Chinese colposcopists' attitudes toward the colposcopic artificial intelligence auxiliary diagnostic system (CAIADS): A nation-wide, multi-center survey.

Objective: The objective of this study was to assess the attitudes toward the Colposcopic Artificial Intelligence Auxiliary Diagnostic System (CAIADS) of colposcopists working in mainland China. Methods: A questionnaire was developed to collect participants' sociodemographic information and assess their awareness, attitudes, and acceptance toward the CAIADS. Results: There were 284 respondents from 24 provinces across mainland China, with 55% working in primary care institutions. Participant data were divided into two subgroups based on their colposcopy case load per year (i.e. ≥50 cases; <50 cases). The analysis showed that participants with higher loads had more experience working with CAIADS and were more knowledgeable about CAIADS and AI systems. Overall, in both groups, about half of the participants understood the potential applications of big data and AI-assisted diagnostic systems in medicine. Although less than one-third of the participants were knowledgeable about CAIADS and its latest developments, more than 90% of the participants were open with the idea of using CAIADS. Conclusions: While a related lack of acknowledgement of CAIADS exists, the participants in general had an open attitude toward CAIADS. Practical experience with colposcopy or CAIADS contributed to participants' awareness and positive attitudes. The promotion of AI tools like CAIADS could help address regional health inequities to improve women's well-being, especially in low- and middle-income countries.

Gaze Sharing, a Double-Edged Sword: Examining the Effect of Real-Time Gaze Sharing Visualizations on Team Performance and Situation Awareness.

OBJECTIVE: The goal of this study was to assess how different real-time gaze sharing visualization techniques affect eye tracking metrics, workload, team situation awareness (TSA), and team performance. BACKGROUND: Gaze sharing is a real-time visualization technique that allows teams to know where their team members are looking on a shared display. Gaze sharing visualization techniques are a promising means to improve collaborative performance on simple tasks; however, there needs to be validation of gaze sharing with more complex and dynamic tasks. METHODS: This study evaluated the effect of gaze sharing on eye tracking metrics, workload, team SA, and team performance in a simulated unmanned aerial vehicle (UAV) command-and-control task. Thirty-five teams of two performed UAV tasks under three conditions: one with no gaze sharing and two with gaze sharing. Gaze sharing was presented using a fixation dot (i.e., a translucent colored dot) and a fixation trail (i.e., a trail of the most recent fixations). RESULTS: The results showed that the fixation trail significantly reduced saccadic activity, lowered workload, supported team SA at all levels, and improved performance compared to no gaze sharing; however, the fixation dot had the opposite effect on performance and SA. In fact, having no gaze sharing outperformed the fixation dot. Participants also preferred the fixation trail for its visibility and ability to track and monitor the history of their partner's gaze. CONCLUSION: The results showed that gaze sharing has the potential to support collaboration, but its effectiveness depends highly on the design and context of use. APPLICATION: The findings suggest that gaze sharing visualization techniques, like the fixation trail, have the potential to improve teamwork in complex UAV tasks and could have broader applicability in a variety of collaborative settings.

Long-Term Impact of an Occupational Therapy Intervention for Children With Challenges in Sensory Processing and Integration.

IMPORTANCE: Research is limited regarding parent-caregiver perspectives of occupational therapy (OT) intervention for children with challenges in sensory processing and integration and whether changes immediately following OT intervention are sustained over time. OBJECTIVE: To evaluate whether changes in identified goals are maintained following OT intervention and to determine what aspects of OT intervention parents-caregivers perceive to be most valuable. DESIGN: A mixed-methods research design. SETTING: A large midwestern pediatric hospital, with follow-up telephone interviews with parents-caregivers. PARTICIPANTS: Sixteen children with sensory challenges and their parents-caregivers. INTERVENTION: Children participated in 1-hr OT intervention sessions, 3 days per wk, for 6 to 7 wk. Parents-caregivers of children who completed OT intervention were interviewed via the telephone 6 to 12 mo after the intervention. OUTCOMES AND MEASURES: The Canadian Occupational Performance Measure (COPM) and Goal Attainment Scaling (GAS) were used to determine whether changes were made and sustained over time. Qualitative data on caregiver perceptions of OT intervention were collected via open-ended questions during phone interviews. COPM and GAS scores before intervention were statistically significant compared with scores immediately following intervention and at 6- to 12-mo follow-up. Five themes emerged from the qualitative data. CONCLUSIONS AND RELEVANCE: Children with sensory challenges made significant changes related to occupational performance following OT intervention, and goal achievement was sustained over time. Parents-caregivers valued many aspects of the OT program, including the increased frequency of therapy services, the occupational therapist's advanced knowledge and skills, and the education and information provided during the program. Plain-Language Summary: This study supports the results of previous studies on OT intervention for children with challenges in sensory processing and integration. The study also adds to the body of knowledge that shows that changes and progress toward goals that result from skilled OT intervention can be sustained over time. The study showed that children participating in OT intervention made statistically significant changes while receiving OT services and maintained progress after intervention ended; however, the children did not continue to make significant progress toward goals once skilled OT services ended. Parents and caregivers of children with sensory challenges reported that they found OT intervention to be beneficial. Other important factors influencing the effectiveness of OT intervention that were identified by parents-caregivers included the education provided by the occupational therapist, the increased frequency of therapy services, and the increased knowledge and skills of the occupational therapists who provided the intervention.

