Yuval Bitan | Ben Gurion University of the Negev (original) (raw)
Papers by Yuval Bitan
Clinical simulation in nursing, Jun 1, 2024
PubMed, 2016
Interoperability is a major challenge in current healthcare systems. It brings big hope for data ... more Interoperability is a major challenge in current healthcare systems. It brings big hope for data exchange, but also raises some concern about patient safety. We study the wireless updating of modern infusion pumps and demonstrate the possible flaws in this process. Through analyzing data on drug limit libraries (DLL) versions in one hospital we could identify the delays in distributing DLL updates and the impact these delays might have on patient safety. We found that 31% of all started infusions had used outdated DLL versions, and 22.6% of all alerts were triggered by outdated DLLs. These findings suggest that clinical and operational stakeholders in healthcare systems must address the unreliable interoperability of medical technologies such as seen on infusion pumps. The impact of information inconsistency across healthcare systems might result in use error which would impair patient safety.
Ergonomics, May 1, 2007
Operators often need to combine self-initiated and respondent actions. Two experiments dealt with... more Operators often need to combine self-initiated and respondent actions. Two experiments dealt with the relative importance of these two types of actions as a function of the predictability of the system and the available information. Participants monitored three stations with different frequencies at which interventions were required. They were aided by warning cues, indicating the need for interventions. The frequencies of inspections of the stations, the response to the warning system and the overall performance were assessed for warning systems with different diagnostic properties. Participants adapted their responses to the relative frequency of required interventions and the reliance on and compliance to the warning system depended on the warning characteristics. The results support the notion that events, such as warning signals, have a complex role in the ongoing activity of the operator and are integrated into the set of information from external and internal sources that guide the operators' actions.
Proceedings of the International Symposium of Human Factors and Ergonomics in Healthcare, Sep 1, 2020
Applied Ergonomics, Nov 1, 2019
Proceedings of the Human Factors and Ergonomics Society ... Annual Meeting, Nov 1, 2019
American Journal of Health-system Pharmacy, Aug 1, 2018
International Journal of Human-computer Interaction, Jul 1, 1995
Two experiments assessed the effect of displaying a boundary on duration estimates and preference... more Two experiments assessed the effect of displaying a boundary on duration estimates and preference ratings for dynamic displays that were shown while users waited for the system's response. Displays were either symbolic (changing numbers) or graphic (increasing rectangles) and could contain a boundary that indicated when the interval was expected to be over. Duration estimates were similar for symbolic and graphic displays and for displays with and without a boundary. However, when the displays were encountered successively ...
Journal of Patient Safety, Mar 1, 2019
BACKGROUND The exponential growth in computing power and increasing digitization of information h... more BACKGROUND The exponential growth in computing power and increasing digitization of information have advanced the machine learning (ML) research field substantially. However, ML algorithms are often considered “black boxes”, and this fosters distrust. In medical domains, in which mistakes can result in fatal outcomes, practitioners may be especially reluctant to trust ML algorithms. OBJECTIVE To explore the effect of user-interface design features on intensivists’ trust in a ML-based clinical decision support system. METHODS Forty-seven physicians from critical care specialties were presented three patient cases of bacteremia in the setting of an ML-based simulation system. Three conditions of the simulation were tested according to combinations of information relevancy and interactivity. Participants’ trust in the system was assessed by their agreement with the system’s diagnoses and a post-experiment questionnaire. Linear regression models were applied to measure the effects RESULTS Participants’ agreement with the system’s diagnoses did not differ according to the experimental conditions. However, in the post-experiment questionnaire, higher information relevancy ratings and interactivity ratings were associated with higher perceived trust in the system (P < 0.001 for both). The explicit visual presentation of the features of the ML algorithm on the user-interface resulted in lower trust by the participants (P < 0.05). CONCLUSIONS : Information relevancy and interactivity features should be considered in the design of user interface of ML-based clinical decision support systems, to enhance intensivists’ trust. This study sheds light on the connection between information relevancy, interactivity, and trust in human–ML interaction, specifically in the intensive care unit environment. CLINICALTRIAL Non- clinical
Proceedings of the Human Factors and Ergonomics Society ... Annual Meeting, Sep 1, 1999
Operators of complex systems respond to external signals and events that guide their actions, but... more Operators of complex systems respond to external signals and events that guide their actions, but they also initiate and schedule the performance of various acts. An experiment was conducted in which the interdependence of scheduling and responding was studied. Participants had to monitor three stations that required different rates of interventions. The experimental conditions differed in the parameters of a warning system that indicated a possible malfunction in a station. The results showed that participants adjusted the frequencies of inspection in accordance with the required frequencies, but the adjustment was much smaller than was actually required. The settings of the warning's sensitivity and criterion threshold affected different aspects of the reliance on the warning system, and a distinction between reliance on warnings and obedience to warnings is suggested. The implications of these findings for the modeling of user actions in complex systems are discussed.
Journal of Medical Systems, Dec 31, 2022
Computer Methods and Programs in Biomedicine, Sep 1, 2021
OBJECTIVE Poor clinical data quality might affect clinical decision making and patient treatment.... more OBJECTIVE Poor clinical data quality might affect clinical decision making and patient treatment. This study identifies quality defects in clinical data collected automatically by bedside monitoring devices in the Intensive Care Unit (ICU) and examines their effect on clinical decisions. METHODS Real-world data collected from 7688 patients admitted to the general ICU in a tertiary referral hospital over seven years was retrospectively analyzed. Data quality defect detection methods that use time-series analysis techniques identified two types of data quality defects: (a) completeness: the extent of non-missing values, and (b) validity: the extent of non-extreme values within the continuous range of values. Data quality defects were compared to five scenarios of medication and procedure prescriptions that are common in ICU settings: Blood-pressure reduction, blood-pressure elevation, anesthesia medications, intubation procedures, and muscle relaxant medications. RESULTS Results from a logistic regression revealed a strong connection between data quality and the clinical interventions examined: lower validity level increased the likelihood of prescription decisions for all five scenarios, and lower completeness level increased the likelihood of prescription decisions for some scenarios. DISCUSSION The results highlight the possible effect of data quality defects on physicians' decisions. Lower validity of certain key clinical parameters, and in some scenarios lower completeness, correlated with stronger tendency to prescribe medications or perform invasive procedures. CONCLUSIONS Data quality defects in clinical data affect decision making even without practitioners' awareness. Thus, it is important to emphasize these effects to ICU staff, as well as to medical device manufacturers.
F1000Research, Nov 8, 2012
Human Factors, Aug 10, 2022
Objective Present a collection of papers focusing on improving healthcare practice through the im... more Objective Present a collection of papers focusing on improving healthcare practice through the implementation of human factors and ergonomics principles that were presented at the International Ergonomics Association (IEA) 2021 international conference. Background The mission of the IEA is to elaborate and advance ergonomics science and practice and to expand its scope of application. Method We reviewed papers that were submitted for presentation at the IEA 2021 international conference and focused on improving healthcare practice through the implementation of human factors and ergonomics principles. Results The eight papers that are included in this special issue cover varied aspects of human factors application and implementation. Conclusion This special issue provides clear evidence that the science of human factors is relevant and is continuing to grow and so is its implementation in healthcare. Application This special issue offers a selection of applied works, providing a wide scope of human factors guidelines, methods, and theories in healthcare work environments.
Proceedings of the International Symposium of Human Factors and Ergonomics in Healthcare, Sep 1, 2020
Proceedings of the International Symposium of Human Factors and Ergonomics in Healthcare, Jun 1, 2018
Proceedings of the International Symposium of Human Factors and Ergonomics in Healthcare, Jun 1, 2016
Motivated by the premise that well designed paramedic response bags can improve paramedics’ perfo... more Motivated by the premise that well designed paramedic response bags can improve paramedics’ performance and patient safety, our objectives in this study were to evaluate performance and preferences when comparing traditional response bags with new ergonomically designed bags. A usability study based on two emergency scenarios was carried out, using 17 active duty paramedic teams as participants. Although most of the objective performance results were not statistically significant, the subjective results showed a clear preference for the new bags.
Proceedings of the Human Factors and Ergonomics Society ... Annual Meeting, Oct 1, 2003
International Journal of Human-computer Interaction, Oct 4, 2022
Clinical simulation in nursing, Jun 1, 2024
PubMed, 2016
Interoperability is a major challenge in current healthcare systems. It brings big hope for data ... more Interoperability is a major challenge in current healthcare systems. It brings big hope for data exchange, but also raises some concern about patient safety. We study the wireless updating of modern infusion pumps and demonstrate the possible flaws in this process. Through analyzing data on drug limit libraries (DLL) versions in one hospital we could identify the delays in distributing DLL updates and the impact these delays might have on patient safety. We found that 31% of all started infusions had used outdated DLL versions, and 22.6% of all alerts were triggered by outdated DLLs. These findings suggest that clinical and operational stakeholders in healthcare systems must address the unreliable interoperability of medical technologies such as seen on infusion pumps. The impact of information inconsistency across healthcare systems might result in use error which would impair patient safety.
Ergonomics, May 1, 2007
Operators often need to combine self-initiated and respondent actions. Two experiments dealt with... more Operators often need to combine self-initiated and respondent actions. Two experiments dealt with the relative importance of these two types of actions as a function of the predictability of the system and the available information. Participants monitored three stations with different frequencies at which interventions were required. They were aided by warning cues, indicating the need for interventions. The frequencies of inspections of the stations, the response to the warning system and the overall performance were assessed for warning systems with different diagnostic properties. Participants adapted their responses to the relative frequency of required interventions and the reliance on and compliance to the warning system depended on the warning characteristics. The results support the notion that events, such as warning signals, have a complex role in the ongoing activity of the operator and are integrated into the set of information from external and internal sources that guide the operators' actions.
Proceedings of the International Symposium of Human Factors and Ergonomics in Healthcare, Sep 1, 2020
Applied Ergonomics, Nov 1, 2019
Proceedings of the Human Factors and Ergonomics Society ... Annual Meeting, Nov 1, 2019
American Journal of Health-system Pharmacy, Aug 1, 2018
International Journal of Human-computer Interaction, Jul 1, 1995
Two experiments assessed the effect of displaying a boundary on duration estimates and preference... more Two experiments assessed the effect of displaying a boundary on duration estimates and preference ratings for dynamic displays that were shown while users waited for the system's response. Displays were either symbolic (changing numbers) or graphic (increasing rectangles) and could contain a boundary that indicated when the interval was expected to be over. Duration estimates were similar for symbolic and graphic displays and for displays with and without a boundary. However, when the displays were encountered successively ...
Journal of Patient Safety, Mar 1, 2019
BACKGROUND The exponential growth in computing power and increasing digitization of information h... more BACKGROUND The exponential growth in computing power and increasing digitization of information have advanced the machine learning (ML) research field substantially. However, ML algorithms are often considered “black boxes”, and this fosters distrust. In medical domains, in which mistakes can result in fatal outcomes, practitioners may be especially reluctant to trust ML algorithms. OBJECTIVE To explore the effect of user-interface design features on intensivists’ trust in a ML-based clinical decision support system. METHODS Forty-seven physicians from critical care specialties were presented three patient cases of bacteremia in the setting of an ML-based simulation system. Three conditions of the simulation were tested according to combinations of information relevancy and interactivity. Participants’ trust in the system was assessed by their agreement with the system’s diagnoses and a post-experiment questionnaire. Linear regression models were applied to measure the effects RESULTS Participants’ agreement with the system’s diagnoses did not differ according to the experimental conditions. However, in the post-experiment questionnaire, higher information relevancy ratings and interactivity ratings were associated with higher perceived trust in the system (P < 0.001 for both). The explicit visual presentation of the features of the ML algorithm on the user-interface resulted in lower trust by the participants (P < 0.05). CONCLUSIONS : Information relevancy and interactivity features should be considered in the design of user interface of ML-based clinical decision support systems, to enhance intensivists’ trust. This study sheds light on the connection between information relevancy, interactivity, and trust in human–ML interaction, specifically in the intensive care unit environment. CLINICALTRIAL Non- clinical
Proceedings of the Human Factors and Ergonomics Society ... Annual Meeting, Sep 1, 1999
Operators of complex systems respond to external signals and events that guide their actions, but... more Operators of complex systems respond to external signals and events that guide their actions, but they also initiate and schedule the performance of various acts. An experiment was conducted in which the interdependence of scheduling and responding was studied. Participants had to monitor three stations that required different rates of interventions. The experimental conditions differed in the parameters of a warning system that indicated a possible malfunction in a station. The results showed that participants adjusted the frequencies of inspection in accordance with the required frequencies, but the adjustment was much smaller than was actually required. The settings of the warning's sensitivity and criterion threshold affected different aspects of the reliance on the warning system, and a distinction between reliance on warnings and obedience to warnings is suggested. The implications of these findings for the modeling of user actions in complex systems are discussed.
