Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jan 12, 2021
Open Peer Review Period: Jan 12, 2021 - Jan 18, 2021
Date Accepted: Apr 11, 2021
Date Submitted to PubMed: Apr 12, 2021
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Effects of an animated blood clot on the decision-making of users inexperienced in viscoelastic testing - Visual Clot technology: a multicenter trial
ABSTRACT
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. Clinical Trial: Not applicable
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