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Metaphor Graphic Display for Cardiovascular System
James Agutter; Noah Syroid, M.S.; Frank Drews, Ph.D.; Dwayne Westenskow, Ph.D.; Julio Bermudez, Ph.D.
Architecture, University of Utah, Salt Lake City, Utah, United States
1. Problem

Anesthesia display design has primarily focused on tradition rather than helping clinicians detect critical events. They still look like the strip chart recorder output Sir Thomas Lewis used in 1912 to record the first ECG. These displays sub-optimally show the information as waveforms and numerics.

2. Design Background

Recent cognitive research has indicated that the human mind is better able to analyze and use complex data when it is presented in a graphic manner (1). In addition, research in thinking, imagination and learning has shown that visualization plays an intuitive and essential role in the association, correlation, and use of information.(2)

3. Display Description

Our research group has designed an innovative, detailed, cardiovascular display for anesthesiologists that aids in the detection, diagnosis and treatment of critical cardiovascular events. The display organizes measured and modeled physiologic information, into relevant data sets or critical functions. These data sets are mapped as graphical objects (e.g., cubes, spheres, cylinders) that work as metaphors of the critical functions of the system.

Using these measurement variables: CO, SV, HR, MAP, LAP, CVP, PAP, PVR and SVR, we spatially located the objects to show a diagrammatic organization of the flow of the blood from right to left. This arrangement placed all relevant measurements together and contextulized, to allow for rapid understanding and diagnosis. This organization also highlights important concepts such as left heart preload, afterload and cardiac output.By providing an adjustable normal reference frame clinicians can easily see when a value is either high or low. In addition, the emergent shape invokes a diagnosis because the objects look very similar to the way a clinician envisions them because the object has a look that is similar to blood vessels and arteries.

4. Usability Testing

To test the usability and intuitiveness of our display we developed a usability testing protocol that allows us to obtain information about the design of the proposed display before implementation. Iterative changes to the design were quickly achieved based on users' input.

1.Show animation of information display showing range of movement of the objects but provide no explanation of the aspects of the display (no labeling, digital numbers)

2.Users attempt to define the meaning of the display anatomy. This is achieved by trying to identify shape movement, iconic or methaphoric representations.

3.Users attempt to define the relationship of the metaphors, icons, and shapes to the abstracted data.

4.Users attempt to identify different states of shock (diagnosis) (e.g. patterns of the shapes, etc).

5. Future Work

Our group plans to test the efficacy of the display by creating a realistic surgical environment with a METI simulator. We will use a between subject design with one set of subjects using only a traditional monitor and the other group using a traditional and our cardiovascular display.

5. References

(1)Rouse WB, Geddes ND, Hammer JM: Computer-aided fighter pilots. IEEE Spectrum 1990; 27: 38-41

(2)Vicente KJ, Christoffersen K, Pereklita A: Supporting operator problem solving through ecological interface design. IEEE Transaction on Systems, M&C 1995; 25: 529-45.

Anesthesiology 2001; 95:A519
Figure 1