Improving decision making through presentation of viscoelastic tests as a 3D animated blood clot: the Visual Clot

Abstract

Summary Point‐of‐care viscoelastic coagulation tests are used increasingly and enable physicians to run precise whole blood coagulation diagnostics. However, the somewhat complicated and abstract presentation of results may hinder these advantages. For this reason, we developed the Visual Clot as an alternative mode of presentation for thrombelastometric data. An algorithm takes existing parameters from rotational thromboelastometry and creates a visual representation in the form of an animated blood clot named ‘Visual Clot’. In a prospective international dual‐centre study, 60 physicians were presented with rotational thromboelastometry results in the standard way or as a Visual Clot. They were then asked to make therapeutic decisions based on pathological findings. Overall proportion of correct therapeutic decisions was median (IQR [range] 100 (83–100 [39–100]) % for Visual Clot vs. 44 (25–50 [0–83]) % for standard rotational thromboelastometry presentation of results, p < 0.001. Mixed regression models yielded a mean OR (95%CI) 22.1 (13.4–36.5), p < 0.001 for correct decisions with the Visual Clot compared with standard rotational thromboelastometry, with an 18.7 (16.4–21.1), p < 0.001 second decrease in decision time. Perceived cognitive work‐load was lower, and participants rated their diagnostic confidence to be higher with the Visual Clot, both p < 0.001. Although correct interpretation of standard rotational thromboelastometry results depended on previous rotational thromboelastometry knowledge and experience, Visual Clot interpretation did not. The Visual Clot improved rotational thromboelastometry‐based therapeutic decisions, as pathologies can be recognised more rapidly and accurately. These findings underline the significance of an alternative additional visualisation technique that simplifies the interpretation of abstract standard data.

Situation Awareness-Oriented Patient Monitoring with Visual Patient Technology: A Qualitative Review of the Primary Research

“…Since the early 1990s, research groups around the world have been developing innovative technologies that aggregate several measurements into one picture to transform number-and waveform-based data into formats that can be more easily understood by care providers [72][73][74][75][76][77][78][79][80][81]. These studies, as well as our Visual Patient and Visual Clot projects [82,83], have shown advantages of alternative presentations for accuracy of diagnosis, time to diagnosis, and perceived workload. Visual Clot is a situation awareness-oriented visualization for rotational thromboelastometry outputs.…”

Point-of-Care Diagnostics in Coagulation Management

“…The way their results are displayed is however not self-explanatory, and their interpretation may be challenging. Visual Clot is a situation awareness-oriented visualization technology for thrombelastometric results [ 33 ]. Examples are shown in Figure 4 and Figure 5 .…”

“…An algorithm transforms parameters of rotational thrombelastometry into an animated model of the blood clot under investigation. In a prospective dual-center study [ 33 ], 60 physicians interpreted results assisted by Visual Clot vs. standard procedures, and based therapeutic decisions on their interpretation. Visual Clot resulted in an overall of 100% correct decisions vs. 44% for standard procedures.…”

“…Additionally, the correct interpretation of Visual Clot did not depend on previous knowledge and experience with rotational thrombelastometry. This new technology resulted in a faster and more accurate detection of alterations, and a higher rate of correct therapeutic decisions in simulated cases [ 33 ]. In a mixed qualitative/quantitative study, 92% percent of 42 physicians indicated a preference to have Visual Clot results displayed in addition to the standard result, and most described it as intuitive and easy to learn [ 34 ].…”

Situation Awareness&ndash;Oriented Patient Monitoring with Visual Patient Technology: A Qualitative Review of the Primary Research

“…Since the early 1990s, several research groups around the world have been developing innovative technologies intending to transform number-and waveform-based data into formats that can be more easily understood by care providers [68][69][70][71][72][73][74]. These studies, as well as our Visual Patient and Visual Clot projects [75], have shown advantages of visual presentations for accuracy of diagnosis, time to diagnosis, and perceived workload. The Visual Clot is a situation awareness-oriented visualization for rotational thromboelastometry outputs.…”