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The Influence of Audible Alarm Loudness and Type on Clinical Multitasking

  • Clinical Systems
  • Published:
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Abstract

In high-consequence industries such as health care, auditory alarms are an important aspect of an informatics system that monitors patients and alerts providers attending to multiple concurrent tasks. Alarms levels are unnecessarily high and alarm signals are uninformative. In a laboratory-based task setting, we studied 25 anesthesiology residents’ responses to auditory alarms in a multitasking paradigm comprised of three tasks: patient monitoring, speech perception/intelligibility, and visual vigilance. These tasks were in the presence of background noise plus/minus music, which served as an attention-diverting stimulus. Alarms signified clinical decompensation and were either conventional alarms or a novel informative auditory icon alarm. Both alarms were presented at four different levels. Task performance (accuracy and response times) were analyzed using logistic and linear mixed-effects regression. Salient findings were 1), the icon alarm had similar performance to the conventional alarm at a +2 dB signal-to-noise-ratio (SNR) (accuracy: OR 1.21 (95% CI 0.88, 1.67), response time: 0.04 s at 2 dB (95% CI: –0.16, 0.24), which is a much lower level than current clinical environments; 2) the icon alarm was associated with 27% greater odds (95% CI: 18%, 37%) of correctly addressing the vigilance task, regardless of alarm SNR, suggesting crossmodal/multisensory multitasking benefits; and 3) compared to the conventional alarm, the icon alarm was associated with an absolute improvement in speech perception of 4% in the presence of an attention-diverting auditory stimulus (p = 0.031). These findings suggest that auditory icons can provide multitasking benefits in cognitively demanding clinical environments.

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Per IRB regulations we have retained the data for a minimum of five years and are happy to turn over all raw data to the Journal of Medical Systems per request.

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Authors and Affiliations

  1. Department of Anesthesiology, Vanderbilt University Medical Center, 1211 21st Avenue South, Medical Arts Building, Suite 422, Nashville, TN, 37212, USA

    Alexandra L. Bruder & Joseph J. Schlesinger

  2. Department of Biomedical Informatics, The Ohio State University, 460 Medical Center Drive, Suite 526, Columbus, OH, 43210, USA

    Clayton D. Rothwell

  3. School of Medicine, University of Virginia, 1215 Lee Street, Charlottesville, VA, 22908, USA

    Laura I. Fuhr

  4. Department of Biostatistics, Vanderbilt University, 2525 West End Avenue, Nashville, TN, 37212, USA

    Matthew S. Shotwell

  5. School of Psychology, University of Plymouth, Drake Circus, Plymouth, PL4 8AA, UK

    Judy Reed Edworthy

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Contributions

Alexandra Bruder: This author acquired all data from the anechoic chamber for the study. She also wrote the original manuscript and was involved in all the revisions and writing of the manuscript; Clayton Rothwell: This author was involved in all the revisions and writing of the manuscript and provided assistance with the figures and verification of results and statistical analyses; Laura Fuhr: This author helped with the IRB approval and participated in writing the original manuscript; Matthew Shotwell: This author performed all the statistical analysis and contributed to the creation for the outline of the figures and tables. This author also helped with revisions and the writing of the manuscript; Judy Edworthy: This author developed the auditory stimuli used in the experiment, contributed to the writing of the manuscript and all the revisions; Joseph Schlesinger: This author oversaw the entire project. This author also contributed to writing the manuscript and overseeing and contributing to all the revisions and interpretation and application of data.

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Correspondence to Alexandra L. Bruder.

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Bruder, A.L., Rothwell, C.D., Fuhr, L.I. et al. The Influence of Audible Alarm Loudness and Type on Clinical Multitasking. J Med Syst 46, 5 (2022). https://doi.org/10.1007/s10916-021-01794-9

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