Voice alerting as a medical alarm modality for next-generation patient monitoring: a randomised international multicentre trial
Acoustic alarms in medical devices are vital for patient safety. State-of-the-art patient monitoring alarms are indistinguishable and contribute to alarm fatigue. There are two promising new sound modalities for vital sign alarms. Auditory icons convey alarms as brief metaphorical sounds, and voice...
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| Veröffentlicht in: | British journal of anaesthesia : BJA 2021-11, Vol.127 (5), p.769-777 |
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| container_title | British journal of anaesthesia : BJA |
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| creator | Roche, Tadzio R. Braun, Julia Ganter, Michael T. Meybohm, Patrick Herrmann, Johannes Zacharowski, Kai Raimann, Florian J. Piekarski, Florian Spahn, Donat R. Nöthiger, Christoph B. Tscholl, David W. Said, Sadiq |
| description | Acoustic alarms in medical devices are vital for patient safety. State-of-the-art patient monitoring alarms are indistinguishable and contribute to alarm fatigue. There are two promising new sound modalities for vital sign alarms. Auditory icons convey alarms as brief metaphorical sounds, and voice alerts transmit information using a clear-spoken language. We compared how reliably healthcare professionals identified alarms using these two modalities.
This investigator-initiated computer-based multicentre simulation study included 28 anaesthesia providers who were asked to identify vital sign alarms in randomised order, once with voice alerts and once with auditory icons. We further assessed time to decision, diagnostic confidence, and perceived helpfulness. We analysed the results using mixed models, adjusted for possible confounders.
We assessed 14 alarms for each modality, resulting in 392 comparisons across all participants. Compared with auditory icons, healthcare providers had 58 times higher odds of correctly identifying alarms using voice alerts (odds ratio 58.0; 95% confidence interval [CI]: 25.1–133.6; P |
| doi_str_mv | 10.1016/j.bja.2021.07.015 |
| format | Article |
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This investigator-initiated computer-based multicentre simulation study included 28 anaesthesia providers who were asked to identify vital sign alarms in randomised order, once with voice alerts and once with auditory icons. We further assessed time to decision, diagnostic confidence, and perceived helpfulness. We analysed the results using mixed models, adjusted for possible confounders.
We assessed 14 alarms for each modality, resulting in 392 comparisons across all participants. Compared with auditory icons, healthcare providers had 58 times higher odds of correctly identifying alarms using voice alerts (odds ratio 58.0; 95% confidence interval [CI]: 25.1–133.6; P<0.001), made their decisions about 14 s faster (coefficient –13.9; 95% CI: –15.8 to –12.1 s; P<0.001), perceived higher diagnostic confidence (100% [392 of 392] vs 43% [169 of 392; P<0.001]), and rated voice alerts as more helpful (odds ratio 138.2; 95% CI: 64.9–294.1; P<0.001). The participants were able to identify significantly higher proportions of alarms with voice alerts (98.5%; P<0.001) and auditory icons (54.1%; P<0.001) compared with state-of-the-art alarms (17.9%).
Voice alerts were superior to auditory icons, and both were superior to current state-of-the-art auditory alarms. These findings demonstrate the potential that voice alerts hold for patient monitoring.]]></description><identifier>ISSN: 0007-0912</identifier><identifier>EISSN: 1471-6771</identifier><identifier>DOI: 10.1016/j.bja.2021.07.015</identifier><language>eng</language><publisher>Elsevier Ltd</publisher><subject>acoustic stimulation ; auditory perception ; clinical alarms ; equipment design ; patient safety ; situation awareness ; user-centred</subject><ispartof>British journal of anaesthesia : BJA, 2021-11, Vol.127 (5), p.769-777</ispartof><rights>2021 British Journal of Anaesthesia</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c373t-fb24f148c6458f94a756d54e78c100f8630a410059e28077e29850754f21b9263</citedby><cites>FETCH-LOGICAL-c373t-fb24f148c6458f94a756d54e78c100f8630a410059e28077e29850754f21b9263</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids></links><search><creatorcontrib>Roche, Tadzio R.</creatorcontrib><creatorcontrib>Braun, Julia</creatorcontrib><creatorcontrib>Ganter, Michael T.</creatorcontrib><creatorcontrib>Meybohm, Patrick</creatorcontrib><creatorcontrib>Herrmann, Johannes</creatorcontrib><creatorcontrib>Zacharowski, Kai</creatorcontrib><creatorcontrib>Raimann, Florian J.</creatorcontrib><creatorcontrib>Piekarski, Florian</creatorcontrib><creatorcontrib>Spahn, Donat R.</creatorcontrib><creatorcontrib>Nöthiger, Christoph B.</creatorcontrib><creatorcontrib>Tscholl, David W.</creatorcontrib><creatorcontrib>Said, Sadiq</creatorcontrib><title>Voice alerting as a medical alarm modality for next-generation patient monitoring: a randomised international multicentre trial</title><title>British journal of anaesthesia : BJA</title><description><![CDATA[Acoustic alarms in medical devices are vital for patient safety. State-of-the-art patient monitoring alarms are indistinguishable and contribute to alarm fatigue. There are two promising new sound modalities for vital sign alarms. Auditory icons convey alarms as brief metaphorical sounds, and voice alerts transmit information using a clear-spoken language. We compared how reliably healthcare professionals identified alarms using these two modalities.
