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1.
PLoS One ; 16(9): e0257642, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34547043

RESUMO

A parameter is a numerical factor whose values help us to identify a system. Connectivity parameters are essential in the analysis of connectivity of various kinds of networks. In graphs, the strength of a cycle is always one. But, in a fuzzy incidence graph (FIG), the strengths of cycles may vary even for a given pair of vertices. Cyclic reachability is an attribute that decides the overall connectedness of any network. In graph the cycle connectivity (CC) from vertex a to vertex b and from vertex b to vertex a is always one. In fuzzy graph (FG) the CC from vertex a to vertex b and from vertex b to vertex a is always same. But if someone is interested in finding CC from vertex a to an edge ab, then graphs and FGs cannot answer this question. Therefore, in this research article, we proposed the idea of CC for FIG. Because in FIG, we can find CC from vertex a to vertex b and also from vertex a to an edge ab. Also, we proposed the idea of CC of fuzzy incidence cycles (FICs) and complete fuzzy incidence graphs (CFIGs). The fuzzy incidence cyclic cut-vertex, fuzzy incidence cyclic bridge, and fuzzy incidence cyclic cut pair are established. A condition for CFIG to have fuzzy incidence cyclic cut-vertex is examined. Cyclic connectivity index and average cyclic connectivity index of FIG are also investigated. Three different types of vertices, such as cyclic connectivity increasing vertex, cyclically neutral vertex and, cyclic connectivity decreasing vertex, are also defined. The real-life applications of CC of FIG in a highway system of different cities to minimize road accidents and a computer network to find the best computers among all other computers are also provided.


Assuntos
Acidentes de Trânsito/prevenção & controle , Planejamento de Cidades/métodos , Apresentação de Dados , Acidentes de Trânsito/estatística & dados numéricos , Lógica Fuzzy , Humanos , Modelos Estatísticos , Redes Neurais de Computação
2.
PLoS One ; 16(7): e0253644, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34297713

RESUMO

BACKGROUND: Few studies have examined the best way to convey the probability of serious events occurring in the future (i.e., risk of stroke or death) to persons with low numeracy or graph literacy proficiency. To address this gap, we developed and user-tested a bar graph and compared it to icon arrays to assess its impact on understanding and preference for viewing risk information. OBJECTIVES: To determine the: (i) formats' impact on participants' understanding of risk information; (ii) formats' impact on understanding and format preference across numeracy and graph literacy subgroups; (iii) rationale supporting participants' preference for each graphical display format. METHODS: An online sample (evenly made up of participants with high and low objective numeracy and graph literacy) was randomized to view either the icon array or the bar graph. Each format conveyed the risk of major stroke and death five years after choosing surgery, a stent, or medication to treat carotid artery stenosis. Participants answered questions to assess their understanding of the risk information. Lastly, both formats were presented in parallel, and participants were asked to identify their preferred format to view risk information and explain their preference. RESULTS: Of the 407 participants, 197 were assigned the icon array and 210 the bar graph. Understanding of risk information and format preference did not differ significantly between the two trial arms, irrespective of numeracy and graph literacy proficiency. High numeracy and graph literacy proficiency was associated with high understanding (p<0.01) and a preference for the bar graph (p = 0.01). CONCLUSION: We found no evidence to demonstrate the superiority of one format over another on understanding. The majority of participants preferred viewing the risk information using the bar graph format.


Assuntos
Compreensão , Apresentação de Dados/normas , Educação em Saúde/métodos , Adulto , Apresentação de Dados/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Comportamento de Redução do Risco
3.
Appl Clin Inform ; 12(3): 664-674, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-34289505

RESUMO

OBJECTIVE: There is a lack of evidence on how to best integrate patient-generated health data (PGHD) into electronic health record (EHR) systems in a way that supports provider needs, preferences, and workflows. The purpose of this study was to investigate provider preferences for the graphical display of pediatric asthma PGHD to support decisions and information needs in the outpatient setting. METHODS: In December 2019, we conducted a formative evaluation of information display prototypes using an iterative, participatory design process. Using multiple types of PGHD, we created two case-based vignettes for pediatric asthma and designed accompanying displays to support treatment decisions. Semi-structured interviews and questionnaires with six participants were used to evaluate the display usability and determine provider preferences. RESULTS: We identified provider preferences for display features, such as the use of color to indicate different levels of abnormality, the use of patterns to trend PGHD over time, and the display of environmental data. Preferences for display content included the amount of information and the relationship between data elements. CONCLUSION: Overall, provider preferences for PGHD include a desire for greater detail, additional sources, and visual integration with relevant EHR data. In the design of PGHD displays, it appears that the visual synthesis of multiple PGHD elements facilitates the interpretation of the PGHD. Clinicians likely need more information to make treatment decisions when PGHD displays are introduced into practice. Future work should include the development of interactive interface displays with full integration of PGHD into EHR systems.


