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A Spatiotemporal and Multisensory Approach to Designing Wearable Clinical ICU Alarms

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Abstract

In health care, auditory alarms are an important aspect of an informatics system that monitors patients and alerts clinicians attending to multiple concurrent tasks. However, the volume, design, and pervasiveness of existing Intensive Care Unit (ICU) alarms can make it difficult to quickly distinguish their meaning and importance. In this study, we evaluated the effectiveness of two design approaches not yet explored in a smartwatch-based alarm system designed for ICU use: (1) using audiovisual spatial colocalization and (2) adding haptic (i.e., touch) information. We compared the performance of 30 study participants using ICU smartwatch alarms containing auditory icons in two implementations of the audio modality: colocalized with the visual cue on the smartwatch’s low-quality speaker versus delivered from a higher quality speaker located two feet away from participants (like a stationary alarm bay situated near patients in the ICU). Additionally, we compared participant performance using alarms with two sensory modalities (visual and audio) against alarms with three sensory modalities (adding haptic cues). Participants were 10.1% (0.24s) faster at responding to alarms when auditory information was delivered from the smartwatch instead of the higher quality external speaker. Meanwhile, adding haptic information to alarms improved response times to alarms by 12.2% (0.23s) and response times on their primary task by 10.3% (0.08s). Participants rated learnability and ease of use higher for alarms with haptic information. These small but statistically significant improvements demonstrate that audiovisual colocalization and multisensory alarm design can improve user response times.

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Acknowledgements

The authors would like to thank Dr. Judy Edworthy and Dr. Michael R. King for their input and assistance. The authors would also like to thank Russ Beebe, interactions designer within the Department of Anesthesiology at Vanderbilt University Medical Center, for his assistance in formatting figures.

Funding

This work was supported by the Office of Naval Research Grant N00014-22-1-2184.

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Authors and Affiliations

  1. Renaissance School of Medicine, Stony Brook University, 100 Nicolls Rd, Stony Brook, NY, 11790, USA

    Ayush Sangari

  2. Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA

    Molly A. Bingham

  3. Department of Neuroscience, Vanderbilt University, Nashville, TN, USA

    Mabel Cummins & Anqy Tong

  4. Long Island Jewish Medical Center, New Hyde Park, New York, USA

    Aditya Sood

  5. The New School, New York City, NY, USA

    Palmer Purcell

  6. Division of Critical Care Medicine, Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA

    Joseph J. Schlesinger

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Contributions

A.S., M.B., M.C., A.T., and J.S. contributed to the study design and conception. M.B., M.C., A.T., and J.S. assisted with data collection. All authors assisted with data analysis. All authors contributed to writing, revising, and finalizing the manuscript.

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Correspondence to Ayush Sangari.

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Sangari, A., Bingham, M.A., Cummins, M. et al. A Spatiotemporal and Multisensory Approach to Designing Wearable Clinical ICU Alarms. J Med Syst 47, 105 (2023). https://doi.org/10.1007/s10916-023-01997-2

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