title: Specific elements of a new hemodynamics display improves the performance of anesthesiologists.
abstract: OBJECTIVE
  We tested the hypothesis that a monitoring display proposed by Blike et al. improves the performance of anesthesiologists. We measured the performance of anesthesiologists using the new display and compared it to their performance with a traditional display. We studied three different displays on how they affected recognition and differentiation of five etiologies of shock-anaphylaxis, bradycardia, hypovolemia, ischemia and pulmonary embolus.
  
  
  METHODS
  The participants monitored heart rate, systemic arterial and pulmonary blood pressure, central venous pressure, and cardiac output during five shock states and five non-shock states. The resulting 10 data sets made up ten decision screens, which we presented randomly on a computer monitor to the subjects in one of three different formats (a Single Sensor Single Indicator (SSSI) Numeric display; an Object display; and an Object Minus Shapes display). Subjects used soft-buttons on a computer touch-screen monitor to: a) advance to the next display; b) differentiate a non-shock state from a shock state; and, c) select the etiology of shock state represented by the display (Figure 4). The internal clock and memory of the computer made the collection of data automatic.
  
  
  RESULTS
  The subjects recognized a problem more rapidly with the help of a graphical "pointer on a reference scale" in both Object displays, but their accuracy had not improved in comparison to the SSSI Numeric display. The shape of the Object display improved performance of etiology determination compared to the Object Minus Shapes display and SSSI Numeric display. Testing (10 trials) was completed in less than 45 minutes.
  
  
  CONCLUSIONS
  The new display with "emergent features" can improve the diagnostic performance of clinicians.
authors.affiliation: Department of Anesthesiology, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756-0001, USA. George.Blike@Hitchcock.org
authors.forename: G T
authors.initials: GT
authors.lastname: Blike
authors.forename: S D
authors.initials: SD
authors.lastname: Surgenor
authors.forename: K
authors.initials: K
authors.lastname: Whalen
authors.forename: J
authors.initials: J
authors.lastname: Jensen
mesh_terms: D000776:Anesthesiology / Q000379:methods*; D001794:Blood Pressure; D002302:Cardiac Output; D003626:Data Display; D004867:Equipment Design; D005069:Evaluation Studies as Topic; D006339:Heart Rate; D006439:Hemodynamics; D006801:Humans; D008991:Monitoring, Physiologic; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted