The Right Picture Is Worth a Thousand Numbers: Data Displays in Anesthesia

Abstract

Objective: To review the literature on data displays in anesthesia identifying issues and developing design recommendations. Background: Unexpected incidents are common in critical care medicine. Adverse outcomes are frequently the catastrophic endpoints of an “evolving” chain of subtle incidents. One strategy to reduce the likelihood of an adverse patient outcome during anesthesia is to improve the anesthesiologist's ability to detect, diagnose, and treat critical incidents. Method: A literature review and analysis of data displays. Results: Current numerical and waveform displays do not support anesthesiologists optimally. An alternative is graphical displays that functionally integrate variables into objects. In a well-designed graphic object, deviations from normal are shown by distortions in the object's symmetry. The emerging patterns that result from distorted symmetry facilitate the correct diagnosis. When treatment is effective, an object's shape is restored to normal. Graphical displays can be an effective tool in supporting anesthesiologists' situation awareness. Conclusion: Problems related to graphical displays have delayed their use in anesthesia, including the lack of conclusive clinical evidence of their value. However, currently more evidence is accumulating that graphical displays have the potential to improve clinical performance. The successful development of these graphical displays takes into account task requirements, a user's perceptual processes, and task-specific cognition. Application: This paper provides suggestions for the development of more effective displays in anesthesiology. Graphical displays can increase the anesthesiologist's situation awareness and improve clinical performance. Clinical use of these displays has the potential to significantly improve patient safety.