Background

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.

Methods

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.

Results

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%).

Conclusions

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.

中文翻译：

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语音警报作为下一代患者监测的医疗警报方式：一项随机国际多中心试验

背景

医疗设备中的声音警报对于患者安全至关重要。最先进的患者监护警报难以区分，并且会导致警报疲劳。生命体征警报有两种很有前景的新声音模式。听觉图标以简短的比喻声音传达警报，而语音警报则使用清晰的语言传达信息。我们比较了医疗保健专业人员使用这两种方式识别警报的可靠性。

方法

这项由研究者发起的基于计算机的多中心模拟研究包括 28 名麻醉提供者，他们被要求以随机顺序识别生命体征警报，一次是语音警报，一次是听觉图标。我们进一步评估了决策时间、诊断信心和感知有用性。我们使用混合模型分析了结果，并针对可能的混杂因素进行了调整。

结果

我们评估了每种模式的 14 个警报，对所有参与者进行了 392 次比较。与听觉图标相比，医疗保健提供者使用语音警报正确识别警报的几率高 58 倍（优势比 58.0；95% 置信区间 [CI]：25.1–133.6；P <0.001），做出决定的速度快 14 秒（系数–13.9；95% CI：–15.8 到 –12.1 s；P <0.001），感知到更高的诊断信心（100% [392 of 392] vs 43% [169 of 392; P <0.001]），并将语音警报评为更有帮助（优势比 138.2；95% CI：64.9–294.1；P <0.001）。参与者能够通过语音警报识别出明显更高比例的警报 (98.5%; P<0.001) 和听觉图标 (54.1%；P <0.001) 与最先进的警报 (17.9%) 相比。

结论

语音警报优于听觉图标，两者都优于当前最先进的听觉警报。这些发现证明了语音警报在患者监测方面的潜力。