Skip to main content
Top
Published in: BMC Medical Informatics and Decision Making 1/2023

Open Access 01-12-2023 | Care | Research

Development and perceived usability evaluation of an interactive smartphone application for the teaching of hemodynamics and evaluation of arterial pulse pressure variation

Authors: Orivaldo Alves Barbosa, Edgar Marçal, David Augusto Batista Sá Araújo, Lucas Severo Melo, Hermano Alexandre Lima Rocha

Published in: BMC Medical Informatics and Decision Making | Issue 1/2023

Login to get access

Abstract

Background

The use of fluids is the most frequently used therapy for circulatory shock. Its inadequate use has adverse effects, requiring hemodynamic goals, highlighting the use of pulse pressure variation due to its high accuracy. One of the problems related to this method is the difficulties in measuring the pulse pressure variation (PPV) in most monitors for clinical use. We assessed the qualitative aspects of perceived usability of a smartphone application (app), which, based on a photograph of the patient's arterial pulse wave, can help measure PPV and help in the diagnosis and management of shock cases.

Methods

To assess the software perceived usability, we used the System Usability Scale (SUS) applied to 30 physicians in 2 tertiary hospitals in Brazil. The software accuracy was measured using a sequence of 3 images with different values ​​of pulse pressure variation, comparing the obtained values ​​ with the gold standard. The educational interface of the app was evaluated qualitativelyfrom the spontaneous testimonies of the selected test participants.The project was approved by the Research Ethics Committee of Centro Universitário Christus.

Results

The analysis showed an average SUS of 86.3 points on a scale of 1–100 (above 80.3 is considered the best in terms of interface). The assessment of the application's accuracy when evaluating pulse pressure variation showed that the average variation of the measurements taken by the participants was small, with a good measure of repeatability and reproducibility. The app's educational interface was qualitatively evaluated, being praised by the users.

