Visual Blood, Visualisation of Blood Gas Analysis in Virtual Reality, Leads to More Correct Diagnoses: A Computer-Based, Multicentre, Simulation Study

Abstract

Interpreting blood gas analysis results can be challenging for the clinician, especially in stressful situations under time pressure. To foster fast and correct interpretation of blood gas results, we developed Visual Blood. This computer-based, multicentre, noninferiority study compared Visual Blood and conventional arterial blood gas (ABG) printouts. We presented six scenarios to anaesthesiologists, once with Visual Blood and once with the conventional ABG printout. The primary outcome was ABG parameter perception. The secondary outcomes included correct clinical diagnoses, perceived diagnostic confidence, and perceived workload. To analyse the results, we used mixed models and matched odds ratios. Analysing 300 within-subject cases, we showed noninferiority of Visual Blood compared to ABG printouts concerning the rate of correctly perceived ABG parameters (rate ratio, 0.96; 95% CI, 0.92–1.00; p = 0.06). Additionally, the study revealed two times higher odds of making the correct clinical diagnosis using Visual Blood (OR, 2.16; 95% CI, 1.42–3.29; p < 0.001) than using ABG printouts. There was no or, respectively, weak evidence for a difference in diagnostic confidence (OR, 0.84; 95% CI, 0.58–1.21; p = 0.34) and perceived workload (Coefficient, 2.44; 95% CI, −0.09–4.98; p = 0.06). This study showed that participants did not perceive the ABG parameters better, but using Visual Blood resulted in more correct clinical diagnoses than using conventional ABG printouts. This suggests that Visual Blood allows for a higher level of situation awareness beyond individual parameters’ perception. However, the study also highlighted the limitations of today’s virtual reality headsets and Visual Blood.

User Perceptions of Visual Blood: An International Mixed Methods Study on Novel Blood Gas Analysis Visualization

“…Visual Blood [24,25] is a novel, three-dimensional representation of blood gas analysis results based on user-centered design principles [28]. The technology presents the animated components of a blood gas analysis represented as icons, including their interactions with each other (Figure 1).…”

“…User perceptions of Visual Blood were collected after two computer-based simulation studies [24,25]. The first one [25] was an international, multicenter, investigator-initiated, prospective, randomized, computer-based simulation study.…”

“…User perceptions of Visual Blood were collected after two computer-based simulation studies [24,25]. The first one [25] was an international, multicenter, investigator-initiated, prospective, randomized, computer-based simulation study. The study was conducted in five tertiary care hospitals (University Hospital Zurich and Hirslanden Clinic of Zurich in Switzerland, University Hospitals Frankfurt and Wuerzburg in Germany, and Hospital Clinic de Barcelona in Spain) between June and August 2021.…”

“…Table 1 provides detailed information about the participants' characteristics. Blood gas analysis skills, self-rated, (0 = novice, 100 = expert), median (IQR) 29 (22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37) *IQR-interquartile range.…”

“…With this in mind, we developed Visual Blood, a three-dimensional computer animation representing a blood gas analysis printout. We tested Visual Blood for the first time in computer-based simulation studies in 2021-2022-once with a visual reality device and once without it [24,25]. We conducted this mixed qualitative-quantitative study simultaneously to capture the participants' perceptions and impressions, which help guide further development.…”