Assuntos
Asma , Apresentação de Dados , Criança , Registros Eletrônicos de Saúde , Humanos , Inquéritos e Questionários , Fluxo de Trabalho
4.
BMJ Health Care Inform ; 28(1)2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34108143

RESUMO

Using administrative data on all Veterans who enter Department of Veterans Affairs (VA) medical centres throughout the USA, this paper uses artificial intelligence (AI) to predict mortality rates for patients with COVID-19 between March and August 2020. First, using comprehensive data on over 10 000 Veterans' medical history, demographics and lab results, we estimate five AI models. Our XGBoost model performs the best, producing an area under the receive operator characteristics curve (AUROC) and area under the precision-recall curve of 0.87 and 0.41, respectively. We show how focusing on the performance of the AUROC alone can lead to unreliable models. Second, through a unique collaboration with the Washington D.C. VA medical centre, we develop a dashboard that incorporates these risk factors and the contributing sources of risk, which we deploy across local VA medical centres throughout the country. Our results provide a concrete example of how AI recommendations can be made explainable and practical for clinicians and their interactions with patients.


Assuntos
Inteligência Artificial , COVID-19/mortalidade , Modelos Estatísticos , Veteranos , Apresentação de Dados , Humanos , Fatores de Risco , Estados Unidos , United States Department of Veterans Affairs
5.
Sci Rep ; 11(1): 13270, 2021 06 24.
Artigo em Inglês | MEDLINE | ID: mdl-34168181

RESUMO

Our understanding of real-world connected systems has benefited from studying their evolution, from random wirings and rewirings to growth-dependent topologies. Long overlooked in this search has been the role of the innate: networks that connect based on identity-dependent compatibility rules. Inspired by the genetic principles that guide brain connectivity, we derive a network encoding process that can utilize wiring rules to reproducibly generate specific topologies. To illustrate the representational power of this approach, we propose stochastic and deterministic processes for generating a wide range of network topologies. Specifically, we detail network heuristics that generate structured graphs, such as feed-forward and hierarchical networks. In addition, we characterize a Random Genetic (RG) family of networks, which, like Erdos-Rényi graphs, display critical phase transitions, however their modular underpinnings lead to markedly different behaviors under targeted attacks. The proposed framework provides a relevant null-model for social and biological systems, where diverse metrics of identity underpin a node's preferred connectivity.


Assuntos
Apresentação de Dados , Modelos Genéticos , Filogenia , Encéfalo/anatomia & histologia , Heurística , Humanos , Rede Nervosa
6.
Phys Eng Sci Med ; 44(2): 581-589, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33999394

RESUMO

An image-display application for medical liquid-crystal display (LCD) monitors called the sharpness recovery (SR) function has been developed to compensate for image sharpness as a function of deficiencies in the modulation transfer function (MTF) of a monitor. We investigated the effects of the SR function for a five-megapixel (MP) mammography LCD monitor on the resolution and noise properties of the displayed images by measuring the MTF and overall noise power spectrum (NPS), respectively. Furthermore, the effectiveness of the SR function for the 5-MP monitor in displaying subtle microcalcifications on digital mammograms was verified using a two-alternative-forced-choice sensitivity measurement as an initial application for medical image interpretation. Four radiologists compared the visibility of 45 regions of interest with a malignant microcalcification cluster shown on SR-processed and unprocessed mammograms. SR processing improved the MTF of the displayed images by approximately 40% at the Nyquist frequency of the 5-MP monitor, whereas it slightly increased the overall NPS values. All observers indicated that the fraction of cases considered to have better visibility of microcalcifications with the SR processing was significantly greater than that without the processing (averaging 82%, with the 95% confidence interval ranging from 70 to 93%). The SR processing for the 5-MP monitor yielded a significant improvement in the resolution properties of the displayed images, with a certain increase in the image noise. The SR function has the potential to improve the observer performance of radiologists, particularly when reading subtle microcalcifications reproduced on 5-MP monitors.