This investigator-initiated computer-based multicentre simulation study included 28 anaesthesia providers who were asked to identify vital sign alarms in randomised order, once with voice alerts and once with auditory icons. We further assessed time to decision, diagnostic confidence, and perceived helpfulness. We analysed the results using mixed models, adjusted for possible confounders.
We assessed 14 alarms for each modality, resulting in 392 comparisons across all participants. Compared with auditory icons, healthcare providers had 58 times higher odds of correctly identifying alarms using voice alerts (odds ratio 58.0; 95% confidence interval [CI]: 25.1–133.6; P<0.001), made their decisions about 14 s faster (coefficient –13.9; 95% CI: –15.8 to –12.1 s; P<0.001), perceived higher diagnostic confidence (100% [392 of 392] vs 43% [169 of 392; P<0.001]), and rated voice alerts as more helpful (odds ratio 138.2; 95% CI: 64.9–294.1; P<0.001). The participants were able to identify significantly higher proportions of alarms with voice alerts (98.5%; P<0.001) and auditory icons (54.1%; P<0.001) compared with state-of-the-art alarms (17.9%).
Voice alerts were superior to auditory icons, and both were superior to current state-of-the-art auditory alarms. These findings demonstrate the potential that voice alerts hold for patient monitoring.]]></description><subject>acoustic stimulation</subject><subject>auditory perception</subject><subject>clinical alarms</subject><subject>equipment design</subject><subject>patient safety</subject><subject>situation awareness</subject><subject>user-centred</subject><issn>0007-0912</issn><issn>1471-6771</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kDFv2zAQhYkiBeq4_QHdOGaReqRFUWqnwGjSAAayJF0JmjoZNCTSIemgnvrXe64zZyAeQbz37vgx9lVALUC03_b1dm9rCVLUoGsQ6gNbiEaLqtVaXLEFAOgKeiE_seuc9wBCy14t2N_f0TvkdsJUfNhxm7nlMw7e2YlebZr5HAc7-XLiY0w84J9S7TBgssXHwA8kGAqZgi8xUcV3Kkg2DHH2GQfuQ8EU_pupcT5OheaFkpCX5O30mX0c7ZTxy5su2fPdz6f1r2rzeP-wvt1UbqVXpRq3shlF07m2Ud3YN1ardlAN6s4JgLFrV2AbuqkeZQdao-w7BVo1oxTbXrarJbu59B5SfDliLobWczhNNmA8ZiNV29IRsiOruFhdijknHM0h-dmmkxFgzrDN3hBsc4ZtQBuCTZkflwzSH149JpMdcXEEMqErZoj-nfQ_ucKIeQ</recordid><startdate>202111</startdate><enddate>202111</enddate><creator>Roche, Tadzio R.</creator><creator>Braun, Julia</creator><creator>Ganter, Michael T.</creator><creator>Meybohm, Patrick</creator><creator>Herrmann, Johannes</creator><creator>Zacharowski, Kai</creator><creator>Raimann, Florian J.</creator><creator>Piekarski, Florian</creator><creator>Spahn, Donat R.</creator><creator>Nöthiger, Christoph B.</creator><creator>Tscholl, David W.</creator><creator>Said, Sadiq</creator><general>Elsevier Ltd</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202111</creationdate><title>Voice alerting as a medical alarm modality for next-generation patient monitoring: a randomised international multicentre trial</title><author>Roche, Tadzio R. ; Braun, Julia ; Ganter, Michael T. ; Meybohm, Patrick ; Herrmann, Johannes ; Zacharowski, Kai ; Raimann, Florian J. ; Piekarski, Florian ; Spahn, Donat R. ; Nöthiger, Christoph B. ; Tscholl, David W. ; Said, Sadiq</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c373t-fb24f148c6458f94a756d54e78c100f8630a410059e28077e29850754f21b9263</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>acoustic stimulation</topic><topic>auditory perception</topic><topic>clinical alarms</topic><topic>equipment design</topic><topic>patient safety</topic><topic>situation awareness</topic><topic>user-centred</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Roche, Tadzio R.