Integrated information visualization to support decision making for use of antibiotics in intensive care: design and usability evaluation.

Overuse of antibiotics is a critical problem in intensive care today. The situation is further complicated by the extremely data-intensive environment with clinical data presented in distributed, often stand-alone information systems. To access and interpret all data is a complex and time-consuming technical and cognitive challenge. We propose a holistic integrated visualization in the form of a patient overview to support physicians in decision making for use of antibiotics at intensive care units. Special emphasis is put on analysis of work processes to identify information needs, the development of a visualization tool based on an integrated data model, and usability testing of the tool in combination with an eye-tracking technology. The visualization tool was highly rated in terms of user performance and preferences, and the analysis of users' visual patterns showed that different types of data visualization may benefit specialist and resident intensive care physicians depending on the task to be performed. A highly interactive tool for integrated information visualization could potentially increase the understanding of a patient's infection status and ultimately enhance decision making for the use of antibiotics.

Combining usability testing with eye-tracking technology: evaluation of a visualization support for antibiotic use in intensive care.

This research work is an explorative study to measure efficiency, effectiveness and user satisfaction of a prototype called Infobiotika aiming to support antibiotic use in intensive care. The evaluation was performed by combining traditional usability testing with eye-tracking technology. The test was conducted with eight intensive care physicians whereof four specialists and four residents. During three test phases participants were asked to perform three types of tasks, namely navigational, clinical and tasks to measure the learning effect after 3-5 minutes free exploring time. A post-test questionnaire was used to explore user satisfaction. Based on the results and overall observations, Infobiotika seems to be effective and efficient in terms of supporting navigation and also a learnable product for intensive care physicians fulfilling their need to get an accurate overview of a patient status quickly. Applying eye-tracking technology during usability testing has shown to be a valuable complement to traditional methods that revealed many unexpected issues in terms of navigation and contributed a supplementary understanding about design problems and user performance.

Screening and treatment of problems after intensive care: a descriptive study of multidisciplinary follow-up.

OBJECTIVES: To describe a multidisciplinary intensive care follow-up and the methods used for identifying and managing physical and psychological problems in ICU survivors. METHODS: Patients treated>four days in an intensive care unit (ICU) were invited three, six and 12 months after intensive care for screening of physical problems with function tests and psychological problems with the Impact of Event Scale (IES) and the Hospital Anxiety and Depression Scale (HADS). RESULTS: 40 of 61 patients had clinically impaired physical function, with no ongoing physical rehabilitation at three months. Twenty-two patients received specific training instructions and 18 patients were referred for physiotherapy. 34 of 61 patients had symptoms of moderate to severe posttraumatic stress and/or symptoms of clinically significant anxiety or depression. Twelve patients accepted referral for psychiatric evaluation and treatment. CONCLUSION: Multidisciplinary follow-up after intensive care can be of value in identifying untreated physical and psychological problems in ICU survivors. Liaison with specialists enables referral for identified problems. Patients screened and treated in the first six months appear to have little need for further follow-up after intensive care.