Assuntos
Doenças Mamárias , Cristais Líquidos , Terminais de Computador , Apresentação de Dados , Humanos , Mamografia
7.
ScientificWorldJournal ; 2021: 8888845, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33833622

RESUMO

Background: Home visit is an integral component of Ghana's PHC delivery system. It is preventive and promotes health practice where health professionals render care to clients in their own environment and provide appropriate healthcare needs and social support services. This study describes the home visit practices in a rural district in the Volta Region of Ghana. Methodology. This descriptive cross-sectional study used 375 households and 11 community health nurses in the Adaklu district. Multistage sampling techniques were used to select 10 communities and study respondents using probability sampling methods. A pretested self-designed questionnaire and an interview guide for household members and community health nurses, respectively, were used for data collection. Quantitative data collected were coded, cleaned, and analysed using Statistical Package for Social Sciences into descriptive statistics, while qualitative data were analysed using the NVivo software. Thematic analysis was engaged that embraces three interrelated stages, namely, data reduction, data display, and data conclusion. Results: Home visit is a routine responsibility of all CHNs. The factors that influence home visiting were community members' education and attitude, supervision challenges, lack of incentives and lack of basic logistics, uncooperative attitude, community inaccessibility, financial constraint, and limited number of staff. Household members (62.3%) indicated that health workers did not adequately attend to minor ailments as 78% benefited from the service and wished more activities could be added to the home visiting package (24.5%). Conclusion: There should be tailored training of CHNs on home visits skills so that they could expand the scope of services that can be provided. Also, community-based health workers such as community health volunteers, traditional birth attendants, and community clinic attendants can also be trained to identify and address health problems in the homes.


Assuntos
Enfermagem em Saúde Comunitária , Visita Domiciliar , Enfermeiros de Saúde Comunitária , Atenção Primária à Saúde/organização & administração , Enfermagem Rural , Adolescente , Adulto , Idoso , Área Programática de Saúde , Enfermagem em Saúde Comunitária/organização & administração , Enfermagem em Saúde Comunitária/estatística & dados numéricos , Estudos Transversais , Coleta de Dados , Apresentação de Dados , Atenção à Saúde/organização & administração , Atenção à Saúde/estatística & dados numéricos , Demografia , Feminino , Gana , Educação em Saúde , Visita Domiciliar/estatística & dados numéricos , Humanos , Renda , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Enfermeiros de Saúde Comunitária/estatística & dados numéricos , Projetos Piloto , Pesquisa Qualitativa , Enfermagem Rural/organização & administração , Enfermagem Rural/estatística & dados numéricos , Amostragem , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
8.
Opt Express ; 29(7): 9878-9896, 2021 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-33820153

RESUMO

Creating immersive 3D stereoscopic, autostereoscopic, and lightfield experiences are becoming the center point of optical design of future head mounted displays and lightfield displays. However, despite the advancement in 3D and light field displays, there is no consensus on what are the necessary quantized depth levels for such emerging displays at stereoscopic or monocular modalities. Here we start from psychophysical theories and work toward defining and prioritizing quantized levels of depth that would saturate the human depth perception. We propose a general optimization framework, which locates the depth levels in a globally optimal way for band limited displays. While the original problem is computationally intractable, we manage to find a tractable reformulation as maximally covering a region of interest with a selection of hypographs corresponding to the monocular depth of field profiles. The results indicate that on average 1731 stereoscopic and 7 monocular depth levels (distributed optimally from 25 cm to infinity) would saturate the visual depth perception. Such that adding further depth levels adds negligible improvement. Also the first 3 depth levels should be allocated at (148), then (83, 170), then (53, 90, 170) distances respectively from the face plane to minimize the monocular error in the entire population. The study further discusses the 3D spatial profile of the quantized stereoscopic and monocular depth levels. The study provides fundamental guidelines for designing optimal near eye displays, light-field monitors, and 3D screens.