Establishing Natural Tactile Mappings: Mapping Tactile Parameters to Continuous Data Concepts.

There has been limited work developing natural mappings between tactile signals and common data concepts in data rich domains. If these mappings can be established, tactile displays can become more intuitive and readily adopted. The present study aims to identify general natural mappings between perceptual dimensions of vibration and continuous data concepts. Twenty-one participants were tasked to map four different tactile parameters to four different data concepts-pressure, concentration, size, and speed. We found that an increase in intensity was good at conveying increases for all data concepts. We also found that speed, pressure, concentration, and size all have at least one strong natural mapping.

Examining Pediatric Resident Electronic Health Records Use During Prerounding: Mixed Methods Observational Study.

BACKGROUND: Electronic health records (EHRs) play a substantial role in modern health care, especially during prerounding, when residents gather patient information to inform daily care decisions of the care team. The effective use of the EHR system is crucial for efficient and frustration-free prerounding. Ideally, the system should be designed to support efficient user interactions by presenting data effectively and providing easy navigation between different pages. Additionally, training on the system should aim to make user interactions more efficient by familiarizing the users with best practices that minimize interaction time while using the full potential of the system's capabilities. However, formal training on EHR systems often falls short of providing residents with all the necessary EHR-related skills, leading to the adoption of inefficient practices and the underuse of the system's full range of capabilities. OBJECTIVE: This study aims to examine the efficiency of EHR use during prerounding among pediatric residents, assess the effect of experience level on EHR use, and identify areas for improvement in EHR design and training. METHODS: A mixed methods approach was used, involving a self-reported survey and video analysis of prerounding practices of the entire population of pediatric residents from a large teaching hospital in the South Atlantic Region. The residents were stratified by experience level by postgraduate year. Data were collected on the number of pages accessed, duration of prerounding, task completion rates, and effective use of data sources. Observational and qualitative data complemented the quantitative analysis. Our study followed the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) reporting guidelines, ensuring completeness and transparency of reporting. RESULTS: Of the 30 pediatric residents, 20 were included in the analyses; of these, 16 (80%) missed at least 1 step during prerounding. Although more experienced residents on average omitted fewer steps, 4 (57%) of the 7 most experienced residents still omitted at least 1 step. On average, residents took 6.5 minutes to round each patient and accessed 21 pages within the EHR during prerounding; no statistically significant differences were observed between experience levels for prerounding times (P=.48) or number of pages accessed (P=.92). The use of aggregated data pages within the EHR system neither seem to improve prerounding times nor decrease the number of pages accessed. CONCLUSIONS: The findings suggest that EHR design should be improved to better support user needs, and hospitals should adopt more effective training programs to familiarize residents with the system's capabilities. We recommend implementing prerounding checklists and providing ongoing EHR training programs for health care practitioners. Despite the generalizability of limitations of our study in terms of sample size and specialization, it offers valuable insights for future research to investigate the impact of EHR use on patient outcomes and satisfaction, as well as identify factors that contribute to efficient and effective EHR usage.

Workload transition rate matters: Evidence from growth curve modeling.

This research examined three specific gaps in the workload transition literature: (1) the impact of workload transition rate, (2) the applicability of current theoretical explanations, and (3) the variability of performance overall and over time. Sixty Naval flight students multitasked in an unmanned aerial vehicle control testbed and workload transitioned at three rates: slow, medium, or fast. Response time and accuracy were analyzed via growth curve modeling. Slow transitions had the largest decline in performance over time. Medium transitions had some of the slowest, but most accurate and consistent performance. Fast transitions had some of the fastest, but least accurate performance. However, all performance trends significantly varied, suggesting multiple theoretical explanations may apply and performance may also depend on the individual. Design guidance on how to maximize performance goals with transition rate is provided, but future research needs to study the theoretical explanations and impact of individual differences further.

