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The effect of a graphical interpretation of a statistic trend indicator (Trigg's Tracking Variable) on the detection of simulated changes

Department of Anaesthesia, Christchurch Hospital and University of Otago-Christchurch, Christchurch, New Zealand

Summary

Anaesthesia involves processing large amounts of information over time. One task of the anaesthetist is to detect substantive changes in physiological variables promptly and reliably. It has been previously demonstrated that a graphical trend display of historical data leads to more rapid detection of such changes. We examined the effect of a graphical indication of the magnitude of Trigg’s Tracking Variable, a simple statistically based trend detection algorithm, on the accuracy and latency of the detection of changes in a micro-simulation. Ten anaesthetists each viewed 20 simulations with four variables displayed as the current value with a simple graphical trend display. Values for these variables were generated by a computer model, and updated every second; after a period of stability a change occurred to a new random value at least 10 units from baseline. In 50% of the simulations an indication of the rate of change was given by a five level graphical representation of the value of Trigg’s Tracking Variable. Participants were asked to indicate when they thought a change was occurring. Changes were detected 10.9% faster with the trend indicator present (mean 13.1 [SD 3.1] cycles vs 14.6 [SD 3.4] cycles, 95% confidence interval 0.4 to 2.5 cycles, P=0.013. There was no difference in accuracy of detection (median with trend detection 97% [interquartile range 95 to 100%], without trend detection 100% [98 to 100%]), P=0.8. We conclude that simple statistical trend detection may speed detection of changes during routine anaesthesia, even when a graphical trend display is present.

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