Assuntos
Percepção de Profundidade/fisiologia , Aumento da Imagem/instrumentação , Imageamento Tridimensional/instrumentação , Visão Binocular/fisiologia , Desenho Assistido por Computador , Apresentação de Dados , Humanos , Sistemas Homem-Máquina , Modelos Teóricos
9.
Artigo em Japonês | MEDLINE | ID: mdl-33883368

RESUMO

The purpose of this study is to examine the maximum brightness of the monitor, which is suitable for radiological technologists' (hereinafter referred to as technicians) interpretation assistance and image inspection. The signal detection ability was evaluated by receiver operating characteristic (ROC) analysis using a chest X-ray image with a simulated nodule. In order to examine the ease of observation and the effect on the subjective evaluation by changing the maximum brightness, evaluation was performed by the normalized ranking method using chest X-ray images. ROC experiments were performed using images with and without simulated nodules in the chest phantom. There was no significant difference in detectability by changing the maximum brightness (p>0.05), but the average area under the curve (AUC) was higher at 350 cd/m2 than at 100 cd/m2 and 170 cd/m2. A normalized ranking method was performed focusing on simulated nodules on chest X-ray images. In the least significant difference (l.s.d.) method, there was a significant difference between the maximum luminance, and the higher the maximum luminance, the better the evaluation. From these results, the change in the maximum brightness did not significantly affect the signal detection ability of the technician's chest X-ray image, but the higher the maximum brightness, the easier it was to observe and the higher the subjective evaluation. It has been reported that the higher the maximum brightness, the shorter the signal recognition time, and a monitor with a high maximum brightness may lead to more efficient image inspection by a technician. From the results of this study, it is considered appropriate to use a medical liquid crystal display (LCD) monitor with a maximum brightness of 350 cd/m2 for the technician's interpretation assistance and image inspection.


Assuntos
Apresentação de Dados , Cristais Líquidos , Área Sob a Curva , Imagens de Fantasmas , Curva ROC , Intensificação de Imagem Radiográfica , Radiografia Torácica
10.
Radiat Prot Dosimetry ; 195(3-4): 426-433, 2021 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-33839793

RESUMO

Many standards and guidelines related to the use of medical displays require viewers to be in dark rooms. The purpose of this theoretical study was to examine the validity of some commonly used requirements in terms of image contrast and contrast stability in rooms with fluctuating illuminance. By using the grayscale standard display function (Dicom part 14), contrast was calculated for several combinations of display minimum and maximum luminance as well as the possible range of illuminance fluctuations that will not exceed given contrast tolerance levels. The results show that some requirements are only valid in dark viewing rooms, which are also usually recommended or enforced. However, image contrast, contrast stability, ergonomics and fatigue would improve by using brighter displays in brighter rooms. With a better set of requirements, it would also be possible for displays in brighter rooms, like dentist departments and operating rooms, to conform to the requirements.


Assuntos
Apresentação de Dados , Padrões de Referência
11.
Appl Clin Inform ; 12(1): 164-169, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33657635

RESUMO

BACKGROUND: The data visualization literature asserts that the details of the optimal data display must be tailored to the specific task, the background of the user, and the characteristics of the data. The general organizing principle of a concept-oriented display is known to be useful for many tasks and data types. OBJECTIVES: In this project, we used general principles of data visualization and a co-design process to produce a clinical display tailored to a specific cognitive task, chosen from the anesthesia domain, but with clear generalizability to other clinical tasks. To support the work of the anesthesia-in-charge (AIC) our task was, for a given day, to depict the acuity level and complexity of each patient in the collection of those that will be operated on the following day. The AIC uses this information to optimally allocate anesthesia staff and providers across operating rooms. METHODS: We used a co-design process to collaborate with participants who work in the AIC role. We conducted two in-depth interviews with AICs and engaged them in subsequent input on iterative design solutions. RESULTS: Through a co-design process, we found (1) the need to carefully match the level of detail in the display to the level required by the clinical task, (2) the impedance caused by irrelevant information on the screen such as icons relevant only to other tasks, and (3) the desire for a specific but optional trajectory of increasingly detailed textual summaries. CONCLUSION: This study reports a real-world clinical informatics development project that engaged users as co-designers. Our process led to the user-preferred design of a single binary flag to identify the subset of patients needing further investigation, and then a trajectory of increasingly detailed, text-based abstractions for each patient that can be displayed when more information is needed.


