scholarly journals Effects of an animated blood clot on the decision-making of users inexperienced in viscoelastic testing - Visual Clot technology: a multicenter trial (Preprint)

10.2196/27124 ◽  
2021 ◽  
Author(s):  
Sadiq Said ◽  
Tadzio Raoul Roche ◽  
Julia Braun ◽  
Micheal Thomas Ganter ◽  
Patrick Meybohm ◽  
...  
Keyword(s):  
Decision Making ◽  
Blood Clot ◽  
Multicenter Trial

scholarly journals Effects of an animated blood clot on the decision-making of users inexperienced in viscoelastic testing - Visual Clot technology: a multicenter trial (Preprint)

2021 ◽  
Author(s):  
Sadiq Said ◽  
Tadzio Raoul Roche ◽  
Julia Braun ◽  
Micheal Thomas Ganter ◽  
Patrick Meybohm ◽  
...  
Keyword(s):  
Decision Making ◽  
Situation Awareness ◽  
Blood Clot ◽  
Tertiary Care ◽  
Multicenter Trial ◽  
Diagnostic Confidence ◽  
Coagulation Management ◽  
Therapeutic Decisions ◽  
International Multicenter Study ◽  
User Centered

BACKGROUND Viscoelastic-test-guided coagulation management has become increasingly important in assessing hemostasis. We developed Visual Clot, an animated, 3-dimensional blood clot that illustrates raw rotational thromboelastometry (ROTEM) parameters in a user-centered and situation awareness-oriented method. OBJECTIVE This study aimed to evaluate the applicability of Visual Clot by examining its effects on users that are novices in viscoelastic-guided resuscitation. METHODS We conducted an investigator-initiated, international, multicenter study between September 16 and October 6, 2020, in five tertiary care hospitals in central Europe. We randomly recruited medical students and inexperienced resident physicians without significant prior exposure to viscoelastic testing. The 7 participants per center managed nine different ROTEM outputs twice, once as standard ROTEM tracings and once as the corresponding Visual Clot. We randomly presented the 18 viscoelastic cases and asked the participants for their therapeutic decisions. We assessed the performance, diagnostic confidence, and perceived workload in managing the tasks using mixed statistical models, adjusted for possible confounding factors. RESULTS Analyzing a total of 630 results, we found that the participants solved more cases correctly (odds ratio [OR]: 33.66; 95% confidence interval [CI]: 21.13–53.64; P<0.001), perceived more diagnostic confidence (OR: 206.2; 95% CI: 93.5–454.75; P<0.001) and less workload (coefficient -41.63; 95% CI: -43.91 to -39.36; P<0.001) using Visual Clot compared to using standard ROTEM tracings. CONCLUSIONS This study emphasizes the practical benefit of presenting viscoelastic test results in a user-centered way. Visual Clot may allow inexperienced users to be involved in the decision-making process to treat bleeding-associated coagulopathy. CLINICALTRIAL Not applicable

scholarly journals Improving decision making through presentation of viscoelastic tests as a 3D animated blood clot: the Visual Clot

Anaesthesia ◽  
2020 ◽  
Vol 75 (8) ◽  
pp. 1059-1069 ◽  
Author(s):  
J. Rössler ◽  
P. Meybohm ◽  
D. R. Spahn ◽  
K. Zacharowski ◽  
J. Braun ◽  
...  
Keyword(s):  
Decision Making ◽  
Blood Clot

scholarly journals Physicians’ Perceptions of a Situation Awareness–Oriented Visualization Technology for Viscoelastic Blood Coagulation Management (Visual Clot): Mixed Methods Study

10.2196/19036 ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. e19036
Author(s):  
Tadzio Raoul Roche ◽  
Sadiq Said ◽  
Julian Rössler ◽  
Malgorzata Gozdzik ◽  
Patrick Meybohm ◽  
...  
Keyword(s):  
Decision Making ◽  
Intensive Care ◽  
Situation Awareness ◽  
Online Survey ◽  
Blood Clot ◽  
Care Providers ◽  
Coagulation Management ◽  
Standard Result ◽  
Field Note ◽  
Visualization Technology

