2017) on sound sequences, Li, Tse, Brecknell, and Sanderson (2019) created sequences of Cantonese spearcons, where each location in the sequence represented the pulse oximetry status of a specific patient (see Figure 2). Patients without any abnormal vital signs were identified with a 'boop' tone rather than a spearcon, so the sound did not need to be processed further by the listener.…”

Comparison of Auditory Icon Alarms and Spearcon Sequences for Patient Monitoring

“…Two possible alternatives are (1) auditory icon alarms (AIA) where sounds have a semantic relationship to the alarm source (Edworthy et al, 2018), or (2) spearcon sequences (SS), which are sequences of time compressed speech phrases presenting status information for multiple patients (Li, Tse, Brecknell, & Sanderson, 2019). Both alternatives have higher learnability and recognizability than the currently recommended alarms.…”