Assuntos
Apresentação de Dados , Informática Médica , Atenção à Saúde , Humanos , Salas Cirúrgicas , Assistência Perioperatória
12.
PLoS One ; 16(3): e0248180, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33760857

RESUMO

Achromatic, mean-modulated flicker-wherein luminance increments and decrements of equal magnitude are applied, over time, to a test field-is commonly used in both clinical assessment of vision and experimental studies of visual systems. However, presenting flicker on computer-controlled displays is problematic; displays typically introduce luminance artifacts at high flicker frequency or contrast, potentially interfering with the validity of findings. Here, we present a battery of tests used to weigh the relative merits of two displays for presenting achromatic, mean-modulated flicker. These tests revealed marked differences between a new high-performance liquid-crystal display (LCD; EIZO ColorEdge CG247X) and a new consumer-grade LCD (Dell U2415b), despite displays' vendor-supplied specifications being almost identical. We measured displayed luminance using a spot meter and a linearized photodiode. We derived several measures, including spatial uniformity, the effect of viewing angle, response times, Fourier amplitude spectra, and cycle-averaged luminance. We presented paired luminance pulses to quantify the displays' nonlinear dynamics. The CG247X showed relatively good spatial uniformity (e.g., at moderate luminance, standard deviation 2.8% versus U2415b's 5.3%). Fourier transformation of nominally static test patches revealed spectra free of artifacts, with the exception of a frame response. The CG247X's rise and fall times depended on both the luminance from which, and to which, it responded, as is to be generally expected from LCDs. Despite this nonlinear behaviour, we were able to define a contrast and frequency range wherein the CG247X appeared largely artifact-free; the relationship between nominal luminance and displayed luminance was accurately modelled using a causal, linear time-invariant system. This range included contrasts up to 80%, and flicker frequencies up to 30 Hz. This battery of tests should prove useful to others conducting clinical assessment of vision and experimental studies of visual systems.


Assuntos
Apresentação de Dados , Cristais Líquidos , Visão Ocular/fisiologia , Percepção Visual/fisiologia , Humanos , Dinâmica não Linear , Estimulação Luminosa
13.
N Z Med J ; 134(1531): 67-76, 2021 03 26.
Artigo em Inglês | MEDLINE | ID: mdl-33767478

RESUMO

AIMS: To assess how well the NZ COVID Tracer QR (Quick Response) code poster is displayed by Dunedin businesses and other venues in which groups of people gather indoors, and to calculate the proportions of visitors to those venues who scan the QR code poster. METHODS: We randomly selected 10 cafes, 10 restaurants, 10 bars, five churches, and five supermarkets and visited them at their busiest times. We evaluated the display of QR code posters using a six-item assessment tool that was based on guidance provided to businesses and services by the Ministry of Health, and we counted the number of people who entered each venue during a one-hour period and the number who scanned the QR code poster. RESULTS: All six criteria for displaying QR code posters were met at half of the hospitality venues, four of five churches, and all supermarkets. Scanning proportions were low at all venues (median 10.2%), and at 12 (30%) no visitors scanned; eight of these venues were bars. CONCLUSION: This audit provides a snapshot of the display and scanning of QR code posters in a city with no managed isolation and quarantine facilities and where no COVID-19 cases have been detected for 10 months.


Assuntos
COVID-19 , Busca de Comunicante , Apresentação de Dados , Instalações não Médicas Públicas e Privadas , Pôsteres como Assunto , Adulto , COVID-19/epidemiologia , COVID-19/prevenção & controle , Busca de Comunicante/métodos , Busca de Comunicante/estatística & dados numéricos , Apresentação de Dados/normas , Apresentação de Dados/estatística & dados numéricos , Feminino , Humanos , Masculino , Auditoria Administrativa , Marketing/normas , Nova Zelândia/epidemiologia , Instalações não Médicas Públicas e Privadas/organização & administração , Instalações não Médicas Públicas e Privadas/normas , Instalações não Médicas Públicas e Privadas/estatística & dados numéricos , Avaliação de Resultados em Cuidados de Saúde , Saúde Pública/métodos , SARS-CoV-2
14.
Phys Eng Sci Med ; 44(1): 117-122, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33523387