Scan-based eye tracking measures are predictive of workload transition performance.

Given there is no unifying theory or design guidance for workload transitions, this work investigated how visual attention allocation patterns could inform both topics, by understanding if scan-based eye tracking metrics could predict workload transition performance trends in a context-relevant domain. The eye movements of sixty Naval flight students were tracked as workload transitioned at a slow, medium, and fast pace in an unmanned aerial vehicle testbed. Four scan-based metrics were significant predictors across the different growth curve models of response time and accuracy. Stationary gaze entropy (a measure of how dispersed visual attention transitions are across tasks) was predictive across all three transition rates. The other three predictive scan-based metrics captured different aspects of visual attention, including its spread, directness, and duration. The findings specify several missing details in both theory and design guidance, which is unprecedented, and serves as a basis of future workload transition research.

Usability challenges with electronic health records (EHRs) during prerounding on pediatric inpatients.

Objective: Prerounding is critical for a healthcare team to develop a shared understanding of the patient's condition and to develop a care plan. However, the design of electronic health records (EHRs) often makes prerounding inefficient, ineffective, and time consuming. The goal of this study was to observe how residents use the EHR while prerounding to identify usability challenges associated with the design of EHRs. Materials and Methods: Thirty residents were tasked to preround 2 pediatric patients using the think-aloud protocol. The data from the surveys, video recordings, and think-aloud comments were analyzed to identify usability issues related to EHR. The time it took for participants to complete the 6 required prerounding tasks were calculated and the pages most commonly accessed were noted. Results: Participants spent on average 6.5 min prerounding each patient with the most time spent on checking lab results and reviewing notes. Twenty-eight distinct pages were visited by at least 2 participants, mostly due to a lack of interconnectivity between related data across pages. Usability issues with the most commonly used pages include: data overload, missing/hidden information, difficulty identifying trends, and having to conduct manual calculations. Conclusions: We list usability issues and provide a set of recommendations to remedy these issues that include: reducing information access cost, creating a checklist, automate calculations, and standardizing notes and EHR training. Ideally, the outcome of this work will help improve EHR design to maximize the time clinicians spend interacting with and providing care to their patients.

Transitions Between Low and High Levels of Mental Workload can Improve Multitasking Performance.

OCCUPATIONAL APPLICATIONS Complex and dynamic environments including military operations, healthcare, aviation, and driving require operators to transition seamlessly between levels of mental workload. However, little is known about how the rate of an increase in workload impacts multitasking performance, especially in the context of real-world tasks. We evaluated both gradual and sudden workload increases in the dynamic multitasking environment of an Unmanned Aerial Vehicle (UAV) command and control testbed and compared them to constant workload. Workload transitions were found to improve response time and accuracy compared to when workload was held constant at low or high. These results suggest that workload transitions may allow operators to better regulate mental resources. These findings can also inform the design of operations and technology to assist operators' management of cognitive resources, which include negating the adverse effects of vigilance decrements during low workload periods and data overload during high workload periods.

TECHNICAL ABSTRACT Background High workload and workload transitions can affect performance; however, it is not clear how the rate of transition from low to high workload influences performance in a multitasking setting. Purpose We investigated the effect of workload transition rate on performance in a multitasking environment that is akin to the expectations of operators in complex, data-rich work domains. Method An Unmanned Aerial Vehicle (UAV) command and control testbed was used to vary workload between low, high, gradually transitioning from low to high, and suddenly transitioning from low to high. Performance measures consisted of the response time and accuracy of one primary task and three secondary tasks. Analyses compared: (a) performance differences between gradual and sudden increases in workload; (b) performance during the low workload phases of the workload transitions; and (c) performance during the high workload phases of the workload transitions. Results Overall, there were limited performance differences between gradual and sudden workload transitions. However, both types of transitions led to better performance than constant workload, lending some support for the effort regulation explanation which suggests that participants actively evaluated the amount of mental resources necessary to successfully complete a task after a workload transition. Conclusions Gradual and sudden workload transitions benefit primary and secondary task performance, suggesting that the applicability of existing theoretical explanations depend on the context. For example, varying task demands can be a means to assist operators in the appropriate regulation of mental resources in domains with interdependent tasks. These findings can inform occupation and technology design to support task management.

Now You Feel It, Now You Don't: The Effect of Movement, Cue Complexity, and Body Location on Tactile Change Detection.

