scholarly journals Application of a user-centered usability evaluation framework to assess a handheld 12-lead electrocardiogram (ECG) device: user perceptions and experience in a clinical setting (Preprint)

JMIR Cardio ◽  
10.2196/21186 ◽  
2021 ◽  
Author(s):  
Kam Cheong Wong ◽  
Aravinda Thiagalingam ◽  
Saurabh Kumar ◽  
Simone Marschner ◽  
Ritu Kunwar ◽  
...  
Keyword(s):  
Clinical Setting ◽  
Usability Evaluation ◽  
Evaluation Framework ◽  
User Perceptions ◽  
Device User ◽  
Electrocardiogram Ecg ◽  
User Centered

scholarly journals Application of a user-centered usability evaluation framework to assess a handheld 12-lead electrocardiogram (ECG) device: user perceptions and experience in a clinical setting (Preprint)

2021 ◽  
Author(s):  
Kam Cheong Wong ◽  
Aravinda Thiagalingam ◽  
Saurabh Kumar ◽  
Simone Marschner ◽  
Ritu Kunwar ◽  
...  
Keyword(s):  
Technology Acceptance ◽  
Mass Screening ◽  
Mean Difference ◽  
Evaluation Framework ◽  
Cardiac Conduction ◽  
Successful Implementation ◽  
User Perceptions ◽  
Handheld Device ◽  
Electrocardiogram Ecg ◽  
User Centered

BACKGROUND Cardiac arrhythmias are a leading cause of death. Twelve-lead electrocardiogram (ECG) is the mainstay for diagnosing arrhythmias e.g. atrial fibrillation (AF) and cardiac conduction disorders e.g. long QTc (LQTc). Handheld 12-lead ECG devices are emerging in the market. With emerging technology options to acquire an ECG in various clinical settings, evaluation of device usability should go beyond validation of the device in a controlled laboratory setting but also assess user perceptions and experience which are crucial for successful implementation in clinical practice. OBJECTIVE This study aimed to evaluate clinician and patient perceptions and experience regarding the usability of a handheld 12-lead ECG device compared to routinely used conventional 12-lead ECG machine. METHODS A mixed methods study was conducted with clinicians and patients in outpatient clinics and cardiology wards at Westmead Hospital, New South Wales, Australia. Each patient had two ECGs in two postures (supine and standing) acquired by each device in random sequence. The times taken by clinicians to acquire the first ECG (efficiency) using the devices were analysed using linear regression. ECG parameters (QT, QTc, HR, PR, QRS) and participant satisfaction survey were collected. The device reliability was assessed by evaluating the mean difference of QTc measurements within ± 15 milliseconds and intraclass correlation coefficients (ICC), and level of agreements (Kappa) of the devices in detecting AF and LQTc. Clinicians’ perceptions and feedback were assessed by semi-structured interviews drawing on the framework of the Technology Acceptance Model. RESULTS 100 patients (mean 57.9y (SD 15.2y), 64% male) participated with 783 ECGs acquired, and engaging 11 clinicians (90.9% of them acquired ECGs daily or weekly). Mean difference in QTc measurements of both devices were within ± 15 milliseconds with high ICC (ranged 0.90-0.96), and the devices had a good level of agreement in diagnosing AF and LQTc (Kappa ranged 0.68 – 0.93). Regardless of device, QTc at standing was lengthened compared with QTc at supine. Clinicians’ ECG acquisition times improved with usage (p for trend <0.001). Clinicians reported that device characteristics (small size, light weight, portability and wireless ECG transmission) were highly desired features. Most clinicians agreed that the handheld device could be used for clinician-led mass screening with enhancement in efficiency by increasing user training. Generally, patients reported that they felt comfortable when they were connected to both ECG devices. CONCLUSIONS The handheld 12-lead ECG device was comparable to a conventional ECG machine in its reliability and usability. The user-centered evaluation approach helped us identify remediable action to improve efficiency of using the device, identified highly desirable device features which could potentially help mass screening and remote assessment of patients, and the approach could be applied to evaluate and better understand the acceptability and applicability of new medical devices. CLINICALTRIAL Not applicable.

scholarly journals Integrating Health Behavior Theory and Design Elements in Serious Games