Conclusions

It can be concluded that the developed mobile application showed excellent qualitative aspects of perceived usability results. More studies with this app will be required to evaluate the potential to help professionals with hemodynamic evaluation in emergency and intensive care settings.
Literature
2.
go back to reference Berg DD, Bohula EA, van Diepen S, Katz JN, Alviar CL, Baird-Zars VM, et al. Epidemiology of shock in contemporary cardiac intensive care units. Circ Cardiovasc Qual Outcomes. 2019;12(3):e005618.CrossRefPubMed Berg DD, Bohula EA, van Diepen S, Katz JN, Alviar CL, Baird-Zars VM, et al. Epidemiology of shock in contemporary cardiac intensive care units. Circ Cardiovasc Qual Outcomes. 2019;12(3):e005618.CrossRefPubMed
3.
go back to reference Douglas IS, Alapat PM, Corl KA, Exline MC, Forni LG, Holder AL, et al. Fluid response evaluation in sepsis hypotension and shock: a randomized clinical trial. Chest. 2020;158(4):1431–45.CrossRefPubMedPubMedCentral Douglas IS, Alapat PM, Corl KA, Exline MC, Forni LG, Holder AL, et al. Fluid response evaluation in sepsis hypotension and shock: a randomized clinical trial. Chest. 2020;158(4):1431–45.CrossRefPubMedPubMedCentral
4.
go back to reference Vandervelden S, Malbrain ML. Initial resuscitation from severe sepsis: one size does not fit all. Anaesthesiol Intensive Ther. 2015;47:s44-55.CrossRefPubMed Vandervelden S, Malbrain ML. Initial resuscitation from severe sepsis: one size does not fit all. Anaesthesiol Intensive Ther. 2015;47:s44-55.CrossRefPubMed
5.
go back to reference Alvarado Sanchez JI, Amaya Zuniga WF, Monge Garcia MI. Predictors to intravenous fluid responsiveness. J Intensive Care Med. 2018;33(4):227–40.CrossRefPubMed Alvarado Sanchez JI, Amaya Zuniga WF, Monge Garcia MI. Predictors to intravenous fluid responsiveness. J Intensive Care Med. 2018;33(4):227–40.CrossRefPubMed
6.
go back to reference Carsetti A, Cecconi M, Rhodes A. Fluid bolus therapy: monitoring and predicting fluid responsiveness. Curr Opin Crit Care. 2015;21(5):388–94.CrossRefPubMed Carsetti A, Cecconi M, Rhodes A. Fluid bolus therapy: monitoring and predicting fluid responsiveness. Curr Opin Crit Care. 2015;21(5):388–94.CrossRefPubMed
7.
go back to reference Chaves RCF, Correa TD, Neto AS, Bravim BA, Cordioli RL, Moreira FT, et al. Assessment of fluid responsiveness in spontaneously breathing patients: a systematic review of literature. Ann Intensive Care. 2018;8(1):21.CrossRefPubMedPubMedCentral Chaves RCF, Correa TD, Neto AS, Bravim BA, Cordioli RL, Moreira FT, et al. Assessment of fluid responsiveness in spontaneously breathing patients: a systematic review of literature. Ann Intensive Care. 2018;8(1):21.CrossRefPubMedPubMedCentral
8.
go back to reference Marik PE, Cavallazzi R, Vasu T, Hirani A. Dynamic changes in arterial waveform derived variables and fluid responsiveness in mechanically ventilated patients: a systematic review of the literature. Crit Care Med. 2009;37(9):2642–7.CrossRefPubMed Marik PE, Cavallazzi R, Vasu T, Hirani A. Dynamic changes in arterial waveform derived variables and fluid responsiveness in mechanically ventilated patients: a systematic review of the literature. Crit Care Med. 2009;37(9):2642–7.CrossRefPubMed
9.
go back to reference Yang X, Du B. Does pulse pressure variation predict fluid responsiveness in critically ill patients? A systematic review and meta-analysis. Crit Care. 2014;18(6):650.CrossRefPubMedPubMedCentral Yang X, Du B. Does pulse pressure variation predict fluid responsiveness in critically ill patients? A systematic review and meta-analysis. Crit Care. 2014;18(6):650.CrossRefPubMedPubMedCentral
10.
go back to reference Roberson RS. Respiratory variation and cardiopulmonary interactions. Best Pract Res Clin Anaesthesiol. 2014;28(4):407–18.CrossRefPubMed Roberson RS. Respiratory variation and cardiopulmonary interactions. Best Pract Res Clin Anaesthesiol. 2014;28(4):407–18.CrossRefPubMed
11.
go back to reference Chen Y, Fu Q, Mi WD. Effects of stroke volume variation, pulse pressure variation, and pleth variability index in predicting fluid responsiveness during different positive end expiratory pressure in prone position. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2015;37(2):179–84.PubMed Chen Y, Fu Q, Mi WD. Effects of stroke volume variation, pulse pressure variation, and pleth variability index in predicting fluid responsiveness during different positive end expiratory pressure in prone position. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2015;37(2):179–84.PubMed
12.
go back to reference Tenório JM, Cohrs FM, Sdepanian VL, Pisa IT, Marin HdF. Desenvolvimento e Avaliação de um Protocolo Eletrônico para Atendimento e Monitoramento do Paciente com Doença Celíaca. Revista de Informática Teórica e Aplicada. 2010;17(2):2011. Tenório JM, Cohrs FM, Sdepanian VL, Pisa IT, Marin HdF. Desenvolvimento e Avaliação de um Protocolo Eletrônico para Atendimento e Monitoramento do Paciente com Doença Celíaca. Revista de Informática Teórica e Aplicada. 2010;17(2):2011.
13.
go back to reference Brooke J. SUS: a quick and dirty usability scale. Usability Eval Ind. 1995;189. Brooke J. SUS: a quick and dirty usability scale. Usability Eval Ind. 1995;189.
14.
go back to reference Grier RA, Bangor A, Kortum P, Peres SC. The system usability scale: beyond standard usability testing. In: Proceedings of the human factors and ergonomics society annual meeting. 2013;57(1):187–91. Grier RA, Bangor A, Kortum P, Peres SC. The system usability scale: beyond standard usability testing. In: Proceedings of the human factors and ergonomics society annual meeting. 2013;57(1):187–91.