OBJECTIVE: To evaluate the effects that movement, cue complexity, and the location of tactile displays on the body have on tactile change detection. BACKGROUND: Tactile displays have been demonstrated as a means to address data overload by offloading the visual and auditory modalities. However, change blindness-the failure to detect changes in a stimulus when changes coincide with another event or disruption in stimulus continuity-has been demonstrated to affect the tactile modality and may be exacerbated during movement. The complexity of tactile cues and locations of tactile displays on the body may also affect the detection of changes in tactile patterns. Limitations to tactile perception need to be examined. METHOD: Twenty-four participants performed a tactile change detection task while sitting, standing, and walking. Tactile cues varied in complexity and included low, medium, and high complexity cues presented to the arm or back. RESULTS: Movement adversely affects tactile change detection as hit rates were the highest while sitting, followed by standing and walking. Cue complexity affected tactile change detection: Low complexity cues resulted in higher detection rates compared with medium and high complexity cues. The arms exhibited better change detection performance than the back. CONCLUSION: The design of tactile displays should consider the effect of movement. Cue complexity should be minimized and decisions about the location of a tactile display should take into account body movements to support tactile perception. APPLICATION: The findings can provide design guidelines to inform tactile display design for data-rich, complex domains.

The Evaluation of Tactile Parameters and Display Prototype to Support Physiological Monitoring and Multitasking for Anesthesia Providers in the Operating Room.

Communicating physiological information via the tactile modality is shown as a promising means to address data overload faced by anesthesia providers. However, it is important to ensure that the tactile parameters which represent information are intuitive. There is currently no consensus on which tactile parameters should be used to present information within anesthesia. The two studies presented here evaluate: (a) a set of 24 tactile cues manipulating intensity, temporal, and spatial tactile parameters in a usability study and (b) a prototype tactile display based on the usability study's findings in a single and dual-task scenario. Findings of the usability study show intensity and temporal were rated most urgent and had the most potential to represent changes in physiological measures. This was confirmed in the follow up study as increases/decreases in intensity were shown to represent increases/decreases in a physiological measure and using different spatial locations to represent physiological measures resulted in greater than 95% response accuracy. Response times and accuracy were not adversely affected while performing a secondary task. The findings contribute to a better understanding of how to map tactile parameters to physiological information and demonstrate the effectiveness of end-user feedback in tactile display design to develop intuitive alerts.

Development of Trauma Level Prediction Models Using Emergency Medical Service Vital Signs to Reduce Over- and Undertriage Rates in Penetrating Wounds and Falls of the Elderly.

Determining triage activation levels in geriatric patients who fall (GF), and patients with penetrating wounds can be difficult and inaccurate, resulting in excessive overtriage (OT) and undertriage (UT) rates. We developed trauma activation prediction models using field data to predict with greater accuracy trauma activation level and triage rates consistent with the ACS recommendations. Using data from the 2014 National Trauma Data Bank, we created binary regression equations for each type of injury (GF and penetrating wounds). The 2014 data were randomized and divided into two halves. The first half for each injury type was used to generate prediction models, whereas the second half of the 2014 data were combined with 2013 and 2015 National Trauma Data Bank data for model verification. Binary regression equations were generated from vital signs collected by EMS. A Cribari grid with ISS ≥ 15 was used to determine the appropriateness of activation level. Chi-square analysis was used to determine significant differences between OT, UT, and accuracy predictions. Using our triage models, we were able to obtain UT rates of less than 4 per cent for GF with OT rates of less than 40 per cent, UT rates less than 4.1 per cent and OT of less than 50 per cent for patients with gunshot wounds, and UT rates less than 4 per cent and OT rates less than 25 per cent for patients who had stab wounds. Our developed trauma level prediction models enable health providers to predict trauma activation levels that can result in OT and UT rates in the recommended ranges by the ACS.

Tactile, Visual, and Crossmodal Visual-Tactile Change Blindness: The Effect of Transient Type and Task Demands.

OBJECTIVE: The present study examined whether tactile change blindness and crossmodal visual-tactile change blindness occur in the presence of two transient types and whether their incidence is affected by the addition of a concurrent task. BACKGROUND: Multimodal and tactile displays have been proposed as a promising means to overcome data overload and support attention management. To ensure the effectiveness of these displays, researchers must examine possible limitations of human information processing, such as tactile and crossmodal change blindness. METHOD: Twenty participants performed a unmanned aerial vehicle (UAV) monitoring task that included visual and tactile cues. They completed four blocks of 70 trials each, one involving visual transients, the other tactile transients. A search task was added to determine whether increased workload leads to a higher risk of change blindness. RESULTS: The findings confirm that tactile change detection suffers in terms of response accuracy, sensitivity, and response bias in the presence of a tactile transient. Crossmodal visual-tactile change blindness was not observed. Also, change detection was not affected by the addition of the search task and helped reduce response bias. CONCLUSION: Tactile displays can help support multitasking and attention management, but their design needs to account for tactile change blindness. Simultaneous presentation of multiple tactile indications should be avoided as it adversely affects change detection. APPLICATION: The findings from this research will help inform the design of multimodal and tactile interfaces in data-rich domains, such as military operations, aviation, and healthcare.