RESUMO

Liquid crystal display (LCD) monitors show a homogenous quadratic pattern in the number of pixels, size, and dimensions. However, their modulation transfer function (MTF) has a non-isotropic effect in the vertical, horizontal, and diagonal directions on the screen from the shape and pattern of arrangement of pixels. Moreover, the MTF of the human eye differs in spatial frequency response directivity among individuals. In this study, the high-brightness LCD monitor detectability was physically simulated and visually examined throughout the system, including the imaging system. Furthermore, the influence of anisotropy of the LCD monitor was evaluated. The MTF of the LCD monitor was measured by acquiring a bar pattern using a digital camera with sufficiently small pixels in the vertical, horizontal, and diagonal directions and by performing interpolation processing through waveform reproduction and frequency analysis. The detectability of the LCD monitor was verified throughout the system, including the imaging system. Radiographs of the rectangular wave chart (0.5-10 LP/mm) were obtained in the vertical, horizontal, and diagonal (45°) directions to assess the perceivable limit of the human eye (LP/mm). The spatial resolution of the LCD monitor in the diagonal direction was higher than that in the vertical or horizontal direction, which was in good agreement with the results of the profile analysis and visual evaluation.


Assuntos
Cristais Líquidos , Apresentação de Dados , Humanos , Monitorização Fisiológica
15.
PLoS One ; 16(2): e0247002, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33606709

RESUMO

2020 saw the continuation of the second largest outbreak of Ebola virus disease (EVD) in history. Determining epidemiological links between cases is a key part of outbreak control. However, due to the large quantity of data and subsequent data entry errors, inconsistencies in potential epidemiological links are difficult to identify. We present chainchecker, an online and offline shiny application which visualises, curates and verifies transmission chain data. The application includes the calculation of exposure windows for individual cases of EVD based on user defined incubation periods and user specified symptom profiles. It has an upload function for viral hemorrhagic fever data and utility for additional entries. This data may then be visualised as a transmission tree with inconsistent links highlighted. Finally, there is utility for cluster analysis and the ability to highlight nosocomial transmission. chainchecker is a R shiny application which has an offline version for use with VHF (viral hemorrhagic fever) databases or linelists. The software is available at https://shiny.dide.imperial.ac.uk/chainchecker which is a web-based application that links to the desktop application available for download and the github repository, https://github.com/imperialebola2018/chainchecker.


Assuntos
Apresentação de Dados , Ebolavirus/fisiologia , Doença pelo Vírus Ebola/transmissão , Doença pelo Vírus Ebola/epidemiologia , Humanos , Internet , Software
16.
J Am Med Inform Assoc ; 28(5): 899-906, 2021 04 23.
Artigo em Inglês | MEDLINE | ID: mdl-33566093

RESUMO

OBJECTIVE: The electronic health record (EHR) data deluge makes data retrieval more difficult, escalating cognitive load and exacerbating clinician burnout. New auto-summarization techniques are needed. The study goal was to determine if problem-oriented view (POV) auto-summaries improve data retrieval workflows. We hypothesized that POV users would perform tasks faster, make fewer errors, be more satisfied with EHR use, and experience less cognitive load as compared with users of the standard view (SV). METHODS: Simple data retrieval tasks were performed in an EHR simulation environment. A randomized block design was used. In the control group (SV), subjects retrieved lab results and medications by navigating to corresponding sections of the electronic record. In the intervention group (POV), subjects clicked on the name of the problem and immediately saw lab results and medications relevant to that problem. RESULTS: With POV, mean completion time was faster (173 seconds for POV vs 205 seconds for SV; P < .0001), the error rate was lower (3.4% for POV vs 7.7% for SV; P = .0010), user satisfaction was greater (System Usability Scale score 58.5 for POV vs 41.3 for SV; P < .0001), and cognitive task load was less (NASA Task Load Index score 0.72 for POV vs 0.99 for SV; P < .0001). DISCUSSION: The study demonstrates that using a problem-based auto-summary has a positive impact on 4 aspects of EHR data retrieval, including cognitive load. CONCLUSION: EHRs have brought on a data deluge, with increased cognitive load and physician burnout. To mitigate these increases, further development and implementation of auto-summarization functionality and the requisite knowledge base are needed.


