JMIR Publications

ABSTRACT

Introduction: The United States Army Institute for Surgical Research (USAISR) conducted an analysis of three prototype sensor suites; all candidates were designed to passively document care delivery in tactical combat casualty care (TCCC) environments.

Methods:

The assessment methodology prioritized functionality, usability and performance. The assessment consisted of three phases: (1) tabletop evaluations, (2) simulated use testing, and (3) a sensor suite rodeo simulation event. The second and third phases included human subject participants leveraging the technology prototypes in hyper-realistic TCCC simulation environments. Additionally, the third phase allowed the researchers to assess the performance of each prototype in a range of operational environmental lighting conditions.

Results:

During the tabletop evaluation phase, all three prototype sensor suite solutions demonstrated acceptable results (>1) in the technical specification assessment. The two-part heuristics analysis revealed variability, where the least complex configurations received the highest assessment scores. To capture and record raw data, scores ranged from 44.6 to 87 on a 100-point scale. To offload and export the raw data, scores ranged from 22.9 to 87.5 on a 100-point scale. During simulated user testing, all three sensor suites achieved passing quantitative scores (> 60); the system usability scores (SUS) ranged from 60 to 85 on a 100-point scale. More complex technology configurations received higher usability scores. From a qualitative perspective, vital sign monitor (VSM) latency display issues led to reliability concerns. All three prototypes successfully generated raw data; the individual outputs ranged from 0.06 to 0.13 gigabytes per minute (GB/min). During the sensor suite rodeo simulation event, all three sensor suites achieved passing quantitative scores (> 60); the SUS ranged from 66.7 to 86.7 on a 100-point scale; the most complex technology prototype configuration scored higher. From a qualitative perspective, data transfer issues with large file sizes were noted, and component pairing issues with VSMs resulted in loss of data. All three prototypes successfully generated raw data; the individual outputs varied (ranging from 0.012 to 0.24 GB/min) based on the environmental lighting conditions (full sun, indoor lighting and low light). However, from a data quality perspective, only one camera component produced viable video data in all three environments. Discussion: The outcomes of this initial comparative assessment revealed opportunities to blend the strengths of each approach into a next generation implementation. This preliminary assessment was constrained by several factors: (1) effective tracking of consumable medical supplies, (2) advancement of artificial intelligence (AI) algorithms to process the raw data and (3) ability to manage multiple casualties/patients. Follow-on evaluations are needed to address these limitations. This systematic, three-part methodology to evaluate the initial, early-stage sensor suite prototypes is a reproducible process to determine the direction of advanced battlefield medical technology capabilities.