Improving the Safety and Functionality of an Artificial Pancreas System for Use in Younger Children: Input from Parents and Physicians.

BACKGROUND: Artificial pancreas (AP) systems have initially been designed for and tested in teens and adults, but there is evidence that an AP system with additional support and safety systems could greatly benefit younger children with type 1 diabetes (T1D). SUBJECTS AND METHODS: Five pediatric endocrinologists and 15 parents of children aged 5-8 years with T1D participated in a total of four focus groups. Focus groups investigated current diabetes technology use and acceptance, as well as possible modifications to the current adult AP system, which would allow for safe and successful use in younger children. Modifications discussed include child-specific functionality for input tasks, safety features, and monitoring capabilities. RESULTS: Participant suggestions included the following: passcodes for differential access to AP features by parents, ancillary caregivers, and the child; preset early, intermediate, and advanced child access categories; maximal customization for general and alarm settings; simplified meal screens utilizing the AP' corrective blood glucose (BG) ability; automated exercise mode; spoken and dictated messaging capabilities; emergency contacts; treatment instructions for the child and caregiver; remote monitoring website and application; animated continuous glucose monitor BG trace; gamification, such as rewarding diabetes-friendly behaviors; and comprehensive training of all individuals involved in the child's diabetes care. CONCLUSION: Parents and physicians were eager for AP applications to be available for younger children, but stressed that a modified system could better serve this group's needs for safety and improved diabetes-related communication. The diverse and emerging needs of 5-8-year olds require flexible and customizable systems for T1D management.

The Development and Evaluation of Countermeasures to Tactile Change Blindness.

OBJECTIVE: The goal of the present study was to develop and empirically evaluate three countermeasures to tactile change blindness (where a tactile signal is missed in the presence of a tactile transient). Each of these countermeasures relates to a different cognitive step involved in successful change detection. BACKGROUND: To date, change blindness has been studied primarily in vision, but there is limited empirical evidence that the tactile modality may also be subject to this phenomenon. Change blindness raises concerns regarding the robustness of tactile and multimodal interfaces. METHOD: Three countermeasures to tactile change blindness were evaluated in the context of a highly demanding monitoring task. One countermeasure was proactive (alerting the participant to a possible change before it occurred) whereas the other two were adaptive (triggered after the change upon an observed miss). Performance and subjective data were collected. RESULTS: Compared to the baseline condition, all countermeasures improved intramodal tactile change detection. Adaptive measures resulted in the highest detection rates, specifically when signal gradation was employed (i.e., when the intensity of the tactile signal was increased after a miss was observed). CONCLUSION: Adaptive displays can be used to counter the effects of change blindness and ensure that tactile information is reliably detected. Increasing the tactile intensity after a missed change appears most promising and was the preferred countermeasure. APPLICATION: The findings from this study can inform the design of interfaces employing the tactile modality to support monitoring and attention management in data-rich domains.

Comparing responsiveness of the quick disabilities of the arm, shoulder, and hand and the upper limb functional index.

OBJECTIVE: The purpose of this study was to measure clinical change in persons with upper extremity (UE) musculoskeletal conditions and to determine if the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) or the Upper Limb Functional Index (ULFI) was a more responsive outcome tool. The objective was to select one tool that was responsive and practical for the occupational therapy (OT) setting. PARTICIPANTS: Participants were patients (N=27) who had musculoskeletal conditions, were age 18 years or older, and received outpatient OT. METHODS: Participants received standard OT treatment for UE musculoskeletal conditions, completing the ULFI and QuickDASH at evaluation and discharge. RESULTS: Paired t-tests showed significant change of 25.1 points in the QuickDASH and 23.6 points in the ULFI. Work module showed significant change of 26.2 points. CONCLUSIONS: The QuickDASH was a more responsive tool compared to the ULFI. Participants made significant improvements in work performance as measured by the QuickDASH Work Module. Large effect sizes and standardized response means of the QuickDASH and the ULFI change scores showed both tools were responsive outcome measures for individuals with musculoskeletal conditions. Although the QuickDASH was more responsive, therapists preferred the ULFI as an efficient outcome measure with client-centered goals.