15.
go back to reference Cannesson M, Pestel G, Ricks C, Hoeft A, Perel A. Hemodynamic monitoring and management in patients undergoing high risk surgery: a survey among North American and European anesthesiologists. Crit Care. 2011;15(4):R197.CrossRefPubMedPubMedCentral Cannesson M, Pestel G, Ricks C, Hoeft A, Perel A. Hemodynamic monitoring and management in patients undergoing high risk surgery: a survey among North American and European anesthesiologists. Crit Care. 2011;15(4):R197.CrossRefPubMedPubMedCentral
16.
go back to reference Hicks P, Huckson S, Fenney E, Leggett I, Pilcher D, Litton E. The financial cost of intensive care in Australia: a multicentre registry study. Med J Aust. 2019;211(7):324–5.CrossRefPubMed Hicks P, Huckson S, Fenney E, Leggett I, Pilcher D, Litton E. The financial cost of intensive care in Australia: a multicentre registry study. Med J Aust. 2019;211(7):324–5.CrossRefPubMed
17.
go back to reference Clermont G, Kong L, Weissfeld LA, Lave JR, Rubenfeld GD, Roberts MS, et al. The effect of pulmonary artery catheter use on costs and long-term outcomes of acute lung injury. PLoS ONE. 2011;6(7): e22512.CrossRefPubMedPubMedCentral Clermont G, Kong L, Weissfeld LA, Lave JR, Rubenfeld GD, Roberts MS, et al. The effect of pulmonary artery catheter use on costs and long-term outcomes of acute lung injury. PLoS ONE. 2011;6(7): e22512.CrossRefPubMedPubMedCentral
18.
go back to reference Aboy M, McNames J, Thong T, Phillips CR, Ellenby MS, Goldstein B. A novel algorithm to estimate the pulse pressure variation index deltaPP. IEEE Trans Biomed Eng. 2004;51(12):2198–203.CrossRefPubMed Aboy M, McNames J, Thong T, Phillips CR, Ellenby MS, Goldstein B. A novel algorithm to estimate the pulse pressure variation index deltaPP. IEEE Trans Biomed Eng. 2004;51(12):2198–203.CrossRefPubMed
19.
go back to reference Cannesson M, Aboy M, Hofer CK, Rehman M. Pulse pressure variation: where are we today? J Clin Monit Comput. 2011;25(1):45–56.CrossRefPubMed Cannesson M, Aboy M, Hofer CK, Rehman M. Pulse pressure variation: where are we today? J Clin Monit Comput. 2011;25(1):45–56.CrossRefPubMed
20.
go back to reference Desebbe O, Joosten A, Suehiro K, Lahham S, Essiet M, Rinehart J, et al. A novel mobile phone application for pulse pressure variation monitoring based on feature extraction technology: a method comparison study in a simulated environment. Anesth Analg. 2016;123(1):105–13.CrossRefPubMed Desebbe O, Joosten A, Suehiro K, Lahham S, Essiet M, Rinehart J, et al. A novel mobile phone application for pulse pressure variation monitoring based on feature extraction technology: a method comparison study in a simulated environment. Anesth Analg. 2016;123(1):105–13.CrossRefPubMed
21.
go back to reference Joosten A, Jacobs A, Desebbe O, Vincent JL, Sarah S, Rinehart J, et al. Monitoring of pulse pressure variation using a new smartphone application (Capstesia) versus stroke volume variation using an uncalibrated pulse wave analysis monitor: a clinical decision making study during major abdominal surgery. J Clin Monit Comput. 2019;33(5):787–93.CrossRefPubMed Joosten A, Jacobs A, Desebbe O, Vincent JL, Sarah S, Rinehart J, et al. Monitoring of pulse pressure variation using a new smartphone application (Capstesia) versus stroke volume variation using an uncalibrated pulse wave analysis monitor: a clinical decision making study during major abdominal surgery. J Clin Monit Comput. 2019;33(5):787–93.CrossRefPubMed
22.
go back to reference Santiago-López J, León-Ramírez V, Hernández-Ramírez S, Vásquez-Márquez PI, Castellanos-Olivares A. Concordance in the measurement of cardiac output. Vigileo vs. Capstesia. Rev Med Inst Mex Seguro Soc. 2018;56(2):136–42.PubMed Santiago-López J, León-Ramírez V, Hernández-Ramírez S, Vásquez-Márquez PI, Castellanos-Olivares A. Concordance in the measurement of cardiac output. Vigileo vs. Capstesia. Rev Med Inst Mex Seguro Soc. 2018;56(2):136–42.PubMed
23.
go back to reference Chase TJG, Julius A, Chandan JS, Powell E, Hall CS, Phillips BL, et al. Mobile learning in medicine: an evaluation of attitudes and behaviours of medical students. BMC Med Educ. 2018;18(1):152.CrossRefPubMedPubMedCentral Chase TJG, Julius A, Chandan JS, Powell E, Hall CS, Phillips BL, et al. Mobile learning in medicine: an evaluation of attitudes and behaviours of medical students. BMC Med Educ. 2018;18(1):152.CrossRefPubMedPubMedCentral
24.
go back to reference Borycki EM, Monkman H, Griffith J, Kushniruk AW. Mobile usability testing in healthcare: methodological approaches. Stud Health Technol Inform. 2015;216:338–44.PubMed Borycki EM, Monkman H, Griffith J, Kushniruk AW. Mobile usability testing in healthcare: methodological approaches. Stud Health Technol Inform. 2015;216:338–44.PubMed
Metadata
Title
Development and perceived usability evaluation of an interactive smartphone application for the teaching of hemodynamics and evaluation of arterial pulse pressure variation
Authors
Orivaldo Alves Barbosa
Edgar Marçal
David Augusto Batista Sá Araújo
Lucas Severo Melo
Hermano Alexandre Lima Rocha
Publication date
01-12-2023
Publisher
BioMed Central
Keyword
Care
Published in
BMC Medical Informatics and Decision Making / Issue 1/2023
Electronic ISSN: 1472-6947
DOI
https://doi.org/10.1186/s12911-023-02131-5

Other articles of this Issue 1/2023

BMC Medical Informatics and Decision Making 1/2023 Go to the issue