Background Viscoelastic tests enable a time-efficient analysis of coagulation properties. An important limitation of viscoelastic tests is the complicated presentation of their results in the form of abstract graphs with a multitude of numbers. We developed Visual Clot to simplify the interpretation of presented clotting information. This visualization technology applies user-centered design principles to create an animated model of a blood clot during the hemostatic cascade. In a previous simulation study, we found Visual Clot to double diagnostic accuracy, reduce time to decision making and perceived workload, and improve care providers’ confidence. Objective This study aimed to investigate the opinions of physicians on Visual Clot technology. It further aimed to assess its strengths, limitations, and clinical applicability as a support tool for coagulation management. Methods This was a researcher-initiated, international, double-center, mixed qualitative-quantitative study that included the anesthesiologists and intensive care physicians who participated in the previous Visual Clot study. After the participants solved six coagulation scenarios using Visual Clot, we questioned them about the perceived pros and cons of this new tool. Employing qualitative research methods, we identified recurring answer patterns, and derived major topics and subthemes through inductive coding. Based on them, we defined six statements. The study participants later rated their agreement to these statements on five-point Likert scales in an online survey, which represented the quantitative part of this study. Results A total of 60 physicians participated in the primary Visual Clot study. Among these, 36 gave an interview and 42 completed the online survey. In total, eight different major topics were derived from the interview field note responses. The three most common topics were “positive design features” (29/36, 81%), “facilitates decision making” (17/36, 47%), and “quantification not made” (17/36, 47%). In the online survey, 93% (39/42) agreed to the statement that Visual Clot is intuitive and easy to learn. Moreover, 90% (38/42) of the participants agreed that they would like the standard result and Visual Clot displayed on the screen side by side. Furthermore, 86% (36/42) indicated that Visual Clot allows them to deal with complex coagulation situations more quickly. Conclusions A group of anesthesia and intensive care physicians from two university hospitals in central Europe considered Visual Clot technology to be intuitive, easy to learn, and useful for decision making in situations of active bleeding. From the responses of these possible future users, Visual Clot appears to constitute an efficient and well-accepted way to streamline the decision-making process in viscoelastic test–based coagulation management.

scholarly journals Physicians’ Perceptions of a Situation Awareness–Oriented Visualization Technology for Viscoelastic Blood Coagulation Management (Visual Clot): Mixed Methods Study (Preprint)

2020 ◽  
Author(s):  
Tadzio Raoul Roche ◽  
Sadiq Said ◽  
Julian Rössler ◽  
Malgorzata Gozdzik ◽  
Patrick Meybohm ◽  
...  
Keyword(s):  
Decision Making ◽  
Intensive Care ◽  
Situation Awareness ◽  
Online Survey ◽  
Blood Clot ◽  
Care Providers ◽  
Coagulation Management ◽  
Standard Result ◽  
Field Note ◽  
Visualization Technology