Journal of Medical Systems, Dec 31, 2022
Computer Methods and Programs in Biomedicine, Sep 1, 2021
OBJECTIVE Poor clinical data quality might affect clinical decision making and patient treatment.... more OBJECTIVE Poor clinical data quality might affect clinical decision making and patient treatment. This study identifies quality defects in clinical data collected automatically by bedside monitoring devices in the Intensive Care Unit (ICU) and examines their effect on clinical decisions. METHODS Real-world data collected from 7688 patients admitted to the general ICU in a tertiary referral hospital over seven years was retrospectively analyzed. Data quality defect detection methods that use time-series analysis techniques identified two types of data quality defects: (a) completeness: the extent of non-missing values, and (b) validity: the extent of non-extreme values within the continuous range of values. Data quality defects were compared to five scenarios of medication and procedure prescriptions that are common in ICU settings: Blood-pressure reduction, blood-pressure elevation, anesthesia medications, intubation procedures, and muscle relaxant medications. RESULTS Results from a logistic regression revealed a strong connection between data quality and the clinical interventions examined: lower validity level increased the likelihood of prescription decisions for all five scenarios, and lower completeness level increased the likelihood of prescription decisions for some scenarios. DISCUSSION The results highlight the possible effect of data quality defects on physicians' decisions. Lower validity of certain key clinical parameters, and in some scenarios lower completeness, correlated with stronger tendency to prescribe medications or perform invasive procedures. CONCLUSIONS Data quality defects in clinical data affect decision making even without practitioners' awareness. Thus, it is important to emphasize these effects to ICU staff, as well as to medical device manufacturers.
F1000Research, Nov 8, 2012
Human Factors, Aug 10, 2022
Objective Present a collection of papers focusing on improving healthcare practice through the im... more Objective Present a collection of papers focusing on improving healthcare practice through the implementation of human factors and ergonomics principles that were presented at the International Ergonomics Association (IEA) 2021 international conference. Background The mission of the IEA is to elaborate and advance ergonomics science and practice and to expand its scope of application. Method We reviewed papers that were submitted for presentation at the IEA 2021 international conference and focused on improving healthcare practice through the implementation of human factors and ergonomics principles. Results The eight papers that are included in this special issue cover varied aspects of human factors application and implementation. Conclusion This special issue provides clear evidence that the science of human factors is relevant and is continuing to grow and so is its implementation in healthcare. Application This special issue offers a selection of applied works, providing a wide scope of human factors guidelines, methods, and theories in healthcare work environments.
Proceedings of the International Symposium of Human Factors and Ergonomics in Healthcare, Sep 1, 2020
Proceedings of the International Symposium of Human Factors and Ergonomics in Healthcare, Jun 1, 2018
Proceedings of the International Symposium of Human Factors and Ergonomics in Healthcare, Jun 1, 2016
Motivated by the premise that well designed paramedic response bags can improve paramedics’ perfo... more Motivated by the premise that well designed paramedic response bags can improve paramedics’ performance and patient safety, our objectives in this study were to evaluate performance and preferences when comparing traditional response bags with new ergonomically designed bags. A usability study based on two emergency scenarios was carried out, using 17 active duty paramedic teams as participants. Although most of the objective performance results were not statistically significant, the subjective results showed a clear preference for the new bags.
Proceedings of the Human Factors and Ergonomics Society ... Annual Meeting, Oct 1, 2003
International Journal of Human-computer Interaction, Oct 4, 2022