(Taken from application abstract): The purpose of this proposal is to design and evaluate a novel graphical system for the presentation of data obtained from routine bedside monitoring of patients undergoing surgical intensive care (SICU). The system, designated the V/Q-P/Q Assistant, is intended to enable expert and trainee physicians, nurses and other personnel to arrive at therapeutic decisions concerning pulmonary gas exchange and hemodynamics more efficiently. This will be achieved at a human-computer interface by providing easier visualization of measured data, improved representation of functional abnormalities and the ability to simulate the particular patient so that trials of virtual therapy may guide the choice of treatment. Analysis suggests that the task of a SICU physician is to translate the dense and unrelenting data stream of the SICU environment into a mental representation of the pathophysiological state. The data sources have been analyzed and software designed to collect data from typical classes of patients, at preselected intervals, from each monitoring device for storage in an Access database. These data will form the basis for the experimental evaluation and design of the V/Q-P/Q Assistant. Previous work on pulmonary pathophysiology has been synthesized into a model that unites the causes of impaired oxygenation (ventilation/perfusion maldistribution) with a complete, and actively regulated pulmonary vasculature. This model, combined with traditional and non-traditional clinical measurements, provides the computational basis for the system. The human-computer interface will be developed under a cognitive system design framework, using an iterative process of rapid prototyping based on formative evaluations. A series of computer display screens is proposed organized in five levels of increasing information. Screen designs use configural representations that are evolved to enhance information transfer, understanding of basic pathophysiology and evaluation of functional trajectories. The ability of the V/Q-P/Q Assistant to improve medical care, enhance learning and contribute economically will be finally tested in a series of summative studies leading to the derivation of a multi attribute utility index.
| Ehrhart, L S; Hanson, C W; Marshall, B E et al. (1999) Collaborative prototyping approaches for ICU decision aid design. Proc AMIA Symp :750-4 |