</creatorcontrib><creatorcontrib>Braun, Julia</creatorcontrib><creatorcontrib>Ganter, Michael T.</creatorcontrib><creatorcontrib>Meybohm, Patrick</creatorcontrib><creatorcontrib>Herrmann, Johannes</creatorcontrib><creatorcontrib>Zacharowski, Kai</creatorcontrib><creatorcontrib>Raimann, Florian J.</creatorcontrib><creatorcontrib>Piekarski, Florian</creatorcontrib><creatorcontrib>Spahn, Donat R.</creatorcontrib><creatorcontrib>Nöthiger, Christoph B.</creatorcontrib><creatorcontrib>Tscholl, David W.</creatorcontrib><creatorcontrib>Said, Sadiq</creatorcontrib><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of anaesthesia : BJA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Roche, Tadzio R.</au><au>Braun, Julia</au><au>Ganter, Michael T.</au><au>Meybohm, Patrick</au><au>Herrmann, Johannes</au><au>Zacharowski, Kai</au><au>Raimann, Florian J.</au><au>Piekarski, Florian</au><au>Spahn, Donat R.</au><au>Nöthiger, Christoph B.</au><au>Tscholl, David W.</au><au>Said, Sadiq</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Voice alerting as a medical alarm modality for next-generation patient monitoring: a randomised international multicentre trial</atitle><jtitle>British journal of anaesthesia : BJA</jtitle><date>2021-11</date><risdate>2021</risdate><volume>127</volume><issue>5</issue><spage>769</spage><epage>777</epage><pages>769-777</pages><issn>0007-0912</issn><eissn>1471-6771</eissn><abstract><![CDATA[Acoustic alarms in medical devices are vital for patient safety. State-of-the-art patient monitoring alarms are indistinguishable and contribute to alarm fatigue. There are two promising new sound modalities for vital sign alarms. Auditory icons convey alarms as brief metaphorical sounds, and voice alerts transmit information using a clear-spoken language. We compared how reliably healthcare professionals identified alarms using these two modalities.
This investigator-initiated computer-based multicentre simulation study included 28 anaesthesia providers who were asked to identify vital sign alarms in randomised order, once with voice alerts and once with auditory icons. We further assessed time to decision, diagnostic confidence, and perceived helpfulness. We analysed the results using mixed models, adjusted for possible confounders.
We assessed 14 alarms for each modality, resulting in 392 comparisons across all participants. Compared with auditory icons, healthcare providers had 58 times higher odds of correctly identifying alarms using voice alerts (odds ratio 58.0; 95% confidence interval [CI]: 25.1–133.6; P<0.001), made their decisions about 14 s faster (coefficient –13.9; 95% CI: –15.8 to –12.1 s; P<0.001), perceived higher diagnostic confidence (100% [392 of 392] vs 43% [169 of 392; P<0.001]), and rated voice alerts as more helpful (odds ratio 138.2; 95% CI: 64.9–294.1; P<0.001). The participants were able to identify significantly higher proportions of alarms with voice alerts (98.5%; P<0.001) and auditory icons (54.1%; P<0.001) compared with state-of-the-art alarms (17.9%).
Voice alerts were superior to auditory icons, and both were superior to current state-of-the-art auditory alarms. These findings demonstrate the potential that voice alerts hold for patient monitoring.]]></abstract><pub>Elsevier Ltd</pub><doi>10.1016/j.bja.2021.07.015</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | acoustic stimulation auditory perception clinical alarms equipment design patient safety situation awareness user-centred |
| title | Voice alerting as a medical alarm modality for next-generation patient monitoring: a randomised international multicentre trial |
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