2020 ◽  
Author(s):  
Colleen Cheek ◽  
Theresa Fleming ◽  
Mathijs FG Lucassen ◽  
Heather Bridgman ◽  
Karolina Stasiak ◽  
...  
Keyword(s):  
Health Behavior ◽  
Behavior Change ◽  
Game Design ◽  
Serious Games ◽  
Well Being ◽  
Health Behavior Change ◽  
Serious Game ◽  
User Perceptions ◽  
Design Elements ◽  
User Centered

Background Internet interventions for improving health and well-being have the potential to reach many people and fill gaps in service provision. Serious gaming interfaces provide opportunities to optimize user adherence and impact. Health interventions based in theory and evidence and tailored to psychological constructs have been found to be more effective to promote behavior change. Defining the design elements which engage users and help them to meet their goals can contribute to better informed serious games. Objective To elucidate design elements important in SPARX, a serious game for adolescents with depression, from a user-centered perspective. Methods We proposed a model based on an established theory of health behavior change and practical features of serious game design to organize ideas and rationale. We analyzed data from 5 studies comprising a total of 22 focus groups and 66 semistructured interviews conducted with youth and families in New Zealand and Australia who had viewed or used SPARX. User perceptions of the game were applied to this framework. Results A coherent framework was established using the three constructs of self-determination theory (SDT), autonomy, competence, and relatedness, to organize user perceptions and design elements within four areas important in design: computer game, accessibility, working alliance, and learning in immersion. User perceptions mapped well to the framework, which may assist developers in understanding the context of user needs. By mapping these elements against the constructs of SDT, we were able to propose a sound theoretical base for the model. Conclusions This study’s method allowed for the articulation of design elements in a serious game from a user-centered perspective within a coherent overarching framework. The framework can be used to deliberately incorporate serious game design elements that support a user’s sense of autonomy, competence, and relatedness, key constructs which have been found to mediate motivation at all stages of the change process. The resulting model introduces promising avenues for future exploration. Involving users in program design remains an imperative if serious games are to be fit for purpose.

Is the Correct Anatomical Placement of the Electrocardiogram (ECG) Electrodes Essential to Diagnosis in the Clinical Setting A Systematic Review

2020 ◽  
Author(s):  
Alexandros Stavros Hadjiantoni
Keyword(s):  
Clinical Diagnosis ◽  
Clinical Setting ◽  
Critical Appraisal ◽  
Care Pathway ◽  
Meta Analysis ◽  
Relevant Literature ◽  
Anatomical Landmarks ◽  
Critical Appraisal Skills ◽  
Electrocardiogram Ecg ◽  
Ecg Morphology

Abstract Background: Anatomical misplacement of the Electrocardiogram (ECG) electrode(s) is common, with significant impact on clinical diagnosis. Reasons are multi-faceted, with this review examining the consequential effects of misplacement to ECG morphology, diagnosis, prognosis, patient outcomes, and potential impact to patient care pathway. Objectives: This review examined the significance of misplacement, its’ commonality and ensuing effect on patient safety, accurate ECG acquisition and diagnosis, with evaluation of reasons for such misplacement.Methodology: Review of available literature was conducted using electronic databases. In-line with the Preferred Reporting Items for Systematic reviews and Meta – analysis protocols (PRISMA) 2015 checklist, this review was conducted with search criteria, search terms, eligibility for inclusion/ exclusion criteria, extraction and data analysis predetermined by the authors. Keywords were arranged according to grouping of terms surrounding ECG, anatomical placement, and diagnosis. The search strategy was conducted during September/October 2019. Scoping searches were conducted alongside reference lists of included studies hand searched (Snowballing) for further relevant studies. The Critical Appraisal Skills Programme (CASP) was used to methodically appraise papers (CASP, 2019). Screening of titles and abstracts of identified citations was performed by a single reviewer. Eligible articles then full text screened independently by two reviewers. Disagreements were discussed and resolved by a third reviewer. In instances of unclear reporting, authors were contacted to provide further information and clarity. Assessment of relevant literature and critical appraisal of primary research, pertaining to the clinical diagnosis and effects of anatomical misplacement of ECG electrodes, formulate the thematic discussion drawn by this review. Results: This review identified a plethora of causes, ranging from: operator error; lack of anatomical awareness; inaccurate assessment of anatomical landmarks; obesity; differences in anatomy/gender; levels of undress and lack of appreciation of consequences of misplacement, both modifiable and non-modifiable attributable to electrode misplacement. Clinical diagnosis can be altered owing to erroneous placement of electrodes. ECG morphology is altered due to incorrect anatomical misplacement, culminating substandard practice, a missed diagnosis or misdiagnosis and potential harm. Conclusion: Correct anatomical placement of ECG electrodes is essential to diagnosis in the clinical setting. Peer-led educational intervention with mandatory training is essential to improve practice. PROSPERO Registration Number: CRD42019152461