BACKGROUND Viscoelastic tests enable a time-efficient analysis of coagulation properties. An important limitation of viscoelastic tests is the complicated presentation of their results in the form of abstract graphs with a multitude of numbers. We developed Visual Clot to simplify the interpretation of presented clotting information. This visualization technology applies user-centered design principles to create an animated model of a blood clot during the hemostatic cascade. In a previous simulation study, we found Visual Clot to double diagnostic accuracy, reduce time to decision making and perceived workload, and improve care providers’ confidence. OBJECTIVE This study aimed to investigate the opinions of physicians on Visual Clot technology. It further aimed to assess its strengths, limitations, and clinical applicability as a support tool for coagulation management. METHODS This was a researcher-initiated, international, double-center, mixed qualitative-quantitative study that included the anesthesiologists and intensive care physicians who participated in the previous Visual Clot study. After the participants solved six coagulation scenarios using Visual Clot, we questioned them about the perceived pros and cons of this new tool. Employing qualitative research methods, we identified recurring answer patterns, and derived major topics and subthemes through inductive coding. Based on them, we defined six statements. The study participants later rated their agreement to these statements on five-point Likert scales in an online survey, which represented the quantitative part of this study. RESULTS A total of 60 physicians participated in the primary Visual Clot study. Among these, 36 gave an interview and 42 completed the online survey. In total, eight different major topics were derived from the interview field note responses. The three most common topics were “positive design features” (29/36, 81%), “facilitates decision making” (17/36, 47%), and “quantification not made” (17/36, 47%). In the online survey, 93% (39/42) agreed to the statement that Visual Clot is intuitive and easy to learn. Moreover, 90% (38/42) of the participants agreed that they would like the standard result and Visual Clot displayed on the screen side by side. Furthermore, 86% (36/42) indicated that Visual Clot allows them to deal with complex coagulation situations more quickly. CONCLUSIONS A group of anesthesia and intensive care physicians from two university hospitals in central Europe considered Visual Clot technology to be intuitive, easy to learn, and useful for decision making in situations of active bleeding. From the responses of these possible future users, Visual Clot appears to constitute an efficient and well-accepted way to streamline the decision-making process in viscoelastic test–based coagulation management.

Discarding optimality: Throwing out the baby with the bathwater?

2018 ◽  
Vol 41 ◽  
Author(s):  
Patrick Simen ◽  
Fuat Balcı
Keyword(s):  
Decision Making ◽  
Perceptual Decision Making ◽  
Reward Rate ◽  
Perceptual Decision ◽  
Standard Observer ◽  
Rate Maximization ◽  
Reward Rate Maximization ◽  
Descriptive Standard ◽  
Observer Model

AbstractRahnev & Denison (R&D) argue against normative theories and in favor of a more descriptive “standard observer model” of perceptual decision making. We agree with the authors in many respects, but we argue that optimality (specifically, reward-rate maximization) has proved demonstrably useful as a hypothesis, contrary to the authors’ claims.

LPCD framework: Analytical tool or psychological model?

2018 ◽  
Vol 41 ◽  
Author(s):  
David Danks
Keyword(s):  
Decision Making ◽  
Analytical Tool ◽  
Mathematical Framework ◽  
Bayesian Decision ◽  
Perceptual Decision Making ◽  
Psychological Model ◽  
Psychological Reality ◽  
Psychological Theories ◽  
Target Article ◽  
Bayesian Decision Making

AbstractThe target article uses a mathematical framework derived from Bayesian decision making to demonstrate suboptimal decision making but then attributes psychological reality to the framework components. Rahnev & Denison's (R&D) positive proposal thus risks ignoring plausible psychological theories that could implement complex perceptual decision making. We must be careful not to slide from success with an analytical tool to the reality of the tool components.

Elaborating the role of reflection and individual differences in the study of folk-economic beliefs

2018 ◽  
Vol 41 ◽  
Author(s):  
Kevin Arceneaux
Keyword(s):  
Decision Making ◽  
Individual Differences ◽  
Cognitive Processes ◽  
Evolutionary History ◽  
Behavioral Responses ◽  
History Of ◽  
Economic Beliefs

AbstractIntuitions guide decision-making, and looking to the evolutionary history of humans illuminates why some behavioral responses are more intuitive than others. Yet a place remains for cognitive processes to second-guess intuitive responses – that is, to be reflective – and individual differences abound in automatic, intuitive processing as well.

The primacy of conscious decision making – ERRATUM

2014 ◽  
Vol 38 (01) ◽  
pp. 46
Author(s):  
David R. Shanks ◽  
Ben R. Newell
Keyword(s):  
Decision Making ◽  
Conscious Decision
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