Assuntos
Apresentação de Dados , Registros Eletrônicos de Saúde , Registros Médicos Orientados a Problemas , Humanos , Armazenamento e Recuperação da Informação , Interface Usuário-Computador , Fluxo de Trabalho
17.
J Med Internet Res ; 23(2): e25682, 2021 02 24.
Artigo em Inglês | MEDLINE | ID: mdl-33577467

RESUMO

BACKGROUND: Since the outbreak of COVID-19, the development of dashboards as dynamic, visual tools for communicating COVID-19 data has surged worldwide. Dashboards can inform decision-making and support behavior change. To do so, they must be actionable. The features that constitute an actionable dashboard in the context of the COVID-19 pandemic have not been rigorously assessed. OBJECTIVE: The aim of this study is to explore the characteristics of public web-based COVID-19 dashboards by assessing their purpose and users ("why"), content and data ("what"), and analyses and displays ("how" they communicate COVID-19 data), and ultimately to appraise the common features of highly actionable dashboards. METHODS: We conducted a descriptive assessment and scoring using nominal group technique with an international panel of experts (n=17) on a global sample of COVID-19 dashboards in July 2020. The sequence of steps included multimethod sampling of dashboards; development and piloting of an assessment tool; data extraction and an initial round of actionability scoring; a workshop based on a preliminary analysis of the results; and reconsideration of actionability scores followed by joint determination of common features of highly actionable dashboards. We used descriptive statistics and thematic analysis to explore the findings by research question. RESULTS: A total of 158 dashboards from 53 countries were assessed. Dashboards were predominately developed by government authorities (100/158, 63.0%) and were national (93/158, 58.9%) in scope. We found that only 20 of the 158 dashboards (12.7%) stated both their primary purpose and intended audience. Nearly all dashboards reported epidemiological indicators (155/158, 98.1%), followed by health system management indicators (85/158, 53.8%), whereas indicators on social and economic impact and behavioral insights were the least reported (7/158, 4.4% and 2/158, 1.3%, respectively). Approximately a quarter of the dashboards (39/158, 24.7%) did not report their data sources. The dashboards predominately reported time trends and disaggregated data by two geographic levels and by age and sex. The dashboards used an average of 2.2 types of displays (SD 0.86); these were mostly graphs and maps, followed by tables. To support data interpretation, color-coding was common (93/158, 89.4%), although only one-fifth of the dashboards (31/158, 19.6%) included text explaining the quality and meaning of the data. In total, 20/158 dashboards (12.7%) were appraised as highly actionable, and seven common features were identified between them. Actionable COVID-19 dashboards (1) know their audience and information needs; (2) manage the type, volume, and flow of displayed information; (3) report data sources and methods clearly; (4) link time trends to policy decisions; (5) provide data that are "close to home"; (6) break down the population into relevant subgroups; and (7) use storytelling and visual cues. CONCLUSIONS: COVID-19 dashboards are diverse in the why, what, and how by which they communicate insights on the pandemic and support data-driven decision-making. To leverage their full potential, dashboard developers should consider adopting the seven actionability features identified.


Assuntos
COVID-19 , Apresentação de Dados , Disseminação de Informação , Internet , Adulto , Gráficos por Computador , Surtos de Doenças , Feminino , Humanos , Armazenamento e Recuperação da Informação , Masculino , Pandemias , SARS-CoV-2 , Adulto Jovem
20.
J Clin Monit Comput ; 35(5): 1119-1131, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-32743757

RESUMO

Conventional electronic health record information displays are not optimized for efficient information processing. Graphical displays that integrate patient information can improve information processing, especially in data-rich environments such as critical care. We propose an adaptable and reusable approach to patient information display with modular graphical components (widgets). We had two study objectives. First, reduce numerous widget prototype alternatives to preferred designs. Second, derive widget design feature recommendations. Using iterative human-centered design methods, we interviewed experts to hone design features of widgets displaying frequently measured data elements, e.g., heart rate, for acute care patient monitoring and real-time clinical decision-making. Participant responses to design queries were coded to calculate feature-set agreement, average prototype score, and prototype agreement. Two iterative interview cycles covering 64 design queries and 86 prototypes were needed to reach consensus on six feature sets. Interviewers agreed that line graphs with a smoothed or averaged trendline, 24-h timeframe, and gradient coloring for urgency were useful and informative features. Moreover, users agreed that widgets should include key functions: (1) adjustable reference ranges, (2) expandable timeframes, and (3) access to details on demand. Participants stated graphical widgets would be used to identify correlating patterns and compare abnormal measures across related data elements at a specific time. Combining theoretical principles and validated design methods was an effective and reproducible approach to designing widgets for healthcare displays. The findings suggest our widget design features and recommendations match critical care clinician expectations for graphical information display of continuous and frequently updated patient data.


Assuntos
Apresentação de Dados , Heurística , Cuidados Críticos , Registros Eletrônicos de Saúde , Humanos
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