scholarly journals A user-centered approach for detecting emotions with low-cost sensors

2020 ◽  
Vol 79 (47-48) ◽  
pp. 35885-35907
Author(s):  
Rita Francese ◽  
Michele Risi ◽  
Genoveffa Tortora
Keyword(s):  
Artificial Intelligence ◽  
Detection System ◽  
Low Cost ◽  
Affective State ◽  
Classification Performance ◽  
Emotion Detection ◽  
Emotion Classification ◽  
User Perceptions ◽  
Machine Learning Classifiers ◽  
User Centered

AbstractDetecting emotions is very useful in many fields, from health-care to human-computer interaction. In this paper, we propose an iterative user-centered methodology for supporting the development of an emotion detection system based on low-cost sensors. Artificial Intelligence techniques have been adopted for emotion classification. Different kind of Machine Learning classifiers have been experimentally trained on the users’ biometrics data, such as hearth rate, movement and audio. The system has been developed in two iterations and, at the end of each of them, the performance of classifiers (MLP, CNN, LSTM, Bidirectional-LSTM and Decision Tree) has been compared. After the experiment, the SAM questionnaire is proposed to evaluate the user’s affective state when using the system. In the first experiment we gathered data from 47 participants, in the second one an improved version of the system has been trained and validated by 107 people. The emotional analysis conducted at the end of each iteration suggests that reducing the device invasiveness may affect the user perceptions and also improve the classification performance.

scholarly journals Integrating Health Behavior Theory and Design Elements in Serious Games

2020 ◽  
Author(s):  
Colleen Cheek ◽  
Theresa Fleming ◽  
Mathijs FG Lucassen ◽  
Heather Bridgman ◽  
Karolina Stasiak ◽  
...  
Keyword(s):  
Health Behavior ◽  
Behavior Change ◽  
Game Design ◽  
Serious Games ◽  
Well Being ◽  
Health Behavior Change ◽  
Serious Game ◽  
User Perceptions ◽  
Design Elements ◽  
User Centered

Background Internet interventions for improving health and well-being have the potential to reach many people and fill gaps in service provision. Serious gaming interfaces provide opportunities to optimize user adherence and impact. Health interventions based in theory and evidence and tailored to psychological constructs have been found to be more effective to promote behavior change. Defining the design elements which engage users and help them to meet their goals can contribute to better informed serious games. Objective To elucidate design elements important in SPARX, a serious game for adolescents with depression, from a user-centered perspective. Methods We proposed a model based on an established theory of health behavior change and practical features of serious game design to organize ideas and rationale. We analyzed data from 5 studies comprising a total of 22 focus groups and 66 semistructured interviews conducted with youth and families in New Zealand and Australia who had viewed or used SPARX. User perceptions of the game were applied to this framework. Results A coherent framework was established using the three constructs of self-determination theory (SDT), autonomy, competence, and relatedness, to organize user perceptions and design elements within four areas important in design: computer game, accessibility, working alliance, and learning in immersion. User perceptions mapped well to the framework, which may assist developers in understanding the context of user needs. By mapping these elements against the constructs of SDT, we were able to propose a sound theoretical base for the model. Conclusions This study’s method allowed for the articulation of design elements in a serious game from a user-centered perspective within a coherent overarching framework. The framework can be used to deliberately incorporate serious game design elements that support a user’s sense of autonomy, competence, and relatedness, key constructs which have been found to mediate motivation at all stages of the change process. The resulting model introduces promising avenues for future exploration. Involving users in program design remains an imperative if serious games are to